How medicine is changing
For several years now, and increasingly, we have been hearing about personalized medicine (referred to in English as PHC, from Personalized Health Care) and precision medecine (Precision Medicine). But what, exactly, do these terms mean? Are they synonymous? And how much has this approach already been applied to disease prevention, diagnosis, and treatment? What about counteracting physiological aging? In this article, we will try to answer all these questions.
Definition of precision medicine
Let’s start by giving a definition of precision medicine, as given by the U.S. drug agency, the Food and Drug Administration (FDA). They define it as an innovative approach that aims to “target the right treatment to the right patient at the right time.” How? Taking into account genetic, environmental and lifestyle differences (called, overall, the exposome). And this is because how much physical activity we do, what and how much we eat, where we live, the work we do, all affect our bodies as well as the functioning of our metabolism, our immune system, our biological ageDifferent from chronological age. It is a measure of the body's ageing, based on the effectiveness of the mechanisms that keep cells young and on markers of the functionality of organs and apparatus.. Aging is also different from person to person, both physical and cognitive. And it actually differs from organ to organ as well.
Precision medicine aims to find the right treatment for the right patient at the right time based on genetic, environmental, and lifestyle differences
From “one-size-fits-all” medicine to “stratified” medicine
Historically, most medical treatments have been developed for an “average patient” who does not exist in reality: this approach may work for most cases but, of course, not for all and not always optimally. With the explosion of the genomics and the omics sciences, and with technological advancements enabling increasingly faster and cheaper genome sequencing (Next Generation Sequencing – NGS), it was possible to move from a philosophy of one size fits all to one tailored to the patient, thanks to the possibility of knowing the genetic profiles of individuals and, in the case of the cancer for example, of their pathologies. It was research in oncology that led the way. We now know that a single tumor can actually contain hundreds of molecularly different neoplasms, which need to be treated with different target drugs that can strike at individual genetic variants.
Benefits of precision medicine include: more effective treatments, fewer side effects, and optimization of resources
Differences between personalized and precision medicine
Ok, fine. But what is the difference between personalized, precision, and individualized medicine? The three terms are often used synonymously and are considered to be interchangeable. This is not incorrect, but it must be said that the term “personalized medicine” is obsolete and is slowly being abandoned in the scientific world in favor of “precision medicine.” There is a specific date -actually two- for this semantic and conceptual shift: 2011 (the year of publication of a U.S. National Research Council report entitled Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease) and 2015 (the year when then-U.S. President Barack Obama unveiled the Precision Medicine Initiative).
The report, in particular, expressed concerns about possible misunderstandings that the word “personalized” might generate, leading people to believe that it means medical treatments would be developed for each individual. This can certainly be true, but generally precision medicine leads to treatment and prevention interventions based on specific characteristics shared by a population of individuals. In addition, some information regarding individuals may be irrelevant to health improvement. That is why the term “precision medicine” is preferred today.
The precision approach also affects the field of longevity science. There are diagnostic tools that can understand one’s susceptibility to aging-related diseases
In what fields precision medicine is applied
A very familiar and prexisting example of precision medicine is blood transfusions that are based on blood type. Certainly this is unique to each person, but shared by a large population of different people. gender medicine, which looks at the differences between men and women, is also an example.
Today, of course, medical science has tools to go and study diseases and differences in great detail, and to be extremely precise (as the very name of the term suggests), and this approach is used especially in oncology (as mentioned above) and in the study of rare diseases. The benefits are increased efficacy and reduced side effects of therapies. better predictions of prognosis and avoidance of unnecessary treatments for those who would not benefit, thanks to new genomic diagnostic tests; and optimization of National Health System resources.
Oncology and rare diseases are some of the major fields of application of precision medicine
The precision approach is also beginning to be applied in the field of longevity science. One example is the development of biological clockswhich take into account epigenetic changes. Major advancements involve diagnostic tools to understand susceptibility to aging-related diseases and the interaction of genetics with environment and lifestyle. Or, even, to assess specific index parameters of cognitive and physiological aging. In collaboration with cutting-edge international entities, SoLongevity has developed -and continues to develop- a highly personalized precision diagnosis and preventive medicine program called the AGE360 Program.
