Three challenges posed by personalized medicine—and how to overcome them
Key Takeaways
Collecting patient-specific data to be used in personalized medicine can involve invasive practices, such as biopsies, thus requiring doctors to consider the impact on the patient’s quality of life.
Accessibility of personalized medicine hinges on the use of digital platforms to deploy care specific to the individual patient.
Doctors who implement personalized care bear major legal responsibilities that the law is only starting to flesh out fully.
The healthcare landscape is expected to transform in the next few years, largely due to the development of personalized medicine (PM). PM has great potential to effectively treat and prevent disease through individualized healthcare methods, according to an article published by the Journal of Translational Medicine.[]
But with innovation comes new challenges related to data collection issues, accessibility concerns, and physician liability. Doctors can address these by considering patients’ quality of life, embracing digitization of AI, and learning about liability risks associated with PM.
Data collection
The success of PM relies not only on data collection from patients, but also effective collection approaches and corresponding databases.
An article published by Frontiers in Digital Health stated that molecular profiling is one way to formulate comprehensive databases.[] These can be used to predict how treatments will affect a patient, and to recommend adjustments as needed.
Gathering patient-driven xenograft samples, however, often requires patients to undergo biopsies or have tumors surgically removed. Both methods are invasive.
Similarly, obtaining patient-derived organoid samples requires invasive extraction of adult stem cells located in bone marrow or blood circulations.
While both approaches are increasingly prevalent in clinically relevant settings to actualize the most effective treatment strategies for each patient, doctors must consider what quality of life the patient presents before taking invasive measures.
If circumstances call for it, doctors can consider other non-invasive or minimally invasive approaches.
The frequency at which data need to be collected is another consideration. For example, patient sample-driven regimens require a one-time collection, whereas artificial intelligence (AI) approaches entail more longitudinal collections.
Accessibility
In addition to data collection challenges, doctors must reckon with patient accessibility to PM.
According to the Frontiers in Digital Health article, harnessing digital platforms is one pathway to deploying PM. Digitized strategies have already been used, and further bridging the gap between PM and digital medicine will expand patient access to this increasingly effective method of care.
CURATE.AI is an AI program that can be digitized to offer rapid optimization of treatment plans with the use of the patient’s clinical data. The Frontiers in Digital Health authors cite its use in a patient with prostate cancer, who was able to return to his desired lifestyle.
The authors also discussed real-world uses of digital medicine in PM, writing, “Digitizing platforms like QPOP can potentially provide more tailored, personalized treatments to patients who are not responding to standard of care. Therefore, digitizing personalized medicine strategies for deployment in clinical settings is one critical step forward to integrate them into established clinical workflows.”
Physician liability
Aside from the challenge of harnessing accessible, PM-friendly technology, doctors who practice PM may struggle with liability concerns.
Consultations with the patient and the family can become problematic in PM, as the physician’s responsibilities are not clear-cut at the present time. The authors of an article published by Frontiers in Medicine raise the following questions:[]
What bearing does infrequent application of genetic knowledge have on a physician's duty to warn a patient's children and family members?
When test results show a multitude of “variants of unknown significance,” what guidance should be provided to physicians as to how to proceed?
When does a physician have a duty to recommend genetic testing for a patient who has a history of a disease generally associated with a genetic mutation?
There are likely many answers. The legal language regarding doctors and the implementation of PM is still in early development, after all.
In the meantime, physicians can familiarize themselves with the risks associated with using PM, as well as those associated with not using it.
What this means for you
Personalized medicine (PM) is changing healthcare, but presents its own challenges. It relies on data collection from patients, who may not fare well with invasive collection methods. Doctors should consider a patient’s quality of life and then determine the best approach. Accessibility of PM is another concern, which doctors can address by embracing the digitization of AI, which paves the way for optimal patient treatment and can increase integration of PM into clinical workflow. Liability is also a growing concern as PM develops, so doctors must assess the risks associated with such methods.