With the right scientific team, the right technology and knowledge of a person on a molecular level, not only can we effectively treat disease, we may be able to prevent it altogether.
Cedars-Sinai Precision Health embraces a new approach to medicine that recognizes every individual is different, not only socially and culturally, but at a molecular level. Understanding people's needs — and their disease or potential illnesses — on this level can result in longer, healthier lives.
"It's going to fundamentally change the way we practice medicine," said Dermot McGovern, MD, PhD, director of Cedars-Sinai Precision Health.
Precision approaches to treatment have evolved in recent decades and continue to advance in many diseases, including cancer, autoimmune disorders and metabolic disorders. The science of matching a medication to the genetic properties of a patient and their disease has traditionally been thought of as precision medicine. This targeted approach is proven to be effective in addressing disease, as well as identifying the best treatments quickly — saving time and resources for patients while making them well again.
Now the field is expanding, and precision approaches are crucial to our treatments from the moment a patient enters their doctor's office, throughout their treatment and into their recovery.
In fact, this philosophy has the potential to help maintain health by predicting who is likely to become ill and taking proactive measures.
Precision medicine will fundamentally change the way we even think about diseases. Right now, patients are generally grouped by their symptoms, which organ or body part is affected and the kind of disease they have — whether it's cancer, diabetes or heart disease.
But precision medicine offers the opportunity to consider disease in a radically different manner that may be much more effective, McGovern said.
When we take what we have learned from studies such as the Human Genome Project, increased understanding of the bacteria that live in our bodies, and the unique proteins that make up every person, diseases begin to look very different from each other on the molecular level. In fact, two people with Crohn's disease may bear very little resemblance to each other and will not respond the same way to treatments.
"Now, if we zoom back out and look again at the same population, we discover that we have a very different picture," he said. "Across diseases, people share molecular signatures. Someone with Crohn's disease could be, on a molecular level, much more similar to a patient with a certain heart disease or rheumatologic condition. So now, armed with this new information, we can regroup people according to shared molecular profiles, and we may find that what is an effective treatment for one person's Crohn's disease can also be used to treat another person's rheumatoid arthritis."
This approach is disease agnostic. The labels we've given diseases based on symptoms and body parts may be less important in the future than the specific genetics of the people those diseases affect.
Some of the areas that Cedars-Sinai Precision Health is already exploring include:
- Genomics, proteomics, metabolomics and technology development
- Bioinformatics and computational biology
- Near-patient technologies
- The microbiome (including looking at the role of fungi in the gut)
- Inflammatory bowel disease (IBD) and genomics
- Cancer genomics
- Biobanking and molecular diagnostics
- Cancer prevention
This work is already happening in myriad areas at Cedars-Sinai, including IBD, heart disease, neurosurgery, pediatrics, regenerative medicine, irritable bowel syndrome, pancreatic cancer and metabolic diseases, such as diabetes and obesity.
"We're getting the right treatment to the right patient at the right time," McGovern said.
And, in time, we'll get to patients before an illness gets to them.