4. INTRODUCTION
• The concept of personalized medicine
dates back many hundreds of years.
• Developments in chemistry,
histochemistry and microscopy allowed
scientists to begin to understand the
underlying causes of disease.
• Sequencing of the human genome at
the turn of the 21st century set in
motion the transformation of
personalized medicine from an idea to
a practice
5. DEFINITION
• The term “personalized medicine” is often described as providing “the right patient
with the right drug at the right dose at the right time.”
• More broadly, “personalized medicine” may be thought of as the tailoring of medical
treatment to the individual characteristics, needs and preferences of a patient
during all stages of care, including prevention, diagnosis, treatment and follow-up.
Other terms
Precision medicine
stratified medicine
Targeted medicine
pharmacogenomics
6. NEED FOR PERSONALIZED
MEDICINE
• Similar symptoms but different illness
• Medical interventions may work in some people
but not in others
• 40% of drugs that are taken are not effective
(Banerjee.,2011)
• Advances in genomics helps to treat a patient
precisely and effectively
• To avoid any allergic and adverse effects.
7. PHARMACOGENOMICS
• the study of variations of DNA and RNA characteristics as related to drug
responsive is a critically important area of personalized medicine
• convergence of advances in pharmacology and genomics
• seeks to understand how differences in genes and their expression affect the body’s
response to medications.
• uses genetic information (such as DNA sequence, gene expression, and copy
number) for purposes of explaining interindividual differences in drug
metabolism (pharmacokinetics) and physiological drug response
(pharmacodynamics).
8. HOW DOES IT WORK??
• Depends on the identification of biomarkers.
• Study of the variation of DNA and RNA related to drug responses.
• Based on patients unique genetic profile.
• It is participatory, engaging patients in lifestyle choices and active health
maintenance to compensate for genetic susceptibilities
9. THE STORY OF HERCEPTIN
-by Robert Weinberg in 1979 of “HER-2,” a gene
involved in multiple cancer pathways.
-Dennis Slamon worked to understand the link
between HER2 and specific types of cancer.
-observed that changes in the HER2 gene caused
breast cancer cells to produce the normal HER2
protein but in higher amounts
-occurred in approximately 20-25% of breast
cancer cases
-HER2 protein overexpression used both as
marker of aggressive disease as well as a target
for treatment.
-it was the first molecularly targeted
cancer therapy designed to “shut off ” the HER2
gene, making the cancerous cells grow more
slowly and without damaging normal tissue
10. CASE STUDY
• https://www.youtube.com/watch?v=tPbiSwok4qs
• http://genomemag.com/what-is-personalized-medicine/#.WY7t7VGg_IU
Stephanie Haney
-Initially took Tarceva
-tested for ALK (anaplastic lymphoma kinase) positive
-took Xalkori
-got cured
12. GENETIC TESTS
• CYP 450 genotyping test:
-determine how quickly and effectively these agents are eliminated
from the body.
• Thiopurine methyltransferase test:
-breaks down a chemotherapy drug called thiopurine
-to treat leukaemia's and autoimmune disorders.
-genetic variations prevent from producing this enzyme.
-As a result, thiopurine levels can build up in the body, leading to
severe toxic reactions.
13. ADVANTAGES
• Reduce the burden of disease
• Focuses on prevention
• Diminishes the duration and severity of illness
• Reduces health care costs
• Increases benefits and reduces risks
14. DISADVANTAGES
• Incorrect diagnostic result
• Genetic variations are numerous and quantitative
• Not yet widely available
• People do not opt for personalized medicine
16. REFERENCES
• F. Randy Vogenberg., Carol Isaacson Barash., Michael Pursel., Personalized
Medicine Part 1: Evolution and Development into Theranostics., Vol. 35 No. 10.,
(2010).
• Paving way for personalized medicine., FDA’s role in new era of medical product
development,2013 .,pg 1-15,29
• Moinak Banerjee., Is pharmacogenomics a reality? Challenges and oppurtunities for
India., Indian J Hum Genet. 2011 May; 17(Suppl 1): S1–S3. doi: 10.4103/0971-
6866.80350
• http://genomag.com/what is personalized medicine/#wxi4vyh971u
Some drugs used commonly
-apart from providing you the relief what happens to them?-
-cyp 450 system(57) genes responsible for catalizing drugs
-all based on your genetic makeup
-decides whether to accumulate or eliminate fast without providing you the relief
-so genes affect your drug metabolism and its effectiveness is my topic
-DNA is essentially a key part of our interactive chemical
operating system in the body, instructing the body how to
behave and interact on a cellular level. A basic gene can have
many different forms and chemical messengers. It is those
interactions that also affect drug activity in the body.
-the human genome project has
created an explosion of information—how to
make sense of it and utilize it responsibly and
effectively in the design of new diagnostics
and therapeutics
-two facets in drug response: drug efficacy, & sideeffects
-identifying responders and non-responders to a drug, and predicting the efficacy and/or toxicity of a drug-
-an integrative study combining genome of person, expression and metabolism of a drug
-alk is a tyrosine kinase receptor, if expressed Tarceva wont work’
-Xalkori is an inhibitor of alk. So got cured.