Patients hold key to prescribing

Molecular medicine: Researchers are working towards more accurate prescribing and reduced side effects from medicines by developing a better understanding of the molecular differences between patients.

Also known as "personalised medicine", molecular medicine research aims to allow clinicians to stratify patients on the basis of their molecular profile, delegates at the conference, BioConnect Ireland, which was held in Dublin last week, were told.

Molecular medicine uses the underlying mechanics of a disease to decide on the best treatment.

"This allows us to treat different groups of people with similar disease in different ways," says Dr Pierre Meulien, chief executive of the Dublin Molecular Medicine Centre (DMMC) said.

Dr Meulien said personalised medicine would bring benefits for patients and clinicians and would remove a lot of the guesswork from prescribing.

"The data from a patient's molecular profile can drive the clinical intervention because depending on the profile we will intervene in different ways," he said.

Dr Meulien presented a paper to delegates at the conference on this subject last week.

He used a Dublin-based prostate cancer research consortium as an example of the structure for molecular medicine research.

"The prostate cancer research is an example of a major project, involving 35 clinicians and scientists across the city, working together."

The consortium is looking for more accurate ways to treat prostate cancer based on the patient's molecular make-up.

The DMMC was established in 2002 to aid this kind of multi-institutional research.

The DMMC is a molecular medicine research partnership between the University College Dublin (UCD), Trinity College Dublin (TCD) and The Royal College of Surgeons in Ireland (RCSI).

The centre also has links with the major hospitals and has provided some of the infrastructure required for large-scale research projects.

However, Dr Meulien cautioned patients not to misinterpret the term personalised medicine as "an individualised treatment for each and every patient that comes through the door".

"Those things just won't happen and that is where an awful lot of the hype about personalised medicine comes in.

"What will happen is that researchers will start to understand more about the molecular basis for diseases, such as what makes cancer cells different.

"We will also better understand why some patients with breast cancer for example respond well to treatment while others do not. Then we can decide on the best form of treatment," said Dr Meulien.

Andrew Lyall a director at Surgen, a pharmacogenomics research firm wholly owned by the Royal College of Surgeons (RCSI) said that rather than tailored treatments for the individual, personalised medicine was based on a far more detailed molecular diagnosis.

He said some of the bigger disease classes such as heart disease or cancer affect so many people in such different ways is "not sensible to consider them as a single disease."

He said pharmacogenetics aimed to help clinicians avoid the two biggest problems with medicines; that they are ineffective or that they have an undesirable side effect.