As we gradually understand more of the complex genetics driving the development of CLL and use that information to better determine what specific treatment regime will provide the longest remission or even a cure, we are in fact moving towards personalised medicine. CAR-T therapy is currently highly personalised medicine and will not be cost competitive until methods are researched and developed to end the reliance on modifying each patient's T-cells to specifically target B-cells, including CLL cells. There are also some regulatory problems that need to be worked through, which according to Nola Ries, Senior Lecturer, University of Newcastle and Dianne Nicol, Professor of Law, University of Tasmania, are:
• personal privacy – the genetic research and testing needed for personalised medicine reveals people’s deepest genetic secrets
• consumer protection – a growing private industry is selling genetic tests to consumers, sidestepping the traditional relationship between doctor and patient
• health care costs – worries about genetic risk factors for disease drive some people to undergo costly, and possibly unnecessary, tests and treatments.
Photo: Flame Heath - brilliant in the scrub this time of year