1. Personalized Medicine
Group 13: Cuade Nauboris, Shruti Patel, Vinny Aggrawal, Arbaaz Shah, Amit Yadav

2. Table of Contents What it is How it works
Origins of Personalized Medicine
Ethical Issues
Social Issues
Benefits and Potential Implications

3. What it is
Personalized medicine is an expansion to the regular approaches of treating and understanding a wide variety of illnesses.
Unlike ordinary medicine tailored for all patients, personalized medicine makes treatment for an individual a lot more specific based upon their needs.
This is accomplished by using the molecular makeup of each patient from which medical specialists get a better understanding of their “genetic mapping.”
Medical specialists will then be able to clearly identify and profile the patient, and use their information to create forms of treatment which will be much more effective.

4. What it is
To summarize: Personalized medicine treats individual patients more effectively through the use of their genetic information rather using the “one size fits all” approach.
Personalized Medicine - Information and Resources. (n.d.). Personalized Medicine - Information and Resources. Retrieved January 7, 2011, from

5. Personalized Medicine – From Theory to Practice. (n. d. )
Personalized Medicine – From Theory to Practice. (n.d.). Upload & Share PowerPoint presentations and documents. Retrieved January 7, 2011, from

6. How does it work?
Personalized medicine is used to make treatment more specific. This type of medicine is used to fit the illness of different individuals. Personalized medicine is also used to find the sickness that is affecting the body. Genetic testing is done and then the genetic material of the patient is used to find a treatment for the sickness.
Personalized medicine has been around for decades but it has not been as popular as it is today. This is because we are starting to learn more about how to predict the risk of the disease.
The knowledge of gene variations has increased through generations and it has become easier to depict a medication for a specific illness.

7. How does it work?
Personalized medicine is known as the future medicine and is considered more effective than one dose fits all approach. This is considerable more effective because personalized medicine is specific for an individual while the one dose fits all approach is for a certain illness/disease.
For drug metabolism, the one dose fits all medicine might work for one individual but not for another due to the difference in the genes. This is due to the reason that when the drug is being processed, group of enzymes called the drug metabolizing enzymes are responsible for breakdown of the drug. These enzymes are present in every individual in different form and amount.

8. How does it work?
The difference in the forms and amount can affect the processing of the drug and its affect towards the illness.
It is a fact that most drugs prescribed only work for 60 % of the patients whereas personalized medicine will have a higher percentage.
In order to have the right medication for the right patient. A sample of the patients DNA is collected and that sample is later used to identify the medication which best suits that patient. The DNA is collected using an Amplichip.

9. How does it work?
After the process of collecting DNA, the DNA is then analyzed and later used to minimize the side effects and to create a strategy for a more successful outcome from the medical treatment.
Personalized Medicine is used for genetic testing for abnormalities and providing treatment.

10. Roche AmpliChip (BBC News, 2010)
Access:

11. How does it work?
The Human Genome Project found that there are approximately 25,000 genes in humans. The project also determined the type of genes that exist and their role in a healthy human.
Furthermore, the gene of a healthy human can be used to compare to the gene of a patient in order to find the abnormalities. Gene testing is only done when symptoms start to appear.
Pharmacogenomics is the study of how an individual's genetic inheritance affects the body's response to drugs.

12. How does it work?
Through the use of personalized medicine it is assured that the drug is best suited for its genes.
This type of medicine helps reduce the length of time that the patient is on medication. This is because the personalized is more accurate and it relates to the genetic code of the patient. Through the name of personalized medicine, it can be stated that words such as personalized proves that this type of medication is only for personal use.
Personalized medicine is described safe when it comes to the amount of dosage that is needed for a certain individual. Every individual has different and unique genes, depending on the genes the amount of dosage that is needed can also be found through the sample of DNA.

13. How does it work?
Personalized medicine will also aims to provide the tools and knowledge to fight chronic diseases and treat them more effectively.
With the use of personalized medicine it is possible that diseases such as cancer, diabetes, alzheimers, and other heart disease can be cured.
Personalized medicine is preventive, coordinated, and evidence-based. It also helps keep patients healthy with a precise treatment.

14. Personalized Medicine from genetic material
(U.S. Department of Health & Human Services, 2010)
Personalized Medicine from genetic material
(U.S. Department of Health & Human Services, 2010)
Access:

15. Genetic Code (Twombly, 2010)
Access:

16. Origins
Personalized medicine is a branch of medicine and genetics  the science of genes.
Although the early concepts of medicine had started almost 2000 years ago, the study of modern medicine started rather late during the 19th century.
The science of genetics traces its roots back to the applied and theoretical work of Gregor Johann Mendel, a German-Czech Augustinian monk and scientist.
He discovered the science of genetics through his studies on the nature of inheritance in plants in 1865.
Mendel’s work did not gain wide understanding until the 1890’s.
Then during the 1990’s personalized medicine was discovered and is currently being developed.

