Personalized Prescription Based Medicine

Published 08/30/10


From daily prescriptions, to customized cancer drugs, designing treatments that take into account the individual patient.


Dr. Adel: People come in all shapes and sizes, yet so many areas of medicine apply a one size fits all approach to treatment. For example, one of America's most prescribed drugs might not work for 14% of the people who take it. News like that is sparking a medical revolution. Man 1: It's one of the top five prescribed drugs in the world. Dr. Adel: The anti-clotting drug, Plavix, is used to prevent heart attacks. Man 1: What Plavix does is it makes our platelets slippery. So people who have active coronary artery disease with chest pains that are unstable, who've had heart attacks, or who have had a stint in the past, those patients need Plavix. Dr. Adel: As with every medication, Plavix is not right for everyone. Studies show it's not effective for about 14% of people who take it. Man 1: In the end it goes down, actually, to our genes. They are not able to metabolize Plavix as efficiently as people with the normal gene. Dr. Adel: Scripps Health, a nonprofit healthcare system based on San Diego is the first in the country to offer routine genetic testing for potential Plavix patients. Man 1: It takes simply a saliva test or a blood test. Dr. Adel: Results tell who should take the drug, at what dosage, and for whom it just may not be the right therapy. Man 1: I believe personalized medicine is now reaching the point where we can use it in daily clinical practice. Dr. Adel: Personalized medicine means different treatments for different individuals that have the same health problems. Targeting transplants is the next frontier. Dennis Manchester had two liver transplants. Dennis: You're right at that threshold where you're going to welcome death or you're going to welcome another life. Dr. Adel: He takes 30 pills a day to prevent rejection. With all these medications come side effects. Dennis: Headaches, tremors, nausea... Dr. Adel: Researchers say about 40% of transplant patients get more medication than they really need. Woman 1: For the first three months it's this. For the next six months it's this. So, it's the same for everybody. Dr. Adel: Doctors at Mt. Sinai School of Medicine are creating a personalized treatment plan for Dennis and others who have had transplants. They've developed tests to measure a patient's genes, antibodies, proteins, and cells. They hope the results will tell them who needs which drugs, and how much. Man 2: What I'd really like to know is am I treating you correctly, and can I take the drugs away from you that could cause injury, and can I do that safely? Dennis: For somebody to get a new organ and only take maybe one or two pills, that would be fantastic. Dr. Adel: Music fuels Beverly Sotere's spirit. She's fighting lung cancer and was given just six months to live. Beverly: I have a CAT scan on my bathroom wall, and every morning I go into the bathroom, take my shower, come out, and I can't tell you what I say to it, but I swear at it. I tell it to get out of my body and leave me alone. Dr. Adel: Beverly endured a brutal regimen of chemotherapy that damaged her kidneys. Beverly: You're just so sick. Dr. Adel: The tumors continued to grow until doctors found a way to target Beverly's treatment. Man 3: This is not a one size fits all disease. This is a disease where we need to find out what makes each individual cancer tick. Dr. Adel: Here at Massachusetts General Hospital, a specially designed robot is used to examine a tumor sample, and determine its DNA fingerprint. Man 3: These specific mutations would give us important clues about how to treat the patients. That was the "Aha" moment. Dr. Adel: For Beverly, it meant taking a drug designed specifically to block her tumor's mutation. The results were remarkable. Man 3: Probably about a 30% to 40% reduction in the tumor itself. Dr. Adel: It's been four years since Beverly first heard she had six months to live. Beverly: I never gave up hope, and all I can say is just fight. Fight it.

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