Forward thinkers at High Tech Summit: Ramneek Gupta, Associate Professor, DTU Bioinformatics, one of the contributors to the Danish Reference Genome, and with a history in “Big Pharma” (five years with Eli Lilly).
Precision medicine, or personalized medicine, promises treatment specific to individual patients or patient subgroups. After decades of talk, things are finally beginning to take off.
“First of all, computer power has grown to a level that makes it possible to handle the vast amounts of data involved. Secondly, our methods for analyzing these data and extracting value from them have evolved a lot. This is not least due to the high level of interest in Artificial Intelligence,” says Ramneek Gupta.
However, new obstacles have also arrived.
“Ethical and legal issues around data security have come very much in focus. This is justified, since we are talking about sensitive, personal data. In my view, the solution is getting patients involved. We need to be completely open about the scope of the research.”
Ramneek Gupta takes an example from cancer treatment:
“As a person is diagnosed with cancer, quite a lot of data will be generated from diagnosis and during treatment. These data are used to evaluate the treatment down the road for the given patient. Generally, not all information stored in these large data sets are taken advantage of in order to optimize treatment for that patient and future patients.”
Empowering patients through blockchain
It is well known that specific drugs and dosages have different effects on individual patients. A given drug and dosage can be highly effective for one patient, and ineffective or even dangerous for the next. Many such differences are likely to be linkable to genetic factors. In other words, with precision medicine, physicians could go straight to subscribing the correct product and dosage, rather than having to subject the patient to a suboptimal treatment first.
“I am confident, that if we see the population as intelligent and explain these potential benefits, people will generally want to give researchers access to their data – in an anonymized form, of course – for this purpose. As data authorities get closer to actual patient wishes, we can solve issues around privacy and data security. E.g. there are companies working with blockchain solutions empowering individual patients to determine who has access to their data. The main thing is a higher engagement with the patients by researchers and by ethical and data regulators, more so than fear-generating media stories.”
A frequent concern is, that personalized medicine will be too costly and exhaust public health care funding. Ramneek Gupta objects:
“Eventually, personalized will actually reduce costs. It is hardly economical to treat large groups of patients with drugs that only have an effect in small subgroups.”
Pharma industry is interested, yet hesitates
The interest of the pharmaceutical industry in personalized medicine is clear:
“Especially in USA and the EU, authorities are calling for “substantial improvement” as a condition for reimbursement of costs for a new treatment. Chances of documenting a substantial improvement are obviously much higher, if you are able to identify a relevant subgroup rather than treating a large group of patients of which many are not likely to benefit.”
Still, the pharma industry seems somewhat reluctant to engage directly in projects with academic precision medicine research groups, Ramneek Gupta notes:
“There is a general lack of understanding on both on the industry and the academic side. Bridging is very much needed – also, obviously, with the clinical practitioners and not least patients. The High Tech Summit will be a fine venue for initiating this type of bridging. Imagine a future where a drop of patient’s spit, together with behavioral and lifestyle data collected over everyday devices, helps determine the right intervention at the right time, to improve the lives of individuals.”
“It’s no use closing your eyes to the changes. We need to constantly keep up and try to influence the process.”
Professor Jan Madsen, DTU Compute