Individualized medicine

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Type of medical treatment


Individualized medicine tailors treatment to a single patient. The term refers to an individual, truly personalized medicine that strives to treat each patient on the basis of his own individual biology.

Individualized medicine represents a further individualization of personalized medicine. While the latter is aimed at a specific group of patients, individualized medicine deals with the individual circumstances of a single person. Thus, individualized medicine goes one step further and can be considered as an increase in personalized medicine.

Individualized medicine seeks to derive tailored therapies for individuals by taking into account a person's genes as well as the full range of that person's unique nature, including biological, physiological and anatomical information.

Background

Individualized medicine was first mentioned in the literature in 2003 and described the individual drug metabolism in pharmacogenomics.<ref name="Srivastava 2003">,

 Drug metabolism and individualized medicine, 
 Curr Drug Metab, 
 
 Vol. 4(Issue: 1),
 pp. 33–44,
 DOI: 10.2174/1389200033336829,
 PMID: 12570744,</ref><ref name="Pokorska 2014">, 
 'Personalized medicine': what's in a name?, 
 Personalized Medicine, 
 
 Vol. 11(Issue: 2),
 pp. 197–210,
 DOI: 10.2217/pme.13.107,
 PMID: 29751382,</ref> Subsequently, the term was used to improve diagnosis based on genetic differences and physiological information and to better tailor the treatment to the needs of a single patient.<ref name="Hall 2003">, 
 Individualized medicine. What the genetic revolution will bring to health care in the 21st century, 
 Can Fam Physician, 
 
 Vol. 49(Issue: 1),
 pp. 12–13,
 
 PMID: 12602834,
 PMC: 2214122,</ref><ref name="Hoffmann 2011">, 
 Electronic medical records and personalized medicine, 
 Hum Genet, 
 
 Vol. 130(Issue: 1),
 pp. 33–39,
 DOI: 10.1007/s00439-011-0992-y,
 PMID: 21519832,</ref><ref name="Pokorska 2014" />

More recently, a second context has been introduced that relates to therapeutic approaches that use a person's own cell material to develop a treatment that is unique to the patient from whom the material originated.<ref name="Pokorska 2014" /> Examples are stem-cell therapies<ref name="Baker 2011">,

 Reprogramming Rx, 
 Nat Med, 
 
 Vol. 17(Issue: 3),
 pp. 241–243,
 DOI: 10.1038/nm0311-241,
 PMID: 21383713,</ref> and cancer vaccines,<ref name="Gravitz 2011">, 
 A fight for life that united a field, 
 Nature, 
 
 Vol. 478(Issue: 7368),
 pp. 163–164,
 DOI: 10.1038/478163a,
 PMID: 21993732,</ref> which are based on individually distinct molecular profiles.<ref name="Graham-Rowe 2011">, 
 Overview: Multiple lines of attack, 
 Nature, 
 
 Vol. 480(Issue: 7377),
 pp. S34–S35,
 DOI: 10.1038/480S34a,
 PMID: 22169797,</ref><ref name="Humphries 2011">, 
 Genetics: Profiling a shape-shifter, 
 Nature, 
 
 Vol. 480(Issue: 7377),
 pp. S50–S51,
 DOI: 10.1038/480S50a,
 PMID: 22169804,</ref>

Genome research

Genome research has led to new resources that allow more accurate diagnosis and disease management to be tailored to each patient.<ref name="Pokorska 2014" /> The challenge of health research is to maximize therapeutic efficacy for each patient while minimizing side effects. An individual medicine approach may be required for those patients who cannot be categorized by mainstream personalized medicine or who suffer diseases without effective drug therapies. The widespread use of advanced imaging techniques and high-throughput technologies that allow for the in-depth study of genes, proteins, and metabolites provides a better understanding of the molecular processes involved in the origin and progression of a disease.<ref name="Pokorska 2014" /> Along with other information, these data form the basis for the development of new diagnostic technologies and treatment approaches that are customized for each individual patient.

