All for (N=)One

Coming together for individualized medicine

May 2018

Though our content is as diverse as ever, there is a distinct strand running through this month’s issue: personalized medicine. Our trio of features all touch on tailoring therapies to patients – the promise of mass spectrometry imaging (see The Inside Story), the problems posed by inconsistent sample collection and preparation (see Garbage In, Garbage Out), and working towards clinical trials with N=1 (see Clinical Chemistry).

The theme continues in the In My View section, with one doctor’s view on the problem with consumer genetic tests (see The Truth About Personal Genetic Tests), and concludes in our Sitting Down With interview with Kelly Zhang, Principal Scientist at targeted oncology pioneer Genentech (see A Driving Force).

Personalized (often known as precision or individualized) medicine has been a buzzword since the 1990s. But at the turn of the millennium, with the human genome project close to completion, we believed we were entering a new era of healthcare that tailored our treatment to our genomic makeup. With progress perhaps not quite as rapid as expected, President Obama launched his Precision Medicine Initiative in 2015, a 215 million dollar plan to collect genetic information from a million American volunteers to further advance personalized medicine. And there have been successes – last year the FDA made headlines with its approval of pembrolizumab based on a patient’s genetic markers rather than the origin of the tumor. But doctors certainly aren’t sequencing patients’ genomes on a routine basis (perhaps just as well, if we’re to avoid Content Director Rich Whitworth’s “Gattaca”-inspired vision of the future [1]).

We now know that the relationship between genes and health is not a straight line, but rather a tangled web of proteins, metabolites and environmental factors. Consequently, personalized medicine research is moving towards a deeper understanding of the proteome and metabolome – made possible by rapid advances in mass spectrometry. The work of the Maastricht MultiModal Molecular Imaging Institute (M4I) is a perfect example.

M4I also exemplifies another core value, not just of this issue, but of this publication – cross-disciplinary collaboration. Nowhere is this more important than in translational research, where so many specialties collide. As M4I’s Ron Heeren says, “Input is needed across the boundary of physics, chemistry, biology and mathematics. All of these different disciplines meet in analytical science, which is why our field lies at the base of so many great discoveries.”

Are we on the cusp of a true personalized revolution in medicine? Time will tell. But if so, close collaboration between analytical scientists and clinicians will be the bedrock on which it is built.

  1. R Whitworth, “G-A-T-T-A-C-A”, The Analytical Scientist, 37, 7 (2016). Available at: tas.txp.to/gattaca

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