Mapping patients’ genetic make-up could lead to better treatment for a wide range of diseases.
Associate Professor Ramneek Gupta from DTU Health Technology believes that personalized medicine is already technologically possible. But there is a need for more involvement from patients, doctors, researchers, and industry.
Q: We have been talking about personalized medicine for a long time. When will it become widespread?
A: We will very soon see genome-profiles (a genome maps out an organism’s genetic information, ed.) linked to patients’ electronic medical records. Technology was previously a bottleneck, but not anymore. For example, it is possible to map the genetic make-up of a patient. This generates large volumes of data, but computing power is sufficient to handle this data. Technological advances have also meant that we can use artificial intelligence to analyse the large data volumes. We are also seeing a greater willingness among patients and healthcare professionals to apply data science to the healthcare sector.
Q: How can the ethical and data security challenges be solved?
A: I believe the solution is to better involve patients and explain the benefits of personalized medicine. Taking cancer as an example, it is well-known that a given dose of a medication can be effective for one patient, but have no effect or perhaps even be toxic to another. Many such differences can most likely be linked to hereditary factors. In other words, personalized medicine would allow physicians to immediately prescribe the right medicine and dose for a given patient. I am convinced that the prospect of such major benefits will create a willingness to give researchers access to data. It will also be possible to resolve the problems surrounding data security. For example, there are companies developing solutions based on the blockchain to ensure patients retain control over what their data can be used for.
Q: Individual treatment sounds expensive. Will health budgets be overrun?
A: In the long term, personalized medicine will reduce costs. It cannot be cost-effective to treat large groups of patients with medication that only has an effect for certain subgroups. Finding the right medication and dose is also only one of the focuses of personalized medicine. It’s also about reducing patient side-effects. You can also use personalized medicine to prevent disease. It is well-known that information campaigns only influence a small part of the population. But what if we can target information to the individual? For example, instead of giving you general advice about a healthier lifestyle, we can tell you that you have to change your diet or exercise in a certain way right now, if you don’t want to put yourself at risk of a specific disease.
Q: What is the role of the pharmaceutical industry?
A: Pharmaceutical companies are increasingly drawing on data from patient treatments—after the clinical trials have been completed. This is because the authorities in USA and the EU, in particular, are increasingly demanding that a new treatment has to provide a ‘significantly greater effect’ in order to receive a subsidy. The chances of demonstrating an effect are considerably better for a company if it can identify a relevant subgroup of patients, rather than giving the product to a large group of people, many of whom will not experience an effect. There is a need for more pilot studies where academic research can also be involved. Actual collaboration projects between industry and academia are rare. Companies do sometimes donate money to academic research projects. This is all well and good, but if we are to really see progress, there must be genuine collaboration between industry, doctors, and university researchers.
Q: Will artificial intelligence replace doctors?
A: By no means. In reality, doctors have always practised personalized medicine, in the sense that they decide on a treatment based on an individual assessment. But using artificial intelligence, a given doctor’s experience and skill may become less crucial factors. In general, we have to acknowledge that biology is extremely complex. We have to draw on both experts and computing power in a wide range of disciplines. If we succeed, the gains will be very great. Imagine a future in which a drop of saliva from a patient, combined with lifestyle data collected from the patient’s smartphone or the like, can help determine the right treatment or prevention at the right time!
More targeted disease prevention and better treatment, and hence lower costs in the health sector. These are some of the advantages of mapping patients’ genetic make-up and thereby offering personalized medicine, according to Associate Professor Ramneek Gupta. Photo: Bax Lindhardt.
DTU is one of the contributors to the Danish Reference Genome, where the genetic make-up of Danes is being mapped in the large multi-year GenomeDenmark research collaboration project.
DTU’s research in genomic data is conducted at DTU Health Technology, which is a new Department. It was established on 1 January 2019 as part of DTU’s strategic focus on health.
DTU has worked with analyses of biological data sets for 20 years, and has contributed several tools which are used in the international research community.
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