17. Origins Gregor Johann Mendel July 20, 1822 – January 6, 1884
At Risk for Huntington's Disease: God, Huntington's disease and the meaning of life. (n.d.). At Risk for Huntington's Disease. Retrieved January 7, 2011, from

18. Origins
Dr. Leroy Hood, MD, PhD and co-founder and board member of the P4 Medicine Institute is one of the most contributing characters in the development of Personalized Medicine.
He is a world-renowned biotechnology visionary and inventor whose discoveries helped changed the course of biology and revolutionized the understanding of genetics, life and human health.
He created the technological foundation for the studies of genomics and proteomics, the basis of personalized medicine, through the inventions of many instruments such as the protein sequencer, the protein synthesizer, the DNA synthesizer, the DNA sequencer and the ink-jet DNA synthesizer.
He coined the term P4 Medicine (personalized, participatory, preventive and predictive) in 2003 and stated that it would transform over the next 5 – 10 years.

19. Origins
Genomics is a branch of genetics concerning the study of the hereditary information of organisms.
Proteomics is the large-scale study of proteins, particularly their structures and functions.
Dr. Leroy Hood
2010 National Conference on Personalized Health Care. (n.d.). Welcome to the Office of Continuing Education!. Retrieved January 7, 2011, from

20. Leroy’s Inventions
His protein sequencer allowed scientists to read and analyze proteins previously inaccessible
This resulted in the characterization of a series of new proteins whose genes could then be cloned and analyzed.
These discoveries are significant as they gave a better understanding of biology, medicine, and pharmacology
N-terminal and internal protein sequencing by Edman degradation - Integriertes Forschungs- und Therapiezentrum - Medizinische Universität Innsbruck. (n.d.). Willkommen - - Medizinische Universität Innsbruck. Retrieved January 7, 2011, from

21. Leroy’s Inventions
The protein synthesizer helped further characterize proteins by analyzing their functions.
Access : Sweet revenge : Nature. Nature Publishing Group : science journals, jobs, and information. Retrieved January 7, 2011, from

22. Leroy’s Inventions
The DNA synthesizer is an instrument for genomic analysis.
It is used for DNA mapping and gene cloning.
WMD Insights. (n.d.). WMD Insights. Retrieved January 7, 2011, from

23. Leroy’s Inventions
The most notable of Dr. Hood’s inventions was the automated DNA sequencer developed in 1986.
Analysis of human genes was made possible with this machine and was the key technology that enabled the study of genomics.
High Throughput BioMEMS DNA Sequencer : Shimadzu Solutions for the Pharmaceutical Industry. (n.d.). SHIMADZU (Shimadzu Corporation). Retrieved January 7, 2011, from

24. Leroy’s Inventions
The ink-jet DNA synthesizer was made in the early 1990’s.
It was used for creating DNA arrays with tens of thousands of gene fragments.
It was one of the first DNA chips capable of measuring the levels and numbers of genes. This instrument helped transformed genomics, biology and medicine.
Technology Development at ISB. (n.d.). Technology Development at ISB. Retrieved January 7, 2011, from

25. Ethical Issues with Personalized Medicine
Brief Overview
Privacy Issues
Discrimination
Entitlement Issues
Security Issues

26. Bioethics overview
Bioethics is an applied philosophical discipline that deals with ethical issues arising in biological research and application
Involves clinical testing, medical practice, privacy and security issues in the medicinal field, etc.
Genetic Ethics is a sub division of bioethics, it covers the same ideas as bioethics though also covers the legal, social and political, cultural, and religious aspects of gene work

27. Privacy Issues
There is a serious dilemma involving privacy in the personalized medicinal world
Genetics are not personal, they are shared between blood relatives, making ones decision applicable for an entire family
It is not one persons information to give away for they would be giving away a group of peoples private, medical history
There must be consent before handing over medical information about anyone besides ones self, therefore it is technically illegal to do give ones genes to a doctor unless all relatives give consent

28. Discrimination
There is a fear that if genes are taken, then there will be a large portion of discrimination by peers, employers and insurance companies (where applicable)
If you genes say that you are a carry or are inevitably going to get a specific illness, ignorant employers will refuse to hire you, or you could be a social pariah
Medical Insurance company will make set person pay large sums for the same benefits, or simply deny set person insurance all together
Ignorance and another chance to find an enemy in each other would spawn a new type of discrimination

29. Entitlement Issues
Living in a free nation, we are given the choice and the freedom to make decisions
If one decides that he/she would rather not share their genes with anyone else, that it is theirs and they want it to remain set way, then that is part of their rights
In some nations a choice like that would not be granted, so to be fortunate enough to make it can cause people to take extreme ownership over themselves

