Precision Medicine: Not Just the Future, It’s Here NOW!

Cynthia Warrick, PhD RPh

Precision Medicine, also known as “Personalized Medicine,” is a fairly new approach to disease prevention and treatment, with the goal of providing the “right treatments to the right patients at the right time.”  Instead of a one-size-fits-all-approach, precision medicine uses genetic and molecular testing to tailor treatments to the specific characteristics of the individual. Currently, precision medicine is used primarily in cancer and the field of pharmacogenomics focuses on the right treatment for a particular disease based on the patients’ lab and genetics data. 

In precision oncology, researchers are identifying the molecular fingerprints of various cancers and using them to identify more specific and precise treatments at the molecular level, which could be very effective in improving chemotherapy, especially in children.  Cancer immunotherapy is also a form of precision oncology that uses a patient’s own immune system to control, and in some cases, even cure their cancer.  Cancer immunotherapy drugs mimic the natural immune-system molecules to “teach” an individual’s immune system to attack tumors.  Unlike chemotherapy drugs that kill every dividing cell (cancer or non-cancer), cancer immunotherapy is specific to the cancer cells. 

The National Institutes of Health (NIH) has discovered that many diseases take root in the body long before a patient shows any symptoms, perhaps early in life or even before birth.  NIH recently launched the Environmental influences on Child Health Outcomes (ECHO) program, a 7-year research initiative that aims to determine which factors give children the highest probability of achieving the best health outcomes over their lifetimes.  ECHO is currently focused on obesity, brain and nervous system, and lung heath develop, and is following 50,000 children from diverse backgrounds.

Precision medicine is an exciting development from the practice of traditional medicine and there are several biomedical research careers that participate in this groundbreaking effort.  The fields of Genetics, Pharmacogenomics and Environmental Toxicology are the foundational disciplines for precision medicine, and technology has advanced new programs in Data Science, Bioinformatics, and Translational Medicine, which partner with geneticists, pharmaceutical scientists, and toxicologists, to discover personalized medical treatments.  Physicians trained in immunology develop individual treatments prepared by the compounding pharmacies that you see and wonder, what’s the difference between compounding pharmacists and Walgreens and CVS? 

I hope this information will motivate you to seek out more information about precision medicine and the fields that contribute to discovering the drugs that are tailored to the individual patient, not just everyone with diabetes, or heart disease.  You might wonder why it may take a while to identify the best blood pressure medicine and why there are so many different drugs for the same disease. Some patients require more than 6 drugs to treat their chronic diseases. Researchers in precision medicine work to reduce the number of drugs and personalize the treatment. Research can help you understand at an earlier age through genomics, the disease you are predisposed, and how you can prevent the onset of diseases like dementia and Alzheimer’s.  According to the NIH, Black Americans are 1.5 to 2 times more likely than Whites to develop Alzheimer’s and related dementias, and Blacks are 35% less likely to be diagnosed than Whites. Most Black patients also have higher rates of hypertension and diabetes, which are potential risk factors for Alzheimer’s and related dementias.

In a previous blog, I highlighted that most PhD programs are fully funded, and that is the case for PhD programs in fields related to Precision Medicine: Genetics, Genomics, Toxicology, Pharmacogenomics, Immunology, Data Science, and Bioinformatics.  The ProFellow.com website provides information about fully funded PhD programs and provides a series on How to Fully Fund Your PhD https://www.profellow.com/tips/how-to-fully-fund-your-phd/  ProFellow lists fully funded PhD programs (pay tuition and stipend for 3 to 6 years) at various institutions in the US and Canada.  For example: The University of Wisconsin, Johns Hopkins, Indiana University, University of Iowa, Texas A&M University and Wayne State University all have fully funded PhD program in Genetics, Molecular Genomics, that also encompass bioinformatics, bioethics, and gene therapy. The area of Pharmacogenomics combines pharmacology, drug development, and genetics, and can be completed through a Master’s program or a post-graduate fellowship after the MD or PharmD.  Most programs are in Colleges of Pharmacy: University of North Carolina Chapel Hill, University of North Texas Health Science Center, University of California San Francisco and University of Pittsburg.

Environmental Toxicology is concerned with the assessment of toxic substances in the environment, and studies how chemicals and biological agents affect the environment and human health.  It combines biology, chemistry, genetics and other fields to understand the impact of these agents on living organisms and environmental systems.  Because of the Environmental Justice movement, PhD programs at HBCUs are interested in the disproportionate impact of toxics on people and communities of color.  Most environmental toxicology graduate programs are found in medical and pharmacy schools. The following HBCUs have funding for students toward the PhD in Environmental Toxicology: Florida A&M University, Texas Southern University, and Southern University of Baton Rouge, LA. Other programs to consider: Texas Tech University, University of California – Riverside, University of Mississippi, and Michigan State University.

Data Science and Bioinformatics graduates are in high demand in government and industry. Bioinformatics is a scientific subdiscipline under genetics and genomics that involves the use of computer technology to collect, store, analyze and disseminate biological data and information.  Data science involves the study of large, complex data sets that arise from various types of research projects.  With respect to genomic studies, expertise in quantitative scientific disciplines such as bioinformatics, computational biology, and biostatistics is important in presenting the outcomes from research in these fields. The University of Delaware and Washington University in St. Louis have PhD programs in Biomedical Informatics & Data Science, that combine these areas for skills in translational science, taking research from the lab (bench) to the community (bedside).

Exploring biomedical graduate programs in any of these areas will fill critical faculty roles in higher education, research in industry (pharmaceutical and biotech companies), and in government (FDA, CDC, NIH, EPA, etc.).