Why Isn’t Medicine One Size Fits All?

In March 2022, news broke that the human genome had finally been fully sequenced. This discovery added 200 million missing base pairs to the map — DNA technology from 20 years ago couldn’t reach. Researchers don’t know yet what they’ll find in the unearthed data. But our genes have already helped us navigate so much of the world: They’re helping scientists make new biofuels, police identify suspects based on crime scene evidence, and doctors predict how people will respond to medicines on a molecular level. That tailored approach is known as precision medicine — and it could help countless people who haven’t seen relief from standard treatments. There’s a long voyage ahead to perfecting it. But now we have a map to help answer an important question:

Why isn’t medicine one size fits all?

To understand where we are with precision medicine, we first need to understand the human genome.

Howard Jacob: The genome is another way of saying a human blueprint.

Your genome is you: 3 billion base pairs of DNA that all live in your cells. If you stretched out the DNA in just one cell, it would measure about 2 meters tall — or roughly one Blackbeard the Pirate.

Even though we’re made of more than 3 billion base pairs of DNA, humans are, genetically, 99.9% identical.

But those 3 million unique pairs — just point one percent — account for things like hair color, if you’d make a good basketball player, or even the diseases we’re more likely to get.

Howard Jacob: It's the blueprint for each cell. It's the blueprint of what makes you who you are. It gives you your characteristics.

That’s Dr. Howard Jacob, Head of Genomic Research at AbbVie. Who, of course, has sequenced his own genome.

Howard Jacob: There's 50 different medications that are modified or I can't take because of my DNA. And that's kind of an important piece of information, right?

In some cases, I actually will metabolize it faster, which means my body chews it up. So the dose I take is actually not the dose that my body sees.

So how does that help a patient dealing with a complex illness?

Sunhwa Kim: When our loved ones are sick, what we want is medicine works for them, medicine delivers benefits for them, how they feel, how they function. That's precision.

Precision medicine, what that means is, tailored treatment for patients. Deeply understand disease, patient, and treatment.

We are identifying different types of biomarkers to really bring the right medicine to the right patient at the right time.

By looking at our genes and not just symptoms, we can see more than the disease in its current stage.

We hope to see where it’s going — and how to treat it.

Sunhwa Kim: Precision medicine is building our data, our knowledge, how patients are responding for medicine, how disease is responding for those medicines.

So ultimately, what we are looking for - clinical data and biomarkers beautifully assemble each other, and in the end, make one nice picture for patients.

Because in order to know how treatments will affect a huge group of people, you need a huge group of data.

The tools that make that science possible exist at AbbVie today.

Howard Jacob: One of the things I'm very excited about is we have a million genomes. And that's an amazing amount of data.

And so we have the ability now to go in and start asking questions at a large scale.

A blueprint, large number of patients that we have information on, and now having clinical trials where we can get that information. That triangulation between those gives us an amazing power to understand disease and how to build better medicines.

Let’s go back to the genome news again. A mapped genome is just the first step. The puzzle is how to use this information best.

Which goes to show: Like the ocean around us, there’s still so much to understand about our genes.

Sunhwa Kim: Science still is evolving. …

I want to be part of this journey for the patients who are not responding the existing medicines, who are partially responding, because ultimately, the lingering disease, because they are not responding fully, will drive them to the certain point where we cannot treat them anymore. So solving puzzle, it's exciting.

In other words: The more we know about ourselves, the more precise our medicine can be. And as more people share their genetic maps, the closer we get to understanding who we are.

All 3 billion base pairs of us.