Will the promise of precision medicine live up to the hype?

Despite all the optimism surrounding President Barack Obama's Precision Medicine Initiative--including excitement from providers who already use patients' genetic data to treat disease--the ambitious proposal is not without its skeptics.

Obama first introduced the initiative in his State of the Union address, saying "I want the country that eliminated polio and mapped the human genome to lead a new era of medicine--one that delivers the right treatment at the right time." He then requested $215 million for various agencies to pursue a wide-reaching effort to use patients' genetic profiles to map out specialized treatments.

But like any politically endorsed scientific or medical initiative, the promise of a medical revolution spurred by precision medicine may belie the long, messy process of tackling such a project, Michael White, a systems biologist at the Washington University School of Medicine in St. Louis, writes in an article for Pacific Standard.

Comparing the Precision Medicine Initiative to former President Richard Nixon's "War on Cancer," which didn't live up to the hype it generated, he noted that the process of fighting cancer has turned out to be "a guerrilla war, made up of many small victories rather than one grand one."

Like the fight against cancer, "precision medicine isn't going to be a revolution--it will be a slow, medical evolution," he wrote.

Bioengineer Aaron Meyers, Ph.D., in a piece for MedCity News, also took a cautious tone in assessing the president's proposal. While the initiative promises a transformation in drug effectiveness for treating disease, the reality is that only a minority of patients respond to genetically targeted therapies, and they tend to be those with less complex cases and fewer genetic abnormalities, he argued.

Furthermore, "overselling [precision medicine] as a harbinger of a medical revolution threatens public confidence in the value of science when these promises fail to be delivered," he added.

But even if implementing the Precision Medicine Initiative will be a slow, difficult process, some providers remain optimistic about its potential.

Charles Sawyers, M.D., who directs the human oncology and pathogenesis program at Memorial Sloan Kettering Cancer Center, told the New York Times he thinks the initiative will not only expand the sequencing of human genomes, but also lead to more drug discoveries.

"No matter what tumor type you have, a certain percentage of patients, often a small percentage, have mutations that would likely result in a treatment that would work and that we never would have thought of," he said.

The Mayo Clinic also has high hopes for precision medicine, according to the Post Bulletin, given that it runs one of the country's largest biobanks that has been collecting samples from volunteers since 2009. The Mayo Clinic biobank also is unique in that it doesn't focus on just one disease, but rather collects information from large numbers of patients regardless of health history, possibly making it a prime target for funding from the Obama administration, the publication reported.

To learn more:
- read the Pacific Standard piece
- here's the MedCity News post
- check out the New York Times report
- read the Post Bulletin article

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