30. Security Issues This goes hand and hand with privacy issues
Who is going to be given the rights to view this information that can explain a great deal about you? What security measures will ensure its safety?
Simply having that information out there can have horrific consequences for some people, depending on who’s hands it falls into
There are no supposed extra safeties measures being put in place for this incredibly personal and important information either

31. Economic Issues
Since personalized medicine is a new and upcoming field, the process of genomic sequencing and the cost of these new treatments are very expensive
As companies continue to recover their research and development expenses and processes become more efficient, the costs will inevitably drop.
This also has the benefit of providing countless new jobs to researchers and medical professionals in the industry.
The market for diagnostic tests and therapeutics that leverage this new science is expected to nearly double by 2015.

32. Economic Issues
An early example of a medicine that used genetic information in its design is trastuzumab, or Herceptin.
This drug is only administered if genetic testing has indicated that a patient an abundance of the protein HER2.
This suggests the presence of a form of cancer that is responsive to transtuzumab.
Once ingested, the drug tags the cells of some cancerous tumors, signaling the body to attack them.
This is a huge development over conventional methods of treating cancer such as chemotherapy, as it targets cancerous cells only and therefore does not induce side effects such as hair loss and digestive problems (The New Science of Personalized Medicine, PcW Health Industries).
However, a course of Herceptin can be very expensive, costing over $ This puts it out of reach for many potential patients who could benefit from the drug’s use.

33. Benefits
As personalized medicine can outline the long-term medical implications on patients, emphasis is placed on overall wellness rather than individual disease treatment.
Theoretically, the personalization of medicine should have enormous benefits.
It ought to make diseases, as well as their cures evident much earlier
Illnesses can be treated more through a better medicine, or be prevented all together
It can save medical costs by identifying the specific cases without the help of expensive treatment
It reduces trial-and-error treatments and ensure that the right medicine for the illness is taken
Personalized medicine could provide the path for curing cancer, by:
Showing why some people are able to fight cancers, while others aren’t
By finding out why some people get it to being with while others don’t.

34. Benefits
Prevention: Genetic coding can indicate a higher susceptibility to certain infections and viruses, allowing for preventative measures to be taken beforehand.
Diagnosis: May allow for maladies to be detected earlier than conventional methods, enabling earlier treatment. Will also be easier to diagnose if they are aware of a high chance of infection (see prevention).
Treatment: Knowledge of one’s genetic structure can allow for the development and administration of drugs and antibodies that will synergize with the patient’s body and be highly effective against the invading disease. Analyzing the effects of diseases on one’s genetic sequencing can aid in the development of medicines to combat the disease. Furthermore, precautionary actions (see prevention) may make it easier to fight against diseases, and earlier treatment (see diagnosis) may make the process easier. Finally, improved predictions can be made as to how the patient will respond to a given treatment.

35. Current Applications of Personalized Medicine
It may be decades before the full benefits of personalized medicine can be seen, so now, it’s being used for the genetic analysis of :
blood clots
colorectal cancer
breast cancer

36. Blood Clots
Before personalized medicine, a drug by the name of Warfarin was prescribed 21 million times a year
It wasn’t very safe, much of the drug lead to excessive bleeding rather than blood clots.
Since 2007 all patients using Warfarin have been recommended to use genetically modified medicine by the U.S. Food and Drug Administration
For individuals that are expected to benefit from a particular drug at a specific dosage, Genotyping allows prescription of drug therapy regimens.

37. Colorectal cancer
Metastatic colorectal cancer kills 50,000 Americans every year, more lives than are lost to breast cancer and AIDS combined. Among the drugs most frequently used in treating colon cancer is cetuximab
For colon cancer patients, the biomarker that predicts how a tumour will respond to certain drugs is a protein encoded by the KRAS gene, which can be now be determined through a simple test.
Because cetuximab is effective only in colon cancer patients with normal KRAS protein, treatment with the drug can be withheld from the 40 percent of patients for whom it would prove ineffective.
Alternative therapies can be pursued immediately instead.

38. Breast Cancer
women with breast tumours can be genetically screened to determine which receptors, if any, their tumour cells contain.
This helps determine which medicine will actually help them recover
For example, the "triple-negative" breast cancer have no estrogen, progesterone
These hormones are necessary for breast cancer therapies.
The application of personalized medicine reduces the time spent on trial-and-error methods, and reduced expenses considerably when finding the best break cancer treatment

39. Potential
Personalized medicine reduces the chances of risks and can optimize the treatment of any patient.
It can be used to minimize side effects, create a more effective strategy for a successful outcome from the medical treatment, save time and expenses, and counter diseases before they become serious.
As the studies of genomics and proteomics advance, medical specialists can classify and discover new treatments for diseases we may face in the new millennium.
Personalized medicine is currently being further developed to help cure complex diseases such as:
Diabetes
Alzheimer’s
Different types of cancer
Heart disease

