How will people be recruited?
The recruitment of individuals will be voluntary. To have truly robust findings, diverse populations need to be included – young, old, male, female, white, black, Asian, Latino, and many others. A special work group has been assigned to handle recruitment.
What are the controversies and concerns raised about precision medicine?
Privacy of data is a major concern. An enormous amount of sensitive patient data will be stored in the database and accessed by researchers and clinicians. Funding is being set aside to develop programs to ensure that patient privacy is secure.
A second concern is the interoperability of EMRs. To collect all of the data and be able to evaluate and look at outcomes across one million people requires having all the data available and accessible. This is an issue that has been identified.
Why is cancer such an important focus of the Precision Medicine Initiative?
The role of genomics in cancer is well established. For example, we know that genotyping can help predict how a person will respond to melanoma treatment. There are FDA-approved treatments that are specific to the genotype of the patient. In breast cancer, genetic risks and hence treatments options can be chosen based on whether the patient has the BRCA1 or BRCA2 gene. An equally important goal is not only selecting which treatment the patient will respond to, but also which treatment will be tolerated by the patient without toxicity, and to go beyond genomics and look at other factors as well.