This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Though precision medicine offers an exciting opportunity for personalized health care, experts this week cautioned officials against overhyping its impact.
"We can't just do sequencing: we have to couple that with clinical trials, and we have to demonstrate improved outcomes and that it is cost effective," said Scott Tomlins, an assistant professor of genitourinary pathology at the University of Michigan.
Tomlins was one of several speakers at the University of Utah's second annual precision medicine symposium Thursday and Friday.
Precision medicine — which involves considering an individual's DNA, environment and lifestyle to provide more personalized care — has been studied by scientists across the country for years. It started receiving national attention in 2015 after President Barack Obama announced the federal Precision Medicine Initiative, which tasked the National Institutes of Health with creating a health and human genetics study involving 1 million Americans.
But experts say precision medicine's effectiveness and affordability remains uncertain.
For example, the use of this science in cancer treatment is being touted, but targeted drugs only are effective for small populations and can be extremely expensive, said Kathy Cooney, chairwoman of the U.'s Department of Internal Medicine.
"Next-generation sequencing is awesome and heralded in the era of precision medicine, but only a small set of patients can have dramatic and prolonged responses to targeted therapies," Cooney said. "It's complicated, expensive for physicians and scientists, and the treatments themselves are prohibitively expensive."
Tomlins noted there has been some success with specific types of lung and breast cancer, but those drugs were beneficial for only a small percentage of people.
"If one in 1 million [benefits], it's hard to justify," he said.
Also problematic is a lack of clinical trial participants, he added, especially when it's a rare mutation of some form of cancer.
In some cases, thousands of patients might have to be screened to find 100 patients who have the specific cancer mutation, and then 50 people might participate in a clinical trial for a drug, he said. That means multiple trials would need to be completed before a drug received approval from the Food and Drug Administration.
Experts this week said health care officials need to develop a way to improve clinical trial participation if they want to move precision medicine forward. But Jessica Roberts, director of the University of Houston Law Center's Health Law and Policy Institute, argued that who participated also needed to be considered.
While a disease like cancer affects most groups equally — regardless of race, ethnicity, gender, disability and income level — that's not the case with all illnesses, Roberts said.
Cystic fibrosis, for example, disproportionately impacts Caucasians, she said. If that disease is studied, another disease that affects a different population, such as sickle cell anemia, should also be examined, she said.
"We want to make sure the majority of Americans can benefit" from what is studied, Roberts said. "A lack of diversity [in clinical trials] could compromise accuracy."
Twitter: @alexdstuckey