Targeted Therapy: It's All About Me

Reported May 04, 2010

NEW YORK, N.Y. (Ivanhoe Newswire) -- You know the routine, go to the doctor and get medication to treat the problem. But not everybody reacts the same way. What if the prescription was designed specifically for you? It's the idea behind what some doctors call a medical revolution, personalized medicine.

We don't all look the same. So should our medical treatment all be the same? What if doctors targeted treatment specifically to your body?

"The whole focus of where medicine is going in the next 10 years is to personalize therapy," Peter Heeger, M.D., professor of medicine director of transplant research, at Mount Sinai School of Medicine, in New York told Ivanhoe.

The anti-clotting drug Plavix is the second-biggest selling drug in the United States -- used to prevent heart attacks. Studies show it might not be effective in up to 14 percent of people because they don't have the right gene to activate the drug.

"Currently, it's recommended you give a single dose to everybody whether they're 7 feet tall, 4 feet tall, female or male, big or small,” Matthew Price, M.D.,
Director at the Cardiac Catheterization Laboratory at Scripps Clinic in La Jolla, CA said.

Scripps health is the first in the country to offer routine genetic testing for patients who need the drug after undergoing stent procedures.

"It's simply a saliva test or a blood test,” Price explained.

Results tell them who should get the drug, what dosage and who's wasting time and money.

"I believe personalized medicine is now reaching the point where we can use it in daily clinical practice," Price said.

The next target is the lungs.

"I was on oxygen around the clock, 24/7," Barbara McKean said.

Barbara McKean has COPD -- the fourth leading cause of death in the United States.

"The last medical therapy that improved outcomes was oxygen that was introduced in 1980," Steven Shapiro, M.D., chairman of the department of medicine at the University of Pittsburgh School of Medicine said.

At the University of Pittsburgh, freezers are packed with lung tissue. Researchers pull out genetic material from each sample and load it on a chip. This machine analyzes each lung sample.

The info will help doctors determine who is going to remain stable, who is going to get worse and who will respond to therapy.

"In a sense, personalized medicine would allow us to tell you should you be worried and what kind of action should be taken," Naftali Kaminski, M.D.,
director of Simmons Center for interstitial lung disease, at the University of Pittsburgh School of Medicine said.

Next up is targeting transplants.

"You're right at that threshold where you're going to welcome death or you're going to welcome another life," Dennis Manchester explained.

Dennis Manchester had two liver transplants. He takes 30 pills a day to prevent another rejection. With all these meds come side effects.

"Headaches … tremors … nausea …,” Manchester recalled.

Researchers say about 40 percent of transplant patients get more meds than they actually need.

"For the first three months, it's this. For the next six months, it's this. It's the same for everybody," Barbara Murphy, M.D., professor of medicine and nephrology,
Chief of the Renal Division at Mount Sinai School of Medicine in New York explained.

Doctors at Mount Sinai School of Medicine are creating a personalized treatment plan for 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.

"What I'd really like to know is am I treating you correctly,” Heeger said. “And can I take the drugs away from you that could cause injury, and can I do that safely?"

"For somebody to get a new organ and only take one or two pills, that'd be fantastic," Manchester said.

Some call it "me" medicine -- a personalized approach that's sweeping the country. Proving one size does not fit all.

Recently, the FDA added a black box warning -- its strongest alert -- to bottles of Plavix. It warns that in patients with previous heart attacks or who have had stent procedures, those who have two bad copies of the gene that is required to activate Plavix are at a higher risk of having a heart attack. There are alternatives to Plavix, including Effient, but the American Heart Association urges patients to consult with their doctor before switching their meds.

FOR MORE INFORMATION, CONTACT:

Mount Sinai Organ Transplant Services
New York, NY
(800) MD-SINAI (637-4624)