Individualized medicine in oncology

Individualized medicine is playing an increasingly important role, especially in oncology, given that cancers can be extremely heterogeneous between individual patients and within the tumor itself.<ref name="Chen 2017">,

 Elements of cancer immunity and the cancer-immune set point, 
 Nature, 
 
 Vol. 541(Issue: 7637),
 pp. 321–330,
 DOI: 10.1038/nature21349,
 PMID: 28102259,</ref> For example, individualized cancer immunotherapy with the production of vaccines tailored to match a person's individual constellation of cancer mutations, the mutanome, has become a new field of research.<ref name="Hilf 2019">, 
 Actively personalized vaccination trial for newly diagnosed glioblastoma, 
 Nature, 
 
 Vol. 565(Issue: 7738),
 pp. 240–245,
 DOI: 10.1038/s41586-018-0810-y,
 PMID: 30568303,</ref><ref name="Keskin 2019">, 
 Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial, 
 Nature, 
 
 Vol. 565(Issue: 7738),
 pp. 234–239,
 DOI: 10.1038/s41586-018-0792-9,
 PMID: 30568305,
 PMC: 6546179,</ref><ref name="Vormehr 2019">, 
 Harnessing Tumor Mutations for Truly Individualized Cancer Vaccines, 
 Annu Rev Med, 
 
 Vol. 70,
 pp. 395–407,
 DOI: 10.1146/annurev-med-042617-101816,
 PMID: 30691374,</ref><ref name="Türeci 2018">, 
 Challenges towards the realization of individualized cancer vaccines, 
 Nat Biomed Eng, 
 
 Vol. 2(Issue: 8),
 pp. 566–569,
 DOI: 10.1038/s41551-018-0266-2,
 PMID: 31015635,</ref><ref name="Sahin 2017">, 
 Personalized RNA mutanome vaccines mobilize poly-specific therapeutic immunity against cancer, 
 Nature, 
 
 Vol. 547(Issue: 7662),
 pp. 222–226,
 DOI: 10.1038/nature23003,
 PMID: 28678784,</ref><ref name="Ott 2017">, 
 An immunogenic personal neoantigen vaccine for patients with melanoma, 
 Nature, 
 
 Vol. 547(Issue: 7662),
 pp. 217–221,
 DOI: 10.1038/nature22991,
 PMID: 28678778,
 PMC: 5577644,</ref><ref name="Kranz 2016">, 
 Systemic RNA delivery to dendritic cells exploits antiviral defence for cancer immunotherapy, 
 Nature, 
 
 Vol. 534(Issue: 7607),
 pp. 396–401,
 DOI: 10.1038/nature18300,
 PMID: 27281205,</ref><ref name="Kreiter 2015">, 
 Mutant MHC class II epitopes drive therapeutic immune responses to cancer, 
 Nature, 
 
 Vol. 520(Issue: 7549),
 pp. 692–696,
 DOI: 10.1038/nature14426,
 PMID: 25901682,
 PMC: 4838069,</ref><ref name="Carreno 2015">, 
 Cancer immunotherapy. A dendritic cell vaccine increases the breadth and diversity of melanoma neoantigen-specific T cells, 
 Science, 
 
 Vol. 348(Issue: 6236),
 pp. 803–808,
 DOI: 10.1126/science.aaa3828,
 PMID: 25837513,
 PMC: 4549796,</ref><ref name="Castle 2012">, 
 Exploiting the mutanome for tumor vaccination, 
 Cancer Res, 
 
 Vol. 72(Issue: 5),
 pp. 1081–1091,
 DOI: 10.1158/0008-5472.CAN-11-3722,
 PMID: 22237626,</ref><ref name="Kreiter 2010">, 
 Intranodal vaccination with naked antigen-encoding RNA elicits potent prophylactic and therapeutic antitumoral immunity, 
 Cancer Res, 
 
 Vol. 70(Issue: 22),
 pp. 9031–9040,
 DOI: 10.1158/0008-5472.CAN-10-0699,
 PMID: 21045153,</ref> Each patient has an individual mutational signature, and only a very small portion of the mutations are shared between patients.<ref name="Kreiter 2012">, 
 Targeting the tumor mutanome for personalized vaccination therapy, 
 Oncoimmunology, 
 
 Vol. 1(Issue: 5),
 pp. 768–769,
 DOI: 10.4161/onci.19727,
 PMID: 22934277,
 PMC: 3429589,</ref><ref name="Vormehr 2019" /> The aim of individualized medicine is to optimize the treatment strategy for a single patient using genetic information as well as molecular and cellular analyzes.

References

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