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Precision medicine, genomics, and the promise of personalized care


Dinesh Kotak, MD

Kaiser Permanente delivers personalized care to meet the unique needs of each patient because a one-size-fits-all approach does not work for everyone. Care teams consider a person’s goals, preferences, and lifestyle, as well as their medical condition and overall health to design effective treatment plans. 

But what if we could customize a treatment plan down to a person’s unique DNA?  

With precision medicine — a rapidly evolving approach to care that uses an immense amount of data and information to tailor prevention, diagnosis, and treatment — we are beginning to do today what was unthinkable just five or 10 years ago.

Related precision medicine story: Precision medicine and physician advocacy: 4 ways doctors can influence public policy – Permanente Medicine 

It might sound like science fiction, but precision medicine’s highly personalized insights are an exciting opportunity to reevaluate traditional approaches to care. This is especially true for more intensive treatments like cancer care, which can have severe side effects. Not all cancers that present in the same areas of the body are identical. Some have genetic mutations that necessitate different treatments. When a physician knows more about the genetic mutation of the cancer they are targeting and the genetic makeup of the person they are treating, they can design a more precise treatment plan.  

Related precision medicine and genomics story: Genetic counseling: An integrated approach at Kaiser Permanente  

Precision medicine in action 

We’ve seen some remarkable results using precision medicine. I recently spoke with a patient with widespread metastatic cancer who needed to use a wheelchair for mobility. Within just a few days of beginning treatment tailored to their specific cancerous mutation, they were able to walk on their own. In my experience, it’s not uncommon for a person to improve dramatically within a short time of beginning their new treatment plan.  

Related AI article: Kaiser Permanente sponsors real-world demonstrations of AI, machine learning in health care – Permanente Medicine 

Precision medicine has great potential for the prevention, diagnosis, and treatment of cancer, but we still have much to learn and overcome. Genomic tests are expensive, costing thousands of dollars, and it can take up to 2 weeks minimum to obtain results. Given the price tag, limited tissue availability, and longer turnaround time, choosing the right test the first time and administering when best indicated is crucial. Additionally, a test of tumor tissue can yield information on more than 600 genes across a several hundred-page report, requiring time-consuming review from physicians and care teams, including genetic counselors, to determine the next step. 

Augmented intelligence — the use of artificial intelligence tools to support physician decision-making — can help reduce costs and time spent by helping to translate genomic testing results into actionable insights. Pairing precision medicine with other predictive and interpretive technologies is paving the way for future innovations, and I’m looking forward to seeing where these efforts will lead us. I encourage you to share your thoughts on precision oncology below.  

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