Precision Medicine: A game changer for brain and mental health

Cancer patients benefit from advances in precision medicine, but a personalised approach to treating neurological disease such as Alzheimer’s is in its relative infancy. Neuroimmunologist Maria-Teresa Ferretti explains why it’s important to invest in precision medicine to improve brain health for all.

According to the US National Institutes of Health: precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. It will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. It is in contrast to a one-size-fits-all approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for individual differences.

The advantages of a precision medicine approach from a patient perspective became crystal clear when I had to face breast cancer 18 months ago

The advantages of a precision medicine approach from a patient perspective became crystal clear when I had to face breast cancer 18 months ago. It took exactly one week for me to have the first diagnosis, two weeks to have the molecular characterization of my tumour and a consequent therapeutic decision, and a grand total of six months for the surgery and the start of radio plus hormonal therapy. Using a predictive algorithm based on a panel of genetic markers, chemo was deemed unnecessary, sparing me from months of suffering.

For me as a patient, precision medicine meant an exact diagnosis in two weeks, a clear therapeutic path tailored to my specific tumour, and avoiding unnecessary treatment that could have been more harmful than beneficial.

The pivot required in healthcare has been spelled out by Dr. Antonella Santuccione Chadha, co-founder and CEO of the Women’s Brain Project (WBP): “Precision medicine will be achieved in brain and mental health when the word differences is replaced by the term characteristics, with sex and gender as the starting point.”

International Forum of the Women’s Brain Project

The topic of this year’s forum is: The Gateway to Precision Medicine Across our LifespanExternal link. The Forum webcast takes place on September 19 – 20.

Composed largely of scientists, the WBP advocates for and conducts research on sex and gender sensitive precision medicine, from basic science to novel technologies. The WBP is an international non-profit organisation based in Switzerland.

swissinfo.ch is a media partner of the WBP.

These are benefits that we must provide to neurological patients, who currently wait up to three years for a diagnosis and are often treated with drugs that are not effective and are accompanied by many side effects.

We now know that patients are extremely heterogeneous, and their differences are key to developing an accurate diagnosis alongside an optimal treatment. For example, two patients with the same symptom – let’s say dementia – might have two completely different underlying scientific causes, or pathologies.

The value of giving the right treatment to the right patient at the right time, reducing the personal suffering of the patient and his/her family, cannot be overstated. This approach also ensures a dramatic reduction on public and socioeconomic costs, which for dementia alone are estimated at $1 trillion for 2020.

Precision medicine tools must be optimized and scaled for large use in the general population – the classical example is a blood biomarker (a molecule that can be detected in the blood, and that indicates an underlying disease) in Alzheimer Disease (AD) patients. This would allow mass-screening of thousands of patients, as opposed to the current PET scan and cerebrospinal fluid (CSF) analysis. It would require the implementation of safe storage systems for personal data. Finally, validated algorithms should be made available to the larger community, and become an integral part of a neurologist’s toolkit. 

Ten to 20 years ago, breast cancer patients were all treated with chemotherapy. Some benefitted, some did not and succumbed to terrible side effects. It took years to learn that the same symptom can be caused by a variety of lesions, with specific molecular and genetic makeup, which also had an impact on the specific response to treatment.

Precision medicine promises to solve all this.

We need to advocate, publish papers, and introduce precision medicine into the curriculum of healthcare providers. This could be achieved through a cross-pollination from different disciplines (e.g. learning from oncology) where the precision medicine approach is much more advanced and tends to be applied.

This is also part of the work we do at the Women’s Brain Project (WBP) – we raise awareness and carry out research on the heterogeneity of patients, starting from sex and gender differences. We believe that differences in disease presentation between men and women, which are increasingly recognized by the medical community, are the gateway to precision medicine.

That is the theme of our International Forum on Women’s Brain and Mental Health 2020, taking place virtually on September 19-20. With speakers from medicine, research, policy, and patients, we will explore sex and gender differences in brain and mental health across the lifespan.

My hope is for neurology to be in 10 years where oncology is today, and that’s why one of WBP’s goals is to create a Sex and Gender Precision Medicine Institute in Switzerland.

Maria Teresa Ferretti

Maria Teresa is a neuroimmunologist and science advocate with 10+ years of international experience in the field of Alzheimer’s Disease. In her research, she works to identify novel biomarkers to increase individual-level prediction of cognitive decline and Alzheimer’s.

In 2016, Maria Teresa co-founded the Women’s Brain Project (WBP). With over 20 peer-reviewed papers co-authored in leading journals including Nature, Maria Teresa’s work is often covered by the national and international press and presented at scientific conferences and policymaker meetings. She is also a TED-x speaker and very active in science communication via social media. Maria Teresa has received several academic awards, prizes and grants, including a research grant from the Synapsis Foundation (Swiss Alzheimer Association).

The views expressed in this article are solely those of the author, and do not necessarily reflect the views of swissinfo.ch.