When we talk regarding precision medicine, we talk regarding personalized treatments. In other words, medical treatment considers the patient’s lifestyle, gender, environmental factors and genetics, for example, so that said treatment is unique and more effective. Because what works for some will not necessarily give the same result to everyone.
Precision medicine seeks not only to adapt and personalize treatments, but also to use the latest technology and markers in order to have a greater chance of attacking the disease and reduce or avoid side effects. An additional advantage is that it allows for a better understanding of diseases and promotes research in the development of new treatments that are more accessible to the general population.
Currently, there are molecular diagnostic tests that provide more information regarding a type of tumor. For example, some types of cancer are due to genetic mutations, that is, changes in the genome sequence, which might make us more susceptible to developing some type of cancer.
With the advancement of technology in recent years, it is now possible to sequence the entire genome in just a few days and identify if there are any mutations that are causing cancer in the patient and, with this, select the most appropriate treatment. Unfortunately, at this time it is not possible to guarantee that anyone can have access to personalized treatments due to their high cost and because until now, probably, only a couple of medical insurance plans in Mexico (GNP and AXA) already cover this type of test. diagnostics
According to Héctor Manuel Alcaraz, general director of Imagene Health with presence in Nuevo León and Mexico City, a service can range from 25,000 pesos to 145,000 pesos. This service consists of extracting DNA from a tumor, performing genomic sequencing, performing bioinformatic analyzes to identify mutations related to the pathology and suggesting personalized therapy for the patient. For example, through this service, breast cancer can be treated when there is a CDK4/6 mutation with the drug Palbociclib instead of surgery, chemotherapy or radiation, which is the most common treatment, the same happens with colon cancer. when it is caused by the EGFR mutation, which should be treated with Cetuximab or Panitumumab instead of chemotherapy, frequently used for this type of cancer.
Likewise, the medical geneticist Herbert García highlights that precision medicine can give great results, as it has been seen that patients with solid tumors with a high mutational load can have responses of up to 70% if the treatment is by immunotherapy with Pembrolizumab. Another example is the drug Entrectinib, also a candidate for patients with solid tumors with mutations in the NTRK gene, where patients with solid tumors such as gliomas in the brain and with mutations in the NTRK or ROS gene have shown a response of up to 58%. in a period of 10 months.
For precision medicine to become a reality for most of the population, it is urgent that in the short term public and private health and research institutions, insurers, society and politicians work together to develop plans and strategies that allow the development and widespread use of precision medicine in Mexico. There needs to be investment to acquire and develop state-of-the-art laboratory equipment, carry out campaigns and courses among medical personnel to publicize the advances and benefits of precision medicine and promote research in the search for more and better markers and treatments. . Likewise, it is necessary that more insurers begin to include this type of service in their policies.
In addition, it is very important that there is a regulation or law that encourages and prepares the ground for an adequate implementation of precision medicine in the short term in our country and that contributes to improving public health and with it the quality of life of the population. . Reaching a consensus on the benefits of precision medicine among the different actors might make it possible to make a large investment that translates into better care, decreased morbidity and mortality, as well as representing savings for families and the health system in the future.
Marco Sanchez Guerra
Postdoctoral in Environmental Health from Harvard University, Researcher in Medical Sciences at the National Institute of Perinatology and Consultant in Environmental Epidemiology and Public Health.
Twitter @MarcoSanchezGue
