New therapeutic approaches give hope for an individual treatment of diseases. Oncology is just one of many areas of application.
(Photo: dpa)
A lot is going on in the development of modern medicine. Surgeons are making increasing use of the assistance of robots. Telemedicine replaces a visit to the doctor’s office. Apps and wearables help patients live healthier lives. Innovative software and artificial intelligence mean that data from large patient groups can be systematically compared.
Biotechnology is advancing into new dimensions in drug development, as the development of the Covid-19 vaccine by Biontech and Moderna based on mRNA technology has just shown. In the Biontech laboratories, it is possible to analyze a new Sars-CoV-2 variant within 48 hours and to convert the vaccine so that it helps against the new virus. That is tremendous progress.
And you may have heard another catchphrase from Biontech that marks a megatrend in modern medicine. The Mainz researchers are researching individualized cancer immunotherapies, with a focus on the term “individualized”. What does that mean?
Medicine has already achieved a great deal in the past. However, today’s guidelines, which scientific societies have developed over decades, are based on an average patient. As a result, treatment regimens and medications are somewhat standardized. One aspirin tablet is one aspirin tablet, regardless of whether a woman weighing 50 kilograms has a headache or a man weighing, say, over 100 kilograms.
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The standardization of course also has advantages for doctors, the specifications are points of orientation and ultimately the outflow of evidence-based studies. Nevertheless, in practice we experience that certain treatments are repeatedly unsuccessful. It is well known that certain antidepressants do not work in all patients. For many, they have no effect. The same applies to medication for heart disease, asthma or diabetes mellitus. And of course there are rare diseases for which there is still no standardized therapy and for which doctors have to proceed in a personalized manner anyway.
Research hotspots: Tübingen, Freiburg, Heidelberg and Ulm
These observations have led to the establishment of the first centers for personalized medicine at university hospitals, for example in Tübingen, Heidelberg, Ulm and Freiburg. In the university sector, Baden-Württemberg is leading this new trend in Germany.
The thesis is that although every patient is different, they are almost always treated with established standard procedures. This ignores the fact that a wide variety of factors contribute to whether and how people get sick. Personality, psyche and social factors all play a key role in the success of the treatment.
Individualized medicine aims to find more tailored solutions for individual patients by including their personal circumstances in the treatment methodology. The new model is tailor-made medicine. The aim is to make the healthcare system more efficient overall.
Breakthroughs in genetic engineering and biotechnology form the basis for more personalized medicine. Cancer therapies are a good example of this. In the past, chemotherapy and radiation were used almost exclusively for cancer. For a few years there have been so-called antibody therapies that are precisely tailored to the type of tumor present, because every tumor is virtually “an individual”.
An upstream genetic test is now required for the use of 87 drugs, 64 of which are cancer drugs that address a wide variety of cancer types.
This gives the therapy a high level of precision. Biomarkers have also brought sensational advances. These are biological and chemical characteristics in the patient’s body. Often it is proteins and enzymes in the blood that indicate a certain disease and contain genetic information.
In order to use individualized therapies, medicine is able to sequence entire genomes of patients, i.e. the entire genetic information of around 25,000 genes, in a few days. It’s breathtaking.
Areas of application: oncology, ophthalmology, autoimmune diseases
In addition to oncology, the fields of ophthalmology, especially retinal diseases, as well as cardiovascular and autoimmune diseases should also be mentioned in the context of personalized medicine. In these areas, individualized treatments can increase response rates to therapies, which improves medical quality.
Personalized medicine also means more responsibility for the individual. Take the metabolism or sound sleep: people tolerate alcohol very differently. For one, the glass of red wine in the evening can be a sensible ritual, for the other it is harmful. In the end, general guidelines and tables are of no help. If you have poor sleep quality, you can print out tips for better sleep on the Internet. But probably only two or three of them will help in practice. So health is also in your own hands.
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Curt Diehm is the medical director of the Max Grundig Clinic, which specializes in executives. The internist also teaches as an adjunct professor at Heidelberg University and is the author of over 200 original scientific publications as well as many non-fiction books.