Precision Medicine

The right drug for the right patient

Disease processes differ from person to person; the effects of drugs also vary. Individual differences between people – such as genes or age – influence not only the onset of diseases, but also how drugs are absorbed and metabolized in the body.

Researchers hope that individually customized therapies will be able to improve a patient's response rate to a chosen treatment, reduce side effects, and (under certain circumstances) shorten the treatment period – depending on the type of disease involved.

No ‘one-size-fits-all’ solution for cancer

Precisely coordinated treatment approaches are invaluable, especially in oncology. Cancer occurs in countless forms, and every tumor has different biochemical and genetic preconditions. It is therefore almost impossible to develop effective 'one-size-fits-all' treatments for cancer, as we now know. In the field of cancer therapy, the response rate to some treatments is only around 20 percent, which means that only one in five patients can be helped.

Researchers are therefore trying to find 'personalized' solutions. On the one hand, this means developing drugs that target specific types of tumor. The more precisely a drug sets its sights on the cancer cells, the more powerful is its effect on the disease and the lower the risk of side effects – a great advantage over conventional chemotherapies, which also attack healthy body tissue and subject the patient to a lot of suffering. On the other hand, the scientists want to develop specific tests that will enable them to assess – even before starting treatment – whether a drug has a good chance of success against a patient's individual form of cancer.

Using tumor markers to assess effectiveness

So-called tumor markers are often the key to a precise diagnosis and a decision in favor of certain treatment for cancer. These markers are particular characteristics of cancer cells, e.g. certain proteins on the cell surface or inside the cells, that make it possible to specifically detect tumors and measure the seriousness of the illness or the patient's response to treatment.

However, modern drugs that target specific cancers, such as therapeutic antibodies, can only be effective if a patient actually has the corresponding tumor marker. In many cases, therefore, researchers are developing an additional diagnostic procedure parallel to the actual therapeutic agent – a field where Bayer is working in close collaboration with external partners. These diagnostic tools aim to detect the tumor markers in samples of blood, tissue or DNA before the therapy begins. In this way, the patients who have a good chance of successful treatment can be identified early on. During the therapy these diagnostic markers also make it possible to directly monitor therapeutic success, i.e. they indicate whether and how well a patient is responding to the drug.

For patients without the specific tumor marker, the corresponding therapy would in all probability not be an effective weapon against cancer. The tumor-marker test can save them the burden of what would probably be an unsuccessful course of treatment, or enable an early shift to drugs that might be more promising.

Benefits for all sides

In order to foster the potential of 'personalized medicine', Bayer wants to develop its own biomarker strategy for every active substance in its development pipeline. In particular, this effort is currently being implemented in all oncology projects. Wherever the scientific possibilities allow, biomarkers are to be identified and test methods developed. The hope is that in future this will make it possible to already identify patients who are most likely to benefit from a new therapeutic approach in time for clinical trials. Bayer also plans to extend the personalized medicine approach and the parallel development of both therapies and biomarkers to cardiovascular research projects, since here too the individualized approach seems to offer good prospects of improving patient outcomes.

Experts expect 'personalized medicine' to play an increasingly important role in the future – especially since this approach creates added value for all sides in the healthcare industry. An individually customized therapy benefits not only patients, but also physicians (by making it easier to choose the right therapy), regulatory authorities (by making risk-benefit assessment more precise), and payers (because available resources can be used more efficiently by potentially reducing the number of additional or ineffective treatments).