“A lot of people think precision medicine is genetic medicine,” says Scott Zeger, biostatician and co-director of the Johns Hopkins Individualized Health Initiative. “While it does include genetic medicine, it has to be much more.” At Johns Hopkins, precision medicine means using the most modern science—today this includes bio-medical and data science—to address individual patients. The three main approaches include:
A mechanistic solution
This approach aims to find the specific mechanism, or physical cause of disease, in a person’s body.
For example, if someone’s breast tumor has the human epidermal growth receptor 2 (HER2) gene, the individual can take a drug called trastuzumab (Herceptin). This treatment can help patients with the HER2 gene in early stage tumors by reducing the risk of recurrence and death.
A new way to measure the state of a disease
Measurements can provide information to more accurately determine how a disease is progressing in a patient and guide interventions for that patient.
An example from Johns Hopkins Medicine is a sweat sensor to monitor cystic fibrosis. People with cystic fibrosis have abnormally high chloride levels in their perspiration. The sensor automatically assesses the concentration of chloride ions in an individual’s sweat to monitor the status of the condition in near-real time.
New interpretations of measurements
By using large quantities of historical data about patients with a certain condition, clinicians can make better analyses of similar patients.
An example is a web application that predicts the status of an individual’s low-risk prostate cancer. The Johns Hopkins Medicine application synthesizes an individual’s demographic, clinical, biomarker and biopsy data into graphs that predict the person’s disease risks based on 20 years of data on similar patients.