Systems medicine, stratified medicine, personalized medicine but not precision medicine.

Abstract

For the first 5 years, the Santorini Biologie Prospective conferences were essentially geared to understanding the influence of genetic polymorphism on the variability of chronic, more specifically cardiovascular diseases. The corresponding evolutions in genomic tools were also discussed, and after 2008, pharmacogenomics became another major theme. Following the 2010 meeting, the second evolution was the creation of the European Society of Phamacogenomics and Theranostics, which is now a co-organizer. Finally, none of the major omics data now produced will be usable without a systems biology/ systems medicine approach, and this is the third evolution coming into the 2014 program with the P4 spirit of Personalized, Predictive, Preventive, Participatory medicine present everywhere, not only for patients but also, more importantly, for healthy people. “Personalized medicine is a medical model using molecular profiling technologies for tailoring the right therapeutic strategy to the right person at the right time, determining the predisposition to disease at the population level and delivering timely and stratified prevention” (World Health Organization, 2013). Stratified medicine is an intermediary situation before real personal medicine. We will discuss what is personal in personalized medicine, but in no way can we accept precision medicine. Medicine is not precise. For the clinical biochemist that I am, precision has a very specific definition in the interpretation of laboratory data including omics, i.e., proteomics data. It should be reported in any clinical trial with laboratory results! The aim of the conference is to bring together clinicians, laboratory medicine specialists, pharmacologists, hospital pharmacists, scientists from the pharmaceutical and biotechnological industries, geneticists, and epidemiologists to discuss how variability in the human genome could affect the protein expressed and the circulatory metabolites that may be helpful in the following: – Prediction of risks, particularly in multifactorial diseases: cardiovascular diseases, cancer, Alzheimer’s disease, etc. – Evaluation of environmental risks: screening individual responses to nutrition, alcohol, tobacco, exercise, and lifestyle. – Pharmacogenomics: measuring the individual response to drugs, including interactions with endogenous compounds.