In the era of precision medicine, why isn't therapeutic dosing more precise? We are at worst one-size-fits-all dosing, at best trial and error adjustments.
Oncology drugs have the narrowest of therapeutic margins yet for oral oncolytics we still use trial and error dosing. Toxicities are common at the highest doses and get better as we reduce, meanwhile the patient takes the brunt of it. Pharmacogenomics is one field I think can improve upon this yet not many places are adopting this technology. AI-based doing using your “phenome” (size, weight, kidney/liver function, family hx, germline and somatic DNA etc) is where the field needs to go. If you haven’t read Lee Hood’s work I encourage you to check it out. Hopefully,
Oncology drugs have the narrowest of therapeutic margins yet for oral oncolytics we still use trial and error dosing. Toxicities are common at the highest doses and get better as we reduce, meanwhile the patient takes the brunt of it. Pharmacogenomics is one field I think can improve upon this yet not many places are adopting this technology. AI-based doing using your “phenome” (size, weight, kidney/liver function, family hx, germline and somatic DNA etc) is where the field needs to go. If you haven’t read Lee Hood’s work I encourage you to check it out. Hopefully,
progress is close by in this space.
Agreed, The Age of Scientific Wellness by Nathan Price and Lee Hood is a great primer on the concept of the phenome and P4 medicine.