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Personalized Medicine
Introducing Personalized Medicine Edward Abrahams
W Edward Abrahams President, Personalized Medicine Coalition
hen it comes to medicine, one size does not fit all. Treatments and prevention strategies that help some are ineffective for others. We've known this for a long time. William Osler (1849-1919), a Canadian physician sometimes referred to as the father of modern medicine, once wrote that “variability is the law of life. As no two faces are the same,” he noted, “so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.” But until the beginning of the 21st century following the mapping of the human genome, physicians lacked the tools and technologies necessary to understand the reasons for variability among patients. Physicians treated all patients essentially the same, relying on trial and error to find the right solution to a particular patient’s predicament.
Personalized medicine allows us to do much better. Also called precision or individualized medicine, personalized medicine is an evolving field in which physicians use diagnostic tests, often but not always genetic, to determine which medical treatments will work best for each patient. By combining data from diagnostic tests with an individual’s medical history, circumstances, and values, health care providers can develop targeted treatment and prevention plans. Genetic testing, for example, can help physicians predict how a patient’s body may metabolize certain drugs. Genetically-guided cancer therapies can target the unique set of molecular variables that drive a patient’s particular cancer. And advanced computing techniques that aggregate and compare real-world data can help tailor health care interventions more closely to the wide range of biological and
environmental characteristics that impact human health. Health systems are still developing and adopting the updated policies and procedures that are necessary to facilitate the widespread implementation of personalized medicine. Change does not come easily. But because biology is complex, it demands that we employ more sophisticated approaches to treating patients. As we learn more about the root causes of certain diseases and develop new ways of delivering health care to patients at home and in physicians’ offices, proponents of personalized medicine envision a new era of medicine in keeping with Osler’s appreciation of the principle of individual variation. It will be one that promises better outcomes for patients at lower systemic costs because medicine in the future will become more targeted and more efficient.
The national CanPath study is a partnership of seven regional cohorts that, together, span all 10 provinces: the BC Generations Project, Alberta’s Tomorrow Project, Healthy Future Sask, the Manitoba Tomorrow Project, the Ontario Health Study, CARTaGENE (Quebec), and Atlantic PATH.
A unique Canadian resource to enable early disease detection and prevention
CanPath: Canada’s Population Platform for Personalized Medicine
One of the most exciting applications of personalized medicine is the potential to identify people at risk of developing a disease years before they're in a doctor’s office needing treatment. As CanPath follows people over decades, some participants who provided a biological sample will develop a disease. Using the samples collected before people develop a disease, scientists can look for genetic and molecular markers that suggest whether someone might be at a greater risk of disease, thereby enabling earlier and more targeted interventions.
Dr. Philip Awadalla and Dr. John McLaughlin
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ersonalized medicine has tremendous potential to improve patient care by tailoring medical interventions to an individual’s unique genetic makeup and life history. Yet, the implementation of personalized medicine programs is challenging as it requires high-quality data collected from a large group of people to capture the complex factors that shape an individual’s health trajectory. In Canada, the promise of personalized medicine is within reach through the Canadian Partnership for Tomorrow’s Health (CanPath). CanPath collects detailed information from one in every 100 Canadians to learn more about how biology, behaviours, and environmental exposures influence the development of chronic diseases and cancer. Over the past decade, CanPath has collected data and biological samples from more than 330,000
volunteer Canadians, making the study a valuable living population laboratory and the largest health data collection of its kind in the nation’s history. CanPath, which has been designed to follow participants for five decades, provides a national platform for made-in-Canada health solutions that will benefit Canadians today and in the future. Never before was this more clearly demonstrated than when CanPath data and biological samples enabled researchers to study the factors that affect an individual’s susceptibility and response to COVID-19 infection, as well as the efficacy of vaccines. Understanding how an individual’s genetics, lifestyle, and environment shape vulnerability to disease will only become more pressing in the future with increased population aging and the health threats posed by climate change.
Understanding the health impacts of climate change Climate change will pose one of the largest threats to our health and our planet in the years to come. With its broad collection of data spanning decades, CanPath offers scientists a chance to understand how different people might be vulnerable to the impacts of a changing environment today and to predict how people will respond to a changing climate in the future. Already, CanPath has enabled Canadian researchers to discover how a collection of environmental factors such as air pollution and neighbour hood walkability, collectively known as our personal exposome, interact with our underlying biology to influence health outcomes. Personalized medicine is a promise for tomorrow that CanPath scientists are delivering on today.
To learn more, visit personalized medicine coalition.org.
Dr. Philip Awadalla National Scientific Director, Canadian Partnership for Tomorrow’s Health
Dr. John McLaughlin Executive Director, Canadian Partnership for Tomorrow’s Health
To learn more about how CanPath is building a healthier Canada, visit canpath.ca.
This article was sponsored by the Canadian Partnership for Tomorrow’s Health.
Publisher: Evan Sebesta Business Development Manager: Julia Colavecchia Country Manager: Nina Theodorlis Content & Production Manager: Raymond Fan Designer: Kylie Armishaw Content & Web Editor: Karthik Talwar All images are from Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve the Toronto Star or its editorial departments. Send all inquiries to ca.editorial@mediaplanet.com.
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