Personalized medicine is becoming a very popular term heard amongst researchers and the scientific community. It is a more tailored approach to preventing disease that is based on an individual’s predispositions. Whichever way you put it – personalized medicine, genomic medicine, precision medicine – it is reshaping healthcare.
Dr. Richard Kim, a scientist at Lawson Health Research Institute and clinical pharmacologist at London Health Sciences Centre (LHSC), has received $4.4 million to study an expanded personalized medicine program at LHSC. One-third of the funding comes from the provincial government’s Ontario Research Fund (ORF) while the remainder is contributions from Thermo Fisher Scientific and donor funding through London Health Sciences Foundation.
Personalized medicine uses pharmacogenomics – the study of genetic changes that alter the way a person responds to individual drugs. The new funding will enable researchers to follow patient outcomes and assess the cost-effectiveness of LHSC’s personalized medicine program, providing evidence on the relationship between the cost of the program and how patient care is improved.
LHSC’s personalized medicine program involves the full integration of research into patient care and was the first in Canada to implement personalized medicine as a clinical strategy. The practice began in 2008 through Dr. Kim’s research on warfarin – a blood thinner prescribed to treat blood clots.
Adverse drug reactions in patients is a significant problem. Some drugs do not metabolize with every patient, and can even lead to toxicity. It is the fourth leading cause of death among hospitalized patients and costs the Canadian health care system over $5 billion a year.
“For every medication, there are patients who should be prescribed lower or higher than the recommended standard dose and patients who should be prescribed an entirely different medication,” explains Dr. Kim. “Personalized medicine studies a patient’s unique DNA to ensure he or she is prescribed the right dose of the right medication at the right time.”
The team’s research continues to grow since inception and is providing testing for several other drugs. For example, they can now offer testing for cancer patients that have been prescribed 5-fluorouracil – a highly toxic form of chemotherapy – but is integral in treating bowel, stomach, head, and neck cancers.
Oncologists at LHSC’s London Regional Cancer Program can now refer patients to get tested for their potential reaction to 5-fluorouracil to better predict if they may or may not have an adverse reaction. A blood sample will be taken and tested with genotyping, and a full report given to the recommending oncologist. If a patient’s predicted to react poorly with the drug, they can follow clinical guidelines to either reduce the dose or find a method of treatment.
“We want to take drugs that are shown to be beneficial and make them even safer and more effective by tailoring them to the individual,” says Kim. “By showing that medications are not ‘one size fits all,’ we can reduce toxicity, enhance outcomes and lower health care costs.”
The team will study the outcomes of any patients referred to the program, including hospital stays, emergency department visits, and physician visits. These patients will be compared to others in the province using provincial health care data from the Institute for Clinical Evaluative Sciences (ICES). The team hopes to demonstrate the cost-effectiveness of implementing personalized medicine in a large acute-care hospital in Ontario.