40. Bibliography
2010 National Conference on Personalized Health Care. (n.d.). Welcome to the Office of Continuing Education!. Retrieved January 7, 2011, from
At Risk for Huntington's Disease: God, Huntington's disease and the meaning of life. (n.d.). At Risk for Huntington's Disease. Retrieved January 7, 2011, from
Gregor Mendel - Wikipedia, the free encyclopedia. (n.d.). Wikipedia, the free encyclopedia. Retrieved January 7, 2011, from
High Throughput BioMEMS DNA Sequencer : Shimadzu Solutions for the Pharmaceutical Industry. (n.d.). SHIMADZU (Shimadzu Corporation). Retrieved January 7, 2011, from
N-terminal and internal protein sequencing by Edman degradation - Integriertes Forschungs- und Therapiezentrum - Medizinische Universität Innsbruck. (n.d.). Willkommen - - Medizinische Universität Innsbruck. Retrieved January 7, 2011, from
Personalized Medicine - Information and Resources. (n.d.). Personalized Medicine - Information and Resources. Retrieved January 7, 2011, from
Personalized Medicine – From Theory to Practice. (n.d.). Upload & Share PowerPoint presentations and documents. Retrieved January 7, 2011, from
Technology Development at ISB. (n.d.). Technology Development at ISB. Retrieved January 7, 2011, from

41. Bibliography
WMD Insights. (n.d.). WMD Insights. Retrieved January 7, 2011, from
 subject. (n.d.). Access : Sweet revenge : Nature. Nature Publishing Group : science journals, jobs, and information. Retrieved January 7, 2011, from
Personalized medicine: Tumor analysis reveals new opportunities for existing cancer drugs. (n.d.). Science Daily: News & Articles in Science, Health, Environment & Technology. Retrieved January 7, 2011, from
traces-the-history « Personalized Medicine. (n.d.). Personalized Medicine. Retrieved January 7, 2011, from
Pharmacogenetics and pharmacogenomics: origin, sta... [Pharmacogenomics J May-Jun] - PubMed result. (n.d.). National Center for Biotechnology Information. Retrieved January 7, 2011, from
Pray, & Education , P. (n.d.). Personalized Medicine | Learn Science at Scitable. Nature Publishing Group : science journals, jobs, and information. Retrieved January 7, 2011, from
The History of Personalized Medicine : Target  Health  Global. (n.d.). Target  Health  Global. Retrieved January 7, 2011, from
Current applications of personalized medicine - The Jackson Laboratory. (n.d.). The Jackson Laboratory - Genetics & Your Health. Retrieved January 7, 2011, from

42. Bibliography
National Institutes Of Health [homepage on the Internet]. Bethesda (MD): 2010 May 14. [cited 2010 Dec. 24]. Available from:
Torrey T. About [homepage on the Internet] Aug. 13. [cited 2010 Dec. 24]. Available from:
Rugnetta M, Kramer W. science progress [homepage on the Internet] Sept. 14. [cited 2010 Dec. 27]. Available from:
Personalized Medicine [homepage on the Internet]. Copyright; n.d. [cited 2010 Dec. 27]. Available from:
Xie H G, Frueh F W. Pharmacogenomics steps towards personalized medicine [homepage on the Internet]. Nashville (TN): [cited 2010 Dec. 27]. Available from: Pharmacogenetics/ucm pdf.
Frueh F W. Personalized Medicine [homepage on the Internet]. Washington (DC): 2005 Apr. 26. [cited 2010 Dec. 27]. Available from: Pharmacogenetics/ucm pdf.
Harmsen E, Sladek R, Orr A. Bioscienceworld [homepage on the Internet]. n.d. [cited 2010 Dec. 30]. Available from: PersonalizedMedicine.
Twombly R. Georgetown/Lombardi: Comprehensive Cancer Center [homepage on the Internet] Oct. 26. [cited 2011 Jan. 1]. Available from:
BBC News [homepage on the Internet]. (UK): 2003 Apr. 14. [cited 2011 Jan. 1]. Available from:

43. Bibliography
Genetic Science Learning Center (2011, January 5) Challenges and Issues in Personalized Medicine and Pharmacogenetics. Learn.Genetics. Retrieved January 7, 2011, from
Standford University of Medicine. "Privacy issues in personalized medicine. [Pharmacogenomics. 2003] - PubMed result." National Center for Biotechnology Information. U.S. National Library of Medicine, 3 Apr Web. 7 Jan <
Standford University of, Medicine. "Privacy issues in personalized medicine. [Pharmacogenomics. 2003] - PubMed result." National Center for Biotechnology Information. U.S. National Library of Medicine, 3 Apr Web. 7 Jan <