Almost everyone knows someone who has been affected by cancer. This includes President Barack Obama, whose mother died at age 52 from uterine cancer when he was only 34 years old.
It is thus fitting that in his recent State of the Union Address, Obama proposed spending $215 million in his 2016 budget to fund his new Precision Medicine Initiative. The ultimate goal of this program is as bold as it is necessary: to use advances in human genetics to develop next-generation treatments for diseases, especially cancers.
While the Precision Medicine Initiative has received widespread support, it is important to remember that this legislation builds on decades of federal support for basic research — the pursuit of knowledge without a direct application in mind — something that remains underfunded and underappreciated.
In precision medicine (better known as personalized medicine), physicians use a patient’s genetic profile to inform their treatment. This can be as simple as looking for the presence of a specific protein in a tumor or as involved as reading all 3 billion base pairs of a patient’s DNA. Armed with this information, physicians can tailor their treatments to provide more effective care. For instance, certain cancers can be treated with drugs or antibodies to inhibit mutant proteins that signal cells to divide uncontrollably.
This is in contrast to so-called “one-size-fits-all” medicine, where every patient who seems to have a similar disease receives the same general treatment. The problem with this approach is that, while diseases might seem similar between patients, they might actually have different genetic roots — which can cause them to respond differently, or not at all, to the standard treatment.
In the excitement about the lifesaving potential of personalized medicine, its humble origins are often passed over. Those who look forward to the future of personalized medicine can only do so because they are standing on the shoulders of decades of basic research in human growth and development, with all of its twists, turns and dead ends.
Although some might like to imagine a more linear approach, science is not a vending machine where time and money are exchanged for technological breakthroughs.
Only now are we beginning to translate this exploratory research into meaningful clinical outcomes. Just as federal support for basic research got us to this point, it should continue to expand in the future.
Finally, the $215 million Precision Medicine Initiative comes at a time when politicians on both sides of the aisle are clamoring to ease cuts to defense and non-defense spending imposed by the budget sequestration of 2013.
