Eric Topol from the Scripps Translational Science Institute envisions a future in which individualized medicine — a term he prefers over personalized or precision medicine — is fueled by a 'panoromic' view of that person's genome, microbiome, epigenome, and all the other omes.
As he writes in Cell this week, this all-encompassing view can begin even before conception as the person's parents consider what potentially deleterious variants they carry, such as ones linked to cystic fibrosis or Fragile X Syndrome. Then fetal and newborn sequencing could catch chromosomal aberrations and monogenic diseases, respectively, early on.
As the person ages, Topol says that genomic and other information can be tapped to figure out rare or idiopathic diseases they might have or determine ways to help keep the person healthy and not develop conditions they may be susceptible to.
"For example, if one’s sequence data indicate a risk for hypertension, that risk may be further modulated by knowledge of his/her proteins, metabolites, microbiome, and epigenomics," Topol says. "The use of a biosensor watch to passively collect continuous blood pressure measurements could make diagnosis at the earliest possible time, avoiding any end-organ damage to the heart or kidney."
And if the person develops cancer or comes down with an infectious disease, all this information could also be used to identify weaknesses in the tumor or infectious agent to target with drugs.
But to get to this future, Topol notes that there will have to be "intensive, rigorous validation" of these new tools as well as increased effort into how to integrate data from the different omics. Additionally, practicing physician will need to be educated about genomics and related fields.
"Although we are still at the nascent stages of individualized medicine, there has never been more promise and opportunity to reboot the way health care can be rendered," Topol adds. "Only with systematic validation of these approaches at the intersection of biology and digital technology can we actualize this more precise, futuristic version of medicine."