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Alpbach Forum: Moving in small steps towards complex precision medicine

The question of the future approach to precision medicine is a crucial one for experts
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[Translate to English:] Bild: Laurent Ziegler
Peter Nilsson, Christian Herold, Giulio Superti-Furga, Michaela Fritz und Patrice Milos

[Translate to English:] (Alpbach/APA, 24-08-2018) "Precision medicine – medicine's answer to diversity?" – that was the topic of a high-level panel debate held on 23 August as part of the Alpbach Technology Symposium. Chaired by Patrice Milos, CEO of Medley Genomics, Providence, USA, MedUni Vienna Vice Rector Michaela Fritz debated with experts about diversity as the foundation of precision medicine being a revolutionary development that will permanently change medicine to incorporate personalised methods of treatment. Among the questions that were addressed were the advantages that precision medicine offers to individual patients and also the impact it has upon future technologies.

Matching diagnostics and treatment as much as possible to particular patient groups or even individual patients is one of the main visions for the future of medicine. However, the experts agreed that there are still many small steps to go before we reach a form "precision medicine" that is sufficiently precise.

For some time now, the search for optimal medical approach to individual diseases and their often numerous subgroups and the search for answers to the question of how differently these manifest in the body of a particular patient, has been captivating hosts of scientists throughout the world. This fact alone and the rapid developments that have been made in diagnostic imaging, in analysis of the genome and the building blocks of the cells, proteins, gives grounds for hope of progress, says Giulio Superti-Furga, Head of the Research Centre for Molecular Medicine (CeMM) of the Austrian Academy of Sciences (ÖAW) in Vienna and Professor of Medical System Biology at MedUni Vienna.

She explained that, thanks to new approaches to data analysis in medicine, we can expect to have much more detailed insights into many diseases in approximately ten years. However, just how difficult it will be to draw more or less definitive conclusions from all of this information becomes clear when we remember that each gene plays a different note, as Superti-Furga put it. However, these do not produce the same sound in every person. And there are some people who are genetically predisposed to a disease but also have a genetic mutation that balances out this error. Says Superti-Furga: "It is amazingly complicated."

She explained that currently clues are constantly popping up to point us towards indicators for diseases or genetic signatures that predict whether or not a treatment will be successful in particular people. However, they are difficult to interpret, as protein specialist Peter Nilsson from the Royal Institute of Technology in Stockholm explains. The problem is that there are great overlaps in the manifestations of various diseases and, at the same time, great similarities between patient groups. However, by taking "many small steps", we might soon have relatively simple blood tests to reliably indicate which specialists should look at a patient.

In the view of the Head of the Department of Biomedical Imaging and Image-guided Therapy at the Medical University of Vienna, Christian Herold, the area of oncology is currently the most advanced in terms of precision medicine. However, the question of who can benefit from such highly specific treatment depends to a large extent upon the healthcare system in which one finds oneself. However, the question of access to specialised institutions is perhaps even more crucial and there is a surprising discrepancy in this, even in highly developed countries, stressed Herold.

Data collection as a question of trust
Apart from access to and, above all, financing of precision medicine approaches, Michaela Fritz, Vice Rector of MedUni Vienna believes there is also the question of trust. Universities and research institutions need to collect increasing amounts of data and, consequently, it is important that patients continue to trust that their data will be used for good and responsible research, said Fritz. CEO of the US company Medley Genomics, Patrice Milos, believes that Europe is in a good position on this issue, because of its stable healthcare systems, which are characterised by a broad base of public confidence.
(APA nt/cm/ren - red)