Both, mass media and scientific publications reveal a rapidly increasing interest in the concept of personalized medicine thereby evoking high hopes and expectations in patients. Scientifically, the concept was initially driven by genomics and is now extended to omics technologies in general, opening enormous scope for future development. In cancer therapy, individualised approaches are already clinical reality e.g. by choosing optimally tailored therapies based on the analysis of prognostic marker gene panels. While the enormous potential of personalised medicine in cancer is undisputed, it is not yet clear, what it could contribute to solve other multifactorial non-communicable diseases such as cardiovascular, metabolic or psychiatric diseases. Can we fulfil the high hopes of patients in the field of these diseases? What will future tools and techniques be? How will personalised medicine impact on the physician-patient relationship? Shifting medical attention forward to pre-disease i.e. “at risk” stages promises a new era of preventive medicine. On the other hand, a whole range of ethical considerations need to addressed in that context.
Besides these patient-oriented questions, there is a fundamental epistemological aspect involved: modern evidence-based medicine is based upon the observational and statistical comparison of groups of patients with similar disease status undergoing highly standardised treatments. While it is attractive to make future medicine better than a one-size-fits-all-approach, the question of how to assess the highly individualised therapeutic strategies in a statistically significant way remains to be solved.