Precision Medicine: When Research Gets Personal?>
Be Well

Precision Medicine: When Research Gets Personal

by John Swartzberg, M.D.  

About a decade ago, Eric Dishman, vice president of the Health and Life Sciences Group at Intel, was nearing the end of his long battle with a rare form of kidney cancer that had subjected him to 23 years of chemotherapy and radiation. While he was on what he assumed was the last business trip of his life, he had a chance encounter with a colleague familiar with the newly evolving field of genomics. The colleague suggested that his genome, as well as the DNA of his tumor, be sequenced.

The results from that sequencing saved his life. It revealed that the genetic engine driving the cancer was similar to that of pancreatic cancer, and he was put on a drug normally prescribed to treat pancreatic cancer. He remains cancer-free to this day—and is now the director of the All of Us research program within the National Institutes of Health.

The overall goal of All of Us is to advance precision medicine (formerly called personalized medicine). This approach uses genetic, environmental, and lifestyle information to tailor health care treatments to the individual. It has been credited with identifying specific genetic mutations found in tumor cells, and with the development of personalized treatments to cure those cancers.

The future of health

The All of Us initiative was announced by President Barack Obama in 2015 in his State of the Union address and was officially launched in 2018. It has a goal of enrolling at least one million people across the U.S., who will share information about their health over a period of 10 years. After providing consent, participants will fill out health surveys and agree to share their electronic health records; most will also give blood samples (to use for genome sequencing) and have their physical measurements (such as weight and blood pressure) taken.

The information will be stored in a massive database that will be made available to approved researchers, and this shared database will have the ability to feed thousands of studies. To address the general concern about data breaches that can occur with any large database, All of Us is removing all personal information from the data.

By following participants over such a long period of time, and with the help of big data analytics, All of Us researchers hope to find patterns in how genetics, lifestyle, and other factors interact in health so they can customize prevention strategies and treatments—the beginning of the end of one-size-fits-all medicine. As partners in the program, participants will be asked for their input about the research process and will have full access to their health information in the database, which they can then share with others, including their family and health care providers, if they wish.

A diverse database

All of Us is different from other large health studies that have been mostly limited to white and male research subjects. Rather, it is actively recruiting participants from populations that have been historically underrepresented in medical research—notably people of color and women, but also rural populations, the elderly, and the LGBTQ community. To build a database of participants that is representative of the diversity in America, All of Us aims to increase accessibility to the program by involving neighborhood health centers and partners such as Walgreens and Blue Cross Blue Shield Association.

If you’re interested in enrolling (at joinallofus.org), the program is open to all adults living in the U.S., regardless of health status, race, ethnicity, education, income level, or citizenship status. It’s awin-win for both participants and researchers.

This article first appeared in the UC Berkeley Wellness Letter.

Also see The Genes-Diet Connection.