Personalized precision medicine is a new way of understanding the therapeutic approach that aims to provide the appropriate treatment for each patient based on therapeutic innovation, precision diagnosis and data analysis through tools such as big data and artificial intelligence. With the aim of knowing its current scope and defining the ways to transfer this innovation to clinical practice, Grupo Joly organized a colloquium breakfast last Thursday in collaboration with Roche Farma. The meeting, moderated by Antonio Méndez, director of Málaga Hoy, was attended by managers, patients, researchers and industry to provide a polyhedral vision of the challenges to be faced in this field.
To explain the scope of personalized precision medicine, Miguel Ángel Guzmán, managing director of the Andalusian Health Service, evoked the clinical sophism that there are no diseases, only sick people. "The sequencing of the human genome was the historical milestone that allowed us to begin to see what correspondence existed between the possible alterations of the genome and the specific fact of suffering from a disease," he explained. In his opinion, all this development of basic and clinical research has allowed for a very powerful transfer of healthcare results. “From the medical-assistance point of view, we focused on diagnosing, treating and recovering from diseases, we have gone back to a previous step, which is the knowledge of these from the biological and molecular point of view. The impact of this knowledge is becoming evident in areas such as oncology, rare diseases or immunology, which allow the application of treatments tailored to the characteristics of the patient”, he added. Likewise, Guzmán stressed that "we are very involved through the SAS and its clinical and research activity to be there, together with the innovative industry, in the search for the best treatment for each patient".
Dr. Ana Casas, a specialist in Oncology and president of the Fundación Actitud Contra el Cancer, has the dual perspective of doctor and patient since she was diagnosed with breast cancer in 2013. The Attitude Against Cancer Foundation works to increase the knowledge of cancer patients, as well as promoting research. “We are already living in the era of precision oncology and personalized medicine. This implies attending individually according to each patient. Now, thanks to the sequencing of tumors, we are experiencing a technological revolution that allows us to better understand how the pathophysiology of cancer itself behaves, ”she said.
For Dr. Casas, the essential thing is to make these advances available to patients.” Although they are not incorporated at the speed that patients would like; when we talk about access, we must be clear that it must be progressive and equitable”, she added.
In general, she believes that "the fact of having biomarkers for some types of cancer has meant an exceptional advance in prognosis and treatment and there are some specific tumors that have undergone a radical change". In addition, she advocates taking advantage of everything that Artificial Intelligence offers so that patient data is made available for research. "We have a health system not only capable of practicing personalized medicine, but also the ability to generate knowledge that can contribute to it," she stressed.
Dr. Joaquín Dopazo, director of the Bioinformatics Area of the Progreso y Salud Foundation, addressed access to sequencing techniques and their impact in recent years. "All of this has made it possible to have data, establish biomarkers, achieve treatments for common diseases and establish the diagnosis of rare diseases." In addition, he predicted that "therapeutic personalization based on genetic sequencing will reach all areas." According to the expert, "this has to reach everyone and the way to achieve it is for sequencing to go from having that connotation associated with research and to be one more systematic tool of the health system." To do this, Dopazo is committed to having large-scale cooperation initiatives and believes that research on Covid has promoted the creation of networks, research platforms and access to data. “Never has a virus been sequenced so much. We must put the machinery at the service of health”, he stressed.
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Finally, Dr. Dopazo defends the need to put this genomic data in the context of the patient's clinical data in order to understand them. “We have one of the largest population databases in the world and we must continue to make efforts to improve it. A system under a single clinical history allows us to have an advantage, ”he stressed.
For her part, Teresa Ramos, head of Personalized Medicine at Roche Farma, delved into the historical link between Roche and this concept of personalized precision medicine. “At Roche we try to provide technology, knowledge and talent so that this massive sequencing, which in the future will address much more complex questions than the current ones, helps clinicians to make decisions”, she stated. Regarding the near future in this field, Ramos explains that "at Roche we want to anticipate to be able to predict the appearance of diseases or which patients may have a higher risk of suffering from a certain cancer".
The idea is to be able to discriminate, through Artificial Intelligence, those people who have a higher risk of developing cancer and help the large-scale analysis of diagnostic tests, “in a scenario that will help lighten the burden on the health system and achieve the best results in Health". In addition, Teresa Ramos emphasized the usefulness of big data for decision-making and the improvement of "more efficient research". “We want to accompany professionals in data management, so that the patient is more involved. Also measure results and design models based on the results. All this goes beyond oncology. It is about putting the tools at the disposal of professionals to work together”, she indicated.
For his part, Isaac Tunis, Secretary General for Research, Development and Innovation of the Andalusian Government, called for greater efforts at the state level in funding research and carried out an analysis of the paradigms that are illuminating this change. “The evolution towards personalized and precision medicine is complex; We must have a strong collaboration to be able to ensure that these resources are optimized to continue favoring an equal, accessible and universal health system”.
For Tunisia, one of the key changes has come within the research work itself. “Big data will help make research more efficient. The data is owned by the patient and guarded by the administration, but we can work in coordination and try to give answers to the questions that clinicians and researchers ask themselves”. In fact, the secretary general announced that "we are already working with our own SSPA investigators to handle the data and we are working on the development of an order or decree to regulate it." For Tunisia, personalized precision medicine is more than just a strategic vision. “It is about transferring research to clinical practice, innovating to improve. That is a strategic line of this Andalusian Government in research. We have 169 projects right now related to personalized medicine”, he underlined.