Precision medicine or “targeted therapy” is said to be the pathway to improved cancer treatment.In fact, UC San Francisco recently opened a $275-million cancer center which is set to provide adult patients with immunotherapy, genetic counseling, molecular profiling of tumors, fully integrated clinical trials, and advanced imaging.  The Bakar Precision Cancer Medicine Building, part of the university's Helen Diller Family Comprehensive Cancer Center, focuses on a range of cancer services including medical care provided by surgical, medical, and radiation oncologists who work with an expanded care team to support the whole patient and their family with specialized psychosocial support, cancer specific nutrition expertise, hereditary cancer care, and wellness programs such as exercise counseling.Related: Precision Medicine Cutting-Edge Developments: What Health Execs Should KnowJeremy Schafer, PharmD, MBA, senior vice president, director, Access Experience, Precision for Value, views precision medicine as a potential game-changer. Here, Schafer offers four ways that he believes precision medicine will change cancer treatment:
Greater workloads
Personalized medicine is making therapy more targeted, but also more confusing for healthcare stakeholders.
“A dramatic expansion in all the biomarker testing that now must be done in oncology adds operational workload for health systems, along with additional expense,” Schafer says.
Genetics, not organs
Precision medicine is increasingly leading to oncolytics being directed at a genetic marker for a disease rather than to the organ of cancer origin.
“The best example of this is the approval of a checkpoint inhibitor for microsatellite instability-high (MSI-H) cancer,” says Schafer. “The approval allows the therapy to be used for a variety of cancers as long as the cancer cells are characteristic of MSI-H.”
Fragmentation
Personalized medicine is fragmenting the treatment of cancer.
Diseases like non–small cell lung cancer, which once was addressed with chemotherapy in most cases, now may be treated by one or more of a variety of agents depending on the biomarker test results, according to Schafer. “Treatment algorithms that once could be represented by the straight trunk of a tree are now more akin to the many branches on top,” he says.
More investigation
Personalized medicine is driving the investigation of more combination regimens.
“Researchers now have access to therapies that attack different biomarkers of a cancer, promoting the concept that attacking multiple targets at once may lead to better results. While efficacy may be enhanced, safety may be an issue and costs rise,” Schafer says.
