Aaron Ciechanover (2014) - The Revolution of Personalized Medicine: Are We Going to Cure All Diseases and at What Price?

Aaron Ciechanover (2014)

The Revolution of Personalized Medicine: Are We Going to Cure All Diseases and at What Price?

Aaron Ciechanover (2014)

The Revolution of Personalized Medicine: Are We Going to Cure All Diseases and at What Price?

Abstract

Many important drugs such as penicillin, aspirin, or digitalis, were discovered by serendipity - some by curious researchers who accidentally noted a "strange" phenomenon, and some by isolation of active ingredients form plants known for centuries to have a specific therapeutic effect. Other major drugs like the cholesterol reducing statins were discovered using more advanced technologies, such as targeted screening of large chemical libraries. In all these cases, the mechanisms of action of the drug were largely unknown at the time of their discovery, and were unraveled only later. With the realization that patients with apparently similar diseases at diagnosis – breast or prostate cancer, for example - respond differently to similar treatments, and that clinical behavior of the disease is different in different patients, we have begun to understand that the mechanistic/molecular basis of what we thought is the same disease entity, is different. Thus, breast cancer or prostate cancers appear to be sub-divided into smaller distinct classes according to their molecular characteristics. As a result, we are exiting the era where our approach to treatment of these and many other diseases is “one size fits all”, and entering a new era of “personalized medicine” where we tailor treatment according to a patient’s molecular/mutational profile. Here, unlike the previous era, an understanding of the mechanisms will drive the development of new drugs. This era will be characterized initially by the development of technologies where sequencing and data processing of individual genomes will be fast (few hours) and cheap (

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