Personalized medicine, who needs it and what for?

​If someone had any doubts as to the importance that medicine has taken in our lives, please refer to the degree of intimacy that it has gained with us in recent decades. In previous centuries, medicine was almost black magic, lay people were trying to stay as far as possible from doctors and hospitals (oftentimes rightly so) and country folks were focusing on staying healthy with natural staples. One apple a day…
And nowadays, what are we talking about? Customized medicine!

Customized, like the newer generations of cars, fully tuned to the customer liking (color, decoration, features), the women’s bracelets with a unique selection of charms, the decoration of our homes, the attention that we get when we meet our private banker of when we flash any frequent user membership card, etc… In short, we now want medicine to be fully tailored to each and every one of us, and in many instances, we’re ready to foot the bill (well, at least some of it) which is commensurate to the level of personalized attention that we get.

Is this a sign of the times, a consequence of the societal evolutions or of the technological leaps that are pushing ever further the boundaries of our understanding of the pathological mechanisms underlying the medical scourges that affect us, down to details specific to an individual?

Before one explores the labyrinth-like paths of the human expectations about medicine, it’s preferable to start by looking at some facts to have a clear picture of where we actually are.

I’d posit that when the buzz is falsely leading everyone to believe that we’re seeing already personalized medicine, insofar as we’re actually looking only at increasingly precisely profiled medicine, but we’re still far from a genuinely individualized medicine.

The latest FDA report on personalized medicine is a case in point. It’s not the easiest document to read, especially not for the unprepared mind, and the lay public might need some form of educational conversion or translation so that the reach and actual meaning of the report is intelligible to all.

Taking a top-line view at its content, the report is (and predictably so) very regulatory and science-driven, about genomics, imaging, devices, with a focus on regulating in vitro diagnostics (companion to the treatment) to ensure availability of safe and effective (and reliable?) diagnostic tools.
​
Yet, at no point is the report giving any perspective on the crude – and cruel – fact that the entirety of the evidence collected through all these newer diagnostic techniques as well as the foundational science available on genetic profile, protein markers … cannot be converted into meaningful medical interventions.