More Precision
for Patients

If this ideal is to be achieved, how­ev­er, a new way of think­ing about health­care is need­ed. Bergen speaks about hav­ing to devel­op a “holis­tic take on health.” This approach, which focus­es on the patient and all of their data, sounds promis­ing. The hope is to gain a pre­cise pic­ture of the indi­vid­ual effects of any given med­ical inter­ven­tion, prefer­ably before try­ing it out. “This could be done by means of a dig­i­tal copy of that per­son, which reflects their biol­o­gy, genet­ic mate­r­i­al, and other spe­cif­ic fea­tures,” she says. She would there­fore sup­port the idea of cre­at­ing “dig­i­tal twins,” an aim also defined as vision­ary by Roman Hipp, the life sci­ences expert. Accord­ing to Bergen, dig­i­tal twins would be of major ben­e­fit to both patients and physi­cians. “We could check the effects of a treat­ment before actu­al­ly apply­ing it. After­ward, we could also deter­mine how it worked.”

The approach seems rev­o­lu­tion­ary. And Bergen insists that appear­ances here do not deceive. “Per­son­al­ized med­i­cine will fun­da­men­tal­ly change the entire health­care sec­tor,” she pre­dicts. The health­care indus­try could con­ceiv­ably devel­op into a “hyper­local­ized econ­o­my” to pro­vide patients with med­ical treat­ment tai­lored to their indi­vid­ual needs. Med­ica­tions would then be pro­duced direct­ly at the point of care, sim­i­lar to how CAR T‑cell ther­a­py is con­duct­ed in part today, or to take an entire­ly dif­fer­ent exam­ple, to how providers such as Amazon’s Pill­pack operate.

These devel­op­ments are not a fore­gone con­clu­sion, how­ev­er. Health­care sys­tems need new and dif­fer­ent incen­tives to put visions such as these into prac­tice, explains Bergen. More­over, fur­ther invest­ment in inno­va­tions is need­ed to make per­son­al­ized and indi­vid­u­al­ized med­i­cine pos­si­ble in the first place. “Money alone is not enough, because the inno­va­tions are based in large part on data,” she says. “In order for us to know exact­ly what will help whom, the data have to be avail­able in dig­i­tal­ized and stan­dard­ized form.”

Bergen there­fore views cur­rent pub­lic debate on this topic as an obsta­cle to achiev­ing more pre­ci­sion-based forms of med­i­cine. “Media reports are often marked by skep­ti­cism as soon the ques­tion of health data comes up. The empha­sis here shouldn’t be on fuel­ing fear but rather on how shar­ing data can ben­e­fit patients.” The expert, who also runs a pod­cast on health­care, urges open dis­cus­sions and a new look at the topic. “When patients real­ize they’re get­ting some­thing from shar­ing their infor­ma­tion, they’re will­ing to do so. We need a pos­i­tive, future-ori­ent­ed nar­ra­tive in our soci­ety in order to clear the way for inno­va­tions in Germany.”

Boidol there­fore prefers to talk about “pre­ci­sion med­i­cine.” For him that would mean the fol­low­ing approach: “The first step is to use the lat­est tech­nol­o­gy to gain an extreme­ly pre­cise under­stand­ing of the indi­vid­ual con­di­tion, and the sec­ond is to find and offer a very pre­cise treat­ment for exact­ly that con­di­tion.” His strong empha­sis on under­stand­ing the con­di­tion is based on very sound rea­son­ing. “The mol­e­c­u­lar caus­es of an ill­ness are often underestimated—but we can only devel­op and suc­cess­ful­ly apply a pre­ci­sion treat­ment if we have thor­ough­ly under­stood the condition.”

Although Boidol may define the mat­ter in some­what tighter terms, he and many other experts agree on one thing: these new meth­ods have already led to enor­mous advances in oncol­o­gy in par­tic­u­lar. Chron­ic myeloid leukemia is one exam­ple. A spe­cif­ic genet­ic muta­tion is often a causal fac­tor in this type of leukemia. If clin­i­cal tests detect the muta­tion, a new type of med­ica­tion can be given that selec­tive­ly binds the genet­ic vari­a­tion and sup­press­es its function—with only min­i­mal side effects. As Boidol notes, “What was a death sen­tence twen­ty years ago is now a chron­ic dis­ease that can be treat­ed for ten or fif­teen years.”

Anoth­er point on which the Prox­y­gen CEO agrees with most experts is that rapid progress in pre­ci­sion med­i­cine can only be made if more data from patients become avail­able. “The data are there,” he says. “The prob­lem lies in the strict and there­fore lim­it­ing data pro­tec­tion reg­u­la­tions.” And in fact one might ask why hos­pi­tals can­not sell their data at least in anonymized form. After all, the data would be used to devel­op med­ica­tions that could help grave­ly ill indi­vid­u­als and there­by reduce suf­fer­ing. “I think that should be pos­si­ble,” he says. The key there­by is to ensure that “the focus is on what ben­e­fits patients.”

Boidol does not cur­rent­ly see an acute need for addi­tion­al mea­sures specif­i­cal­ly designed to boost these new meth­ods to a break­through. As he explains, “Many things that would advance the phar­ma­ceu­ti­cal indus­try in gen­er­al would also be help­ful from a pre­ci­sion med­ical per­spec­tive.” In his view, progress would already be served by leav­ing the pric­ing of cer­tain med­ica­tions such as antibi­otics to com­pa­nies and refrain­ing from impos­ing price caps. “The rapid and suc­cess­ful devel­op­ment of the Covid vac­cines is a good exam­ple of the level of med­ical and com­pet­i­tive ben­e­fits that pol­i­cy can have.”

Promis­ing inno­va­tions in the field of per­son­al­ized med­i­cine are expect­ed to make this pos­si­ble. “We have to get away from the ‘one pill fits all’ approach and adopt treat­ments tai­lored as close­ly as pos­si­ble to indi­vid­ual diag­noses and needs,” she says. “We have to move beyond the repair approach to sick people—which is more of an ill­ness than a health system—and estab­lish a health­care sys­tem wor­thy of the name.”

The good news is that the first steps have already been taken and we’ve entered the new world of pre­ci­sion med­i­cine. Cit­ing cur­rent infor­ma­tion from the Ger­man Asso­ci­a­tion of Research-Based Phar­ma­ceu­ti­cal Com­pa­nies (vfa), Brak­mann notes that 97 med­ica­tions autho­rized in Ger­many meet the cri­te­ria of tar­get­ed treat­ment, most of them in oncol­o­gy. Com­mon to all is a con­sid­er­a­tion of indi­vid­ual genet­ic char­ac­ter­is­tics. In other words, before one of these med­ica­tions is admin­is­tered, spe­cial­ists test the patient’s genet­ic mate­r­i­al. The bio­chem­i­cal and genet­ic pre­lim­i­nary assess­ments show which prepa­ra­tions will work well and which will prob­a­bly not. “This is a way to give the right sub­stances to the right patients at the right times,” she says.

There’s a good rea­son for why this approach is being used espe­cial­ly in oncol­o­gy. “Can­cer is a dis­ease of the genes,” says Dorothee Brak­mann. It there­fore makes sense to look for rel­e­vant genet­ic fea­tures and exam­ine them before pre­scrib­ing treat­ment. Janssen is work­ing in this area and has devel­oped numer­ous active agents for var­i­ous blood, lung, prostate, and blad­der can­cers. Pre­ci­sion med­i­cine is not restrict­ed to treat­ing can­cer, how­ev­er. As Brak­mann explains, “Oncol­o­gy has made a start, and other areas are following.”

Near­ly all the fields of research at Janssen take a per­son­al­ized approach—“with all the atten­dant prob­lems,” observes Brak­mann. One chal­lenge has to do with the con­sid­er­ably small­er patient cohorts. Par­tic­i­pants are select­ed on the basis of genet­ic fea­tures need­ed for clin­i­cal stud­ies focus­ing on ever more spe­cif­ic sub­groups of a par­tic­u­lar dis­ease. Anoth­er chal­lenge con­cerns the high costs required to devel­op med­ica­tions for only a few patients, albeit with tar­get­ed effects. “Health­care sys­tems do not com­mand end­less resources,” says Brak­mann. “We, too, are well aware of this.”

The phar­ma­ceu­ti­cal expert there­fore draws a “fine line” between three deter­min­ing fac­tors in a health sys­tem: patient access to med­ica­tion, afford­abil­i­ty, and incen­tives for research com­pa­nies to pur­sue inno­va­tions. “We need to main­tain a good level of dia­logue among every­one involved,” she says, while not­ing that’s eas­i­er said than done. “When you focus your efforts on one fac­tor in this magic tri­an­gle, you always affect the other two as well.”

While Dorothee Brak­mann attests to the good work done by reg­u­la­to­ry author­i­ties, she sees room for improve­ment in the reim­burse­ment system—including in Ger­many. “There are far too many old-school mod­els in oper­a­tion here,” she says with ref­er­ence to the exten­sive ran­dom­ized clin­i­cal stud­ies that fun­ders pre­fer. “They’re the gold stan­dard of course,” she con­cedes. “But if you’re devel­op­ing med­ica­tions for very small groups of patients, it’s very dif­fi­cult to set up that type of com­pre­hen­sive study.” To enable pre­ci­sion med­i­cine to take a quan­tum leap for­ward, adjust­ments are need­ed to the sys­tem itself—over and above the release of anonymized health data that Brak­mann and many other experts are call­ing for.

If we devote our efforts to the research part of the health­care system’s magic tri­an­gle, a clear road stretch­es on into the future—namely a future in which we stop dis­eases before they have a chance to set in. At Janssen this approach is called “dis­ease inter­cep­tion.” It func­tions sim­i­lar­ly to that for per­son­al­ized can­cer treat­ments: by iden­ti­fy­ing bio­mark­ers such as spe­cif­ic gene muta­tions that make cer­tain dis­eases more like­ly. “If you detect this type of pre­dic­tor, there’s an espe­cial­ly high like­li­hood that the dis­ease will be found in that indi­vid­ual even before any symp­toms appear. You can there­fore take coun­ter­mea­sures at an early point in time to pre­vent it from break­ing out.”

The more bio­mark­ers can be detect­ed with the help of AI-sup­port­ed analy­ses and the more anonymized patient data are made avail­able, the eas­i­er it will be for com­pa­nies to devel­op bet­ter treat­ments. Brak­mann is con­vinced we won’t have to wait too much longer. “The first treat­ments could come onto the mar­ket in four or five years,” she says. Which sounds like sci­ence fic­tion might in fact become reality.

Trained as a radi­ol­o­gist, he became CