Personalized medicine, an incoming reality. How far are we? And why do we need it?

Isaac Asimov, Richard Fleischer and, more recently, Matt Groening, they all share a piece of an incredible trip: The Fantastic Voyage. However, if that was only a science-fiction why is it important, nowadays, to personalize the medicine? If we can choose and customize almost every aspect of our lives why shouldn’t we personalize our drugs? Moreover, how should we do it? In a world that highlights the differences between people more and more often, get special treatments for diseases according to our body could become a must-have. For example, a point mutation of the LMA gene causes progeria, but, to date, there are more than 1400 single nucleotide polymorphisms that can manifest in changes of mRNA causing progeria. According to this fact, why should we assume that only one treatment could result in the best one for progeria? Let’s look at another example. Two tissues from two different patients which are HPV-positive will give the same results at p16INK4a staining, but they are still very different tissues from very different people who can differently react to the staining as well as the drug. Moreover, there are epigenetic factors that always and continuously affect our DNA and lead to constant DNA evolution for the entire duration of our life. If specific mutations are pointing to a particular illness, not all the diseases can be correlated to a specific gene. We know only a piece of what is going on in cells and how DNA, RNA, and proteins interact to build pathways that rule cells life. Thus, having a personalized medicine would mean that we should know the exact sequence of our DNA in the exact moment we would like to treat that disease, but we cannot have a full sequence quickly and cheaply. In a sci-fi scenario, we could build synthetic cells according to the DNA of a sick patient and use them for diagnosis and, possibly, to screen all the available drugs in a much faster way than live cell culture. It will not be the right approach for every person and every disease, but it could be a good solution for some. Unfortunately, we are not there yet, but we are on the right way to do it and years of research are shortening these days. Increasing our efforts in research and building better tools model we will be soon able to test new drugs in a cells model, making better use of existing drugs and testing new medications for truly customized personal medicine approach.