Recent Basket Trial Success Points to Precision Medicine

Years ago, before entering medical school and embarking on my journey to become a full-fledged medical doctor, I had the privilege to take flying lessons. As a prerequisite, I was asked to review and have a sound comprehension of “Aeronautical Decision Making” (ADM). ADM entails what is called the “3P Model” of Perceive, Process and Perform. This mental exercise of gathering information, analyzing the information and arriving at decisions based on them, is crucial for the success of a flight. Fast forward, now, with the advent of process driven precision medicine, I cannot help but be reminded of the knowledge I had gained during my time at the flying school. I believe clinical drug development as a whole has matured to a point that to me reminds me of the process driven decision making akin to ADM.

Precision Medicine

The Clarity Challenge that was undertaken by Dr. Kohane and colleagues,

achieved through an international network of clinical research collaborators spanning several continents around the globe has successfully demonstrated to us the significance of process driven approaches in medicine. Now, with the marriage of medicine and technology, doctors are able to better “perceive” all the disparate sources of complex information and “process” them enabling them to optimally “perform” their actions. This ability to diagnose disease pathologies, in the past, was a solo exercise based on very limited information made available to doctors.  With these new generations of technology embedded in today’s world of medicine, the art of decision making for us doctors has become more refined complementing our diagnoses and care delivery. An incidental, unintended yet positive consequence of this is a new wave of path breaking doctors who are extremely comfortable in tapping into technology that was not at their disposal years ago.

Basket Trial

The recent landmark international trial that was conducted at 23 cancer centers around the world including Memorial Sloan Kettering Cancer Center, New York, and results published last month is a testament to the application of converging data and its application in precision medicine. As evidenced from the results of this trial, the ability to precisely target the oncogene (BRAF V600 mutated cancers), based on genomic data is a prime example of how far we have come along in this arduous journey of clinical drug development, all along, fine tuning the process of decision making at every step of the way. This commendable feat, achieved through a lot of medical perseverance, is indeed a proud moment in the history of drug development and will be carved out as a historical milestone in drug development. Thus, this remarkable accomplishment gives me the pleasure of reminiscing my days of flying lessons, with the hope that there is many more exciting endeavors to come on the precision medicine front for the betterment of patients.