by
Martin Banks
According to top health expert Helmut Brand "personalised medicine is not just an idea, it will be a new reality."
That was one of the main messages to emerge from an event in Brussels designed to formally launch an EU-wide awareness-raising campaign and accelerate the development, delivery and uptake of PM and diagnostics.
"We are working towards making PM the mainstream, towards making it a reality. As well as the other stakeholders in this room, the next generation of scientists, policymakers and patients sitting here today can play a large part in that," said Prof Brand, head of the Department of International Health at Maastricht University and co-chair of the European Alliance for Personalised Medicine (EAPM).
The academic was speaking as EAPM this week launched its ‘Five steps towards a healthier Europe’ (STEPs) campaign before a packed audience in the Brussels European Parliament.
Around 100 public health and medical students from across the EU, plus MEPs, representatives from the Greek Presidency of the EU and the European Commission, as well as patients, scientists and other stakeholders, heard that STEPs aims to secure patients’ quality of life through personalised medicine.
The campaign will continue during the run-up to the European elections in May and already has the backing of many cross-party MEPs.
The event heard that PM is about "empowering the patient and giving the right treatment to the right one at the right time."
In practice, rather than having a unique treatment for each individual, patients are sub-divided into groups based on their molecular make up, by using biomarkers. These are characteristics that can be used as indicators to measure, for example, pharmacological responses to a particular treatment.
So, while any two patients may have the same disease their molecular make-ups may mean that one of them responds to a certain treatment, while the same treatment won’t work for the other.
By such stratification it becomes possible to create a medical model using molecular profiling to tailor the right therapeutic strategy for the right person at the right time. It can also flag up a predisposition to a disease as well as allowing for timely prevention.
Other key messages to emerge from the event, held Wednesday 19 February, were that fears about so-called big data among the public need to be allayed, more general discussion is needed at policy level and new payment models need to be brought about to allow this radical concept to fulfill its promise.
"We are working towards making PM the mainstream, towards making it a reality. As well as the other stakeholders in this room, the next generation of scientists, policymakers and patients sitting here today can play a large part in that," added Prof Brand.
The meeting heard that personalised medicine has already changed the lives of hundreds of thousands of patients and, when coupled with personal pharmacogenetics, is a "unique" approach to treatment that advocates believe is well-suited to tackle many of the health challenges we face.
Many chronic diseases, such as diabetes, heart disease, cancer and Alzheimer’s, are thought to be caused by a combination of genetic and other factors. Such diseases place a significant burden on the healthcare system as well as the patient. PM, it was said, provides the tools to treat such diseases "more effectively than ever before" because it is the tailoring of medical treatment to the individual characteristics of each patient.
The STEPs (Specialised treatment for Europe´s Patients) launch included a lively Q and A session alongside expert input from EFPIA’s chief economist Richard Torbett, Angela Brand, from the Institute for Public Health Genomics, prostate cancer patient Louis Denis, Science Europe’s Bonnie Wolff-Boenisch, urologist Didier Jacqmin and Olivier Arnaud, of JDRF.
These were joined on the podium by the European Commission’s Andrejz Ryz, Antonis Lanaras, Health Counsellor for the Permanent Representation of Greece to the EU, plus MEPs Marian Harkin, Vittorio Prodi and Petru Luhan.
The assembly heard that the Alliance (EAPM) initiative calls on decision-makers to commit to various measures for 2014-2019.
These include creating a regulatory environment which "allows early patient access to novel and efficacious PM" and increasing research and development for PM. Policymakers are also urged to improve the education and training of healthcare professionals and support new approaches to reimbursement and HTA assessment, required for patient access to PM. Torbett said, "EAPM believes that achieving these goals will improve the quality of life for patients in every country in Europe."
Further comment comes from Jacqmin, who acknowledges that two major challenges with PM involve getting patients to clinical trials and the cost of producing drugs that work for sub-groups. Once genetic profiles have been selected the trials that are then held are by definition smaller. Getting patients involved is already an issue with bigger trials.
“There is a fear of trials among some patients,” said Didier, “and also a lack of awareness that they are taking place. We need to get patients more involved, better informed, and advertise these trials to the public. Even a lot of GPs don’t know that trials are ongoing.”
Jacqmin: “It‘s not only about understanding and using the science. PM is also about adapting to the patient in front of you. He or she may have several options – such as surveillance, surgery, radiotherapy etcetera – and we have to take into account the patient’s choices.
“We are not in the patient’s place and do not know his or her lifestyle, family circumstances and so on. It’s important to listen and we always send them home with plenty of advice and written information that will help them make the right choice for their unique circumstances."
By: N. Peter Kramer
