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Angelina Jolie and the promise of personalized medicine

 

 

Angelina Jolie. Photo courtesy of  CNN

Carolyn Poirot
Special to the Business Press

Someday in the not too distant future, people will know all their own genetic risk factors and which diseases, disorders and disabilities they are most likely to develop – long before their first symptoms.
And their physicians will know how best to treat them – which drugs will work best against those particular diseases in those particular people at that particular time – and even how to prevent a lot of diseases, including many forms of cancer, with prophylactic drug therapy.
With genetic sequencing, the near-certain knowledge of who needs such preventive therapy could become readily available in as little as five years for a cost as low as $100, says Myron (Mike) Jacobson, dean of the University of North Texas System College of Pharmacy.
“We will be preventing BRCA breast cancers in five years,” Jacobson predicted at the Third Annual Life Sciences Symposium on May 17 at the University of North Texas Health Science Center in Fort Worth. The focus was “Improving the Quality of Life through DNA Technology.”
“That’s the promise of ‘personalized medicine,’” Jacobson said. “DNA technology has opened that door.”
The symposium was presented by the French American Chamber of Commerce and UNTHSC. It was three days after actress Angelina Jolie confirmed that she had had a double mastectomy and reconstructive surgery after genetic testing determined that she carries the BRCA 1 gene mutation, which puts women at 60 percent risk of developing breast cancer. Women overall have about a 12 percent lifetime risk of breast cancer.
Jolie said in a letter published in The New York Times that along with her family history, her doctor said the BRCA 1 gene mutation put her at 87 percent risk. With the mastectomy, her risk is now about 5 percent.
Jolie and other women at highest risk for BRCA breast cancer can greatly reduce, but not eliminate, their risk of developing breast cancer with a double mastectomy, Jacobson pointed out.
Soon – and five years is not an unrealistic timetable, Jacobson said during a break in the meetings – babies will be screened for defective BRCA genes the day they are born, before they ever leave the hospital. They will be able to take a pill for a week once a year, like a round of antibiotic treatments, to prevent breast cancer.
Other forms of cancer that are good candidates for prevention in individuals whose genetic makeup puts them at risk include melanoma, ovarian cancer, prostate cancer, testicular cancer and pancreatic cancer, Jacobsen said.
New drugs specifically targeted against such cancers are being developed along with the screening tests.
BRCA 1 and 2 are known as tumor suppressor genes because they control cell growth and repair. Most cancer results from a combination of factors including defective genes.
With full gene sequencing at birth, people can also establish their risk of ever developing Alzheimer’s disease, Huntington’s disease, bipolar disorder, drug abuse, alcoholism and other complex, adult-onset diseases as well as attention deficit disorder and autism.
Jacobson said he always reminds UNTHSC graduate students that they are earning doctor of philosophy degrees, not doctor of technology.
“We need to train more genetic counselors to give meaning to all the new data and help patients make appropriate decisions,” he said.
The $2.7 billion Human Genome Project produced the first full genomic sequencing of an individual human being in 2003.
It cost $10 million to get your genome sequenced in 2007.
As recently as five years ago, full genome sequencing of a single individual carried a price tag of $1 million. The price has been dropping dramatically ever since.
Less than two years ago, Steve Jobs reportedly paid $100,000 for sequencing to help him fight the rare form of pancreatic cancer that killed him. Earlier this year, Jolie paid “more than $3,000” according to her letter.
Today, there is competition among a dozen companies to see who can get the price down to $1,000. Several claim that they have already done just that.
And, in five years, the same extensive testing will cost $100, Jacobson and others involved in developing DNA technology predicted at the Life Sciences Symposium.
 

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