Precision Medicine: Making Medicine Personal

The standard of care for treating many diseases is typically a general approach, meaning every patient gets a relatively similar treatment or path towards recovery no matter the intricacies of their individual disease. The more we learn about disease, the more we realize how truly individualized to each person they are. For example, though two people might have the same cancer, the makeup of their cancer may be entirely different and subsequently respond differently to treatment. These response variations from patient to patient can be driven by lifestyle, genetics, family history, or environment. As medicine advances, so does the effort towards precision, or personalized, medicine.

Precision medicine is the idea that disease prevention and treatment can be pursued on an individual basis – e.g., instead of being prescribed a generic cancer treatment, a patient would be prescribed a treatment for their cancer specifically (Fig. 1). Ideally, instead of a patient receiving the average chemotherapeutic drug to treat their cancer, each patient would receive a custom chemotherapy cocktail made specifically with their body and cancer in mind.

Ever hear those commercials on TV advertising drugs for “blah blah positive” or “something negative” diagnoses? This is personalized and targeted therapy. To open the door for effective personalized treatment plans,  it is imperative to understand each patient’s disease and immune system.. To do soit requires an in-depth understanding of what makes up the disease and how it differs from person to person.

Years of research have investigated the unique characteristics of diseased cells and how they may influence and respond to treatments. Other groups have developed cell therapy techniques that harvest a patient’s own immune cells, engineer them to be more effective, and then infuse them back into that patient (CAR-T cell therapy, for example). To gain these insights for individual patients, diseases must often be investigated at the cell level, which requires cell isolation, identification, and characterization. If done correctly, it is possible that cells to be studied can be isolated from a heterogenous population from a patient sample/biopsy, characterized by their response to drugs and treatments ex vivo, and identified and correlated to overall patient response.  Personalized medicine requires precision cell recovery. Moving away from the “one-size-fits-all” approach to patient care, precision medicine requires new tools to understand the disease and offer treatments as individualized as the patient. For these tools to be used clinically, the protocols must also be efficient, accurate, and relatively inexpensive to be applied to every patient.

CytoRecovery’s technology offers a powerful advantage to the field of precision medicine: the ability to isolate, characterize, and identify individual cells based on their disease aggressiveness or drug resistance. The basis of our technology is dielectrophoresis (DEP), a label-free method for isolation and characterization of cells. Interestingly, cells that are more aggressive or more resistant to therapeutics have unique bioelectric signatures that differ from other similar cells (even other disease cells!). This unique change in their electrical properties can be detected and manipulated using DEP. For example, cancer cells with differing metastatic potential behave differently in a CytoChip, meaning one can tell the difference between a cancer cell that is more aggressive than the other cancer cells in the sample! The literature indicates that cells with varying degrees of aggressiveness or drug resistance can be identified among other similar cells, characterized electrically, and isolated from a mixed sample.1-4 Specifically, the CytoR1 platform performs these capabilities even when faced with limitations such as low sample volume and cell count – positioning the technology well for complex diseases, small liquid biospies, and rare cell types. Additionally, its label-free nature is optimal for downstream analysis, such as genomic sequencing and drug toxicity studies – techniques used heavily in precision medicine efforts.

Precision medicine is an exciting endeavor at the forefront of biomedical and clinical research. Though great strides have been made, there remain limitations that our technology is poised to address. Adjusting our focus away from treating disease based on “average” outcomes and aligning our efforts towards individualized care, the more successful disease prevention and treatment may be, hopefully, bringing patients more targeted diagnosis and therapy with reduced healthcare cost burdens. Further, the earlier we can identify the anomalies from patient to patient that indicate a unique response to treatments, the better for patient care to become timely and more effective. Label-free cell identification, such as that performed by the CytoR1 Platform, poises itself as an advantageous and much-needed tool in precision medicine research.

Written by Dr. Josie Duncan, PhD

References

  1. Salmanzadeh, A., Sano, M. B., Gallo-Villanueva, R. C., Roberts, P. C., Schmelz, E. M., & Davalos, R. v. (2013). Investigating dielectric properties of different stages of syngeneic murine ovarian cancer cells. Biomicrofluidics, 7(1), 011809. https://doi.org/10.1063/1.4788921
  2. Johari, J., H bner, Y., Hull, J. C., Dale, J. W., & Hughes, M. P. (2003). Dielectrophoretic assay of bacterial resistance to antibiotics. Physics in Medicine and Biology, 48(14), N193–N198. https://doi.org/10.1088/0031-9155/48/14/401
  3. Elitas, M., Martinez-Duarte, R., Dhar, N., McKinney, J. D., & Renaud, P. (2014). Dielectrophoresis-based purification of antibiotic-treated bacterial subpopulations. Lab Chip, 14(11), 1850–1857. https://doi.org/10.1039/C4LC00109E
  4. Rane, A., Jarmoshti, J., Siddique, A.-B., Adair, S., Torres-Castro, K., Honrado, C., Bauer, T. W., & Swami, N. S. (2024). Dielectrophoretic enrichment of live chemo-resistant circulating-like pancreatic cancer cells from media of drug-treated adherent cultures of solid tumors. Lab on a Chip, 24(3), 561–571. https://doi.org/10.1039/D3LC00804E