The Time Is Now for the Precision Medicine Initiative
Education & Research In the U.S., life expectancy nearly doubled during the 20th century, due in large measure to biomedical research. Now, bold new research promises to revolutionize disease prevention and treatment in the 21st century and beyond.
Historically, doctors have had to make most recommendations about disease prevention and treatment based on the expected response of the average patient. This one-size-fits all approach works for some patients and some conditions, but not others. Precision medicine is an innovative approach that takes into account individual differences in genes, environments and lifestyles.
The concept of precision medicine is not exactly new; for example, blood typing has been used to guide transfusions for more than a century. However, what is new is the potential to apply precision medicine across the whole range of health and disease. Thanks to the development of more affordable DNA sequencing, the availability of better methods of assessing environmental exposure, the revolution in mobile health technologies, the emergence of computational tools for analyzing large amounts of data and other recent innovations in science and technology, we are now in an excellent position to realize this potential. The president recognized this exceptional opportunity earlier this year when he unveiled plans for the Precision Medicine Initiative.
"There is no better time than now to embark upon this bold effort to revolutionize medicine."
We believe that the time is right for the Precision Medicine Initiative and are excited to take a lead role in this multi-agency endeavor. The NIH component of this bold, new research effort will focus on cancer in the near term, and, over the longer term, build the scientific foundation needed to move precision medicine into virtually all aspects of health. Both of these goals are within our reach, thanks to decades of NIH-supported breakthroughs in basic, translational and clinical science.
Cancer research has been leading the way in precision medicine for many years. Significant strides have been made in learning the molecular signatures of many types of cancer. Still, much more remains to be done. The Precision Medicine Initiative will explore fundamental aspects of cancer biology, establish a “cancer knowledge network” to fuel scientific discovery and guide treatment decisions, and accelerate the design and testing of more precisely targeted cancer therapies, including immunotherapies. Researchers will also seek to understand the mechanisms of drug resistance, explore new combination therapies aimed at specific tumor mutations and develop non-invasive methods to track how patients respond to targeted treatments.
As a longer term goal, the Precision Medicine Initiative will launch a national research cohort of 1 million or more volunteers from all across the country. These volunteers will share their genomic information, clinical data from electronic health records, results of imaging and laboratory tests, and lifestyle data and environmental exposures tracked in real time with mobile health devices. The goal will be to expand the benefits of precision medicine into myriad aspects of health and health care.
We are deeply committed to ensuring that this component of the Precision Medicine Initiative will pioneer a new model for doing biomedical research, one in which the people who participate are true partners. That’s right—not subjects, not patients, but partners. These volunteers will be at the center of the project design and will have access to their own data, as well as research using their data, to inform their own health decisions. With proper protections in place to safeguard the volunteers’ private information, researchers from many organizations will have access to the cohort’s data so that the world’s brightest scientific and clinical minds can contribute insights that will yield new biomedical knowledge, approaches and treatments.
In order to achieve its ambitious goals, the Precision Medicine Initiative will require the involvement of many different sectors of science and society, including biologists, environmental researchers, technology developers, data scientists, ethicists, health care professionals, and, most importantly, the American people. With sufficient resources and a strong, sustained commitment of time, energy and ingenuity, I am confident that we together can realize precision medicine’s full potential to give everyone the best chance at good health. There is no better time than now to embark upon this bold effort to revolutionize medicine.