706
Concluding Remarks About the Future
of Personalized Medicine
In the year 1998, when the fi rst monograph with the title (“Personalized Medicine”
was published, there was little interest in this topic (Jain 1998 ). Currently, there is a
tremendous interest in this topic. Suddenly many experts have appeared on this
topic. Some of them have backgrounds in pharmacogenetics and pharmacogenom-
ics, but had not made any efforts to integrate other emerging technologies into per-
sonalized medicine. Others accept that personalized medicine will come but try to
put the date off into the distant future.
A report published by the Royal Society of UK in 2005 identifi ed important
areas of application and the problems facing development of personalized medicine,
and concluded “its true potential may not become apparent for 15–20 years, during
which time a great deal more information may become available about the practi-
calities of applying information derived from complex multifactorial systems in the
clinic” (Anonymous 2005 ). This conclusion was disputed even though the Royal
Society claims to have consulted a broad spectrum of persons and organizations
involved in personalized medicine, because they ignored the most important play-
ers, the biopharmaceutical industry (Jain 2006 ). The Royal Society’s view of per-
sonalized medicine seems to be restricted to pharmacogenetics/pharmacogenomics
and ignores several other technologies such as pharmacoproteomics and metabolo-
mics. If one reviews the progress in molecular diagnostics during the past decade,
current developments have surpassed the forecasts. Molecular diagnostics that are
already in the market, or would become available in the next 5 years, will fulfi l
many of the needs of personalized medicine. The concept of personalized medicine
is being accepted by the medical profession, regulatory authorities, health insurance
organizations, and the biopharmaceutical industry.
Some skeptics of the results of HGP, HapMap and genome-wide association
studies say that the personalization of medicine will not occur before a decade after
completion of the HGP. Actually personalized medicine started before sequencing
of the human genome was completed, but received a considerable impetus in its
development from advances in genomic technologies. Some of these are stated
briefl y as:
- Sequencing is becoming cheap enough only recently to look for rare variants,
and that many common variants do have roles in diseases. - Numerous sites on the genome, most of them near genes, have been implicated
in common diseases. Although many more remain to be discovered, work can
proceed to develop diagnostics and look for therapeutic possibilities of some
diseases. - The only way to fi nd rare genetic variations is to sequence a person’s whole
genome. That approach is now becoming feasible because the cost of sequencing
is dropping and $1,000 genome is now feasible. The price may go down even
further.
24 Future of Personalized Medicine