Making N-of-1 Medicine a Reality

The fields of personalized and precision medicine promise substantial improvements in treatment outcomes across a broad spectrum of indications ranging from oncology to infectious diseases and cardiovascular medicine. The immense potential of these disciplines has led to important advances in profiling patient genomic information to better prescribe treatment regimens, applying engineering approaches to dynamically optimize and personalize combination therapy in a continuous fashion; and tracking treatment progress using a spectrum of biomarkers. This suite of advances may collectively redefine the level of efficacy and safety that can be realized in every patient, leading to dramatic improvements in how the diseases of our generation are addressed.

Many of the key advances that will form the foundation for the widespread implementation of personalized and precision medicine are featured in this special issue of SLAS Technology. For example, in the area of diagnostics and big data, a key breakthrough in exclusion-based sample preparation for individualized lung cancer data analytics and management will play a key role in designing treatment strategies in the clinic in a patient-specific manner. ¹ In addition, high-throughput screening is being used to assess cystic fibrosis mutations, ² demonstrating the importance of genome-based analytics toward personalizing care. Another exciting development is examining the use of cell culture assays to predict drug resistance in cancer therapy, which may help improve clinical actionability when alternative regimens are required. ³ Automated flow cytometry is also being applied toward the measurement of pharmacological profiles in acute myeloid leukemia toward the potential individualization of chemotherapy. ⁴ Furthermore, multibiomarker analysis is being used for lupus nephritis monitoring, which may serve as an important readout for the accurate tracking of treatment progression. ⁵

In the area of personalized and precision therapy, this issue reports a key breakthrough using the phenotypic personalized medicine technology platform where combination therapy in acute lymphoblastic leukemia may be optimized in a continuous fashion, which could markedly improve treatment outcomes. ⁶ Optimized combination therapy and drug development are further highlighted in the area of engineering-based approaches.^7–9 In the area of liver cancer, the application of metabolic pathway inhibitors is also discussed in a review that may inspire new combination therapies to be realized using powerful strategies. ¹⁰

To chart a path for the future of personalized and precision medicine, this special issue also provides key perspectives into how these fields can adopt successful approaches from the tech industry to accelerate innovation in health care. ¹¹ Furthermore, applying new technologies and knowledge from these fields will likely challenge conventional thinking to deliver the most powerful therapies possible at a much faster pace and with unprecedented levels of efficacy and safety.

In summary, this issue highlights innovation from a cross section of the disciplines that will drive major advances in clinical personalized and precision medicine. Based on the aforementioned findings and insight, the future at the intersection of technology and medicine is bright.

As the guest editors of this special issue, we would like to congratulate the contributors for their important work, and thank them for their efforts to make the fruition of N-of-1 medicine a reality.

Guest EditorsDean Ho, PhDUniversity of California, Los AngelesLos Angeles, CA, USA Ali Zarrinpar, MD, PhDUniversity of California, Los AngelesLos Angeles, CA, USA