AI CORNER: NYT TABERY OP ED, PMC REBUTTAL

 

By CHAT GPT3.5

Editorial: A Revolution Is Coming to Medicine. Who Will It Leave Out?

The editorial by James Tabery highlights the promises and challenges of personalized medicine, focusing on the case of his father's battle with lung cancer. Tabery emphasizes the potential of personalized medicine, which tailors treatments based on molecular-genetic information, to revolutionize healthcare. He discusses the hope that this approach could improve treatment efficacy, reduce waste, and address health disparities, especially through research involving marginalized communities.

Tabery recounts how his father's cancer, with its specific molecular marker, made him a candidate for the personalized medicine drug erlotinib. The drug initially yielded positive results, shrinking tumors and offering hope. However, Tabery raises concerns about the cost of such treatments, pointing out that the process of carving patient populations into smaller subgroups for personalized medicine increases drug prices due to smaller user pools.

While personalized medicine holds promise for diseases with clear genetic mechanisms, Tabery argues that for common and complex conditions like hypertension, diabetes, and asthma, where a single gene doesn't cause the disease, the potential for a revolution benefiting most patients is limited. He underscores the importance of focusing on preventive measures to improve health outcomes for everyone, particularly addressing health disparities along racial and economic lines.

In conclusion, Tabery advocates for a shift from genetic-focused personalized medicine to addressing shared environmental factors for improving health on a larger scale.

Rebuttal: Understanding the Case for Personalized Medicine

In the rebuttal by PMC President Edward Abrahams, the author counters Tabery's arguments by asserting that the landscape of personalized medicine has evolved significantly since the time of Tabery's father's illness. Abrahams challenges the notion that Tabery's father's case is representative of today's potential benefits from personalized medicine, citing the development of over 200 additional personalized medicines that extend life and reduce cancer deaths.

Abrahams acknowledges the high costs associated with personalized medicines but highlights their potential to recoup research and development expenses and eventually reduce overall healthcare costs. He argues against forsaking the efficiency of personalized medicine for trial-and-error approaches, which can be wasteful and lead to prolonged suffering for patients.

Regarding Tabery's suggestion of focusing on shared environments, Abrahams asserts that personalized medicine and public health efforts are not mutually exclusive. He emphasizes the partnership between the two, contributing to the decline in lung cancer deaths through early detection, targeted therapies, and smoking cessation.

The rebuttal closes by highlighting that the author's own family experience with cancer, in a pre-genomic medicine era, underscores the importance of embracing the advances brought about by personalized medicine today.

Response: Both the editorial and the rebuttal provide valuable perspectives on the topic of personalized medicine. Tabery's editorial raises valid concerns about the costs associated with personalized medicine and the challenges of applying it to complex diseases. His emphasis on addressing shared environmental factors to improve overall health is a thought-provoking perspective. On the other hand, Abrahams' rebuttal highlights the progress made in personalized medicine and its potential to save lives, reduce healthcare costs, and complement public health efforts. The notion that personalized medicine and public health are not mutually exclusive is an important one, as both approaches can contribute to better health outcomes.

The debate underscores the need for a balanced approach to personalized medicine, acknowledging both its potential benefits and its limitations. It also highlights the importance of ongoing research and policy discussions to ensure that personalized medicine is accessible and affordable to a broader population while addressing health disparities. Ultimately, the convergence of personalized medicine and public health efforts could lead to a more comprehensive and effective healthcare system.