Chapter 14

Personalized Medicine and Targeted Drug Delivery

Robert E. Smith

Abstract

Personalized medicine is designed for the specific genetic, epigenetics and environmental properties of the individual and their diseased cells. Eventually, new technologies will enable people to take a drop of blood from their fingertips, analyze it at home and send it to a central computer. The data will be analyzed and compared to the individual’s genome and epigenome. It may also be able to predict whether a patient will respond well to a medicine. People with different genotypes and phenotypes can metabolize drugs differently. The HIV viral genome is always changing, and resistance testing can help doctors choose the drug that will best match the virus and suppress it. The development of new biomarkers through advanced genomic, proteomic, metabolomic and imaging technologies has a very high priority because they can improve diagnosis, and define disease subsets. Clinical trials are being modernized by automating the trials and managing the data. Instead of just making the medicine specific for the DNA that a person is born with, it can also be made specific for a type of cancer. This is being done by developing monoclonal antibodies, which will bind to receptors that are specific for a particular type of cancer. Some of them are even parts of FDA-approved medications. Most can’t kill cells by themselves, but they can still bind to cancer-specific antigens and deliver drugs that are covalently attached to the monoclonal antibody. Thus, there is much research required to bind drugs to monoclonal antibodies, so that the drug only reaches the target organ.

Total Pages: 336-349 (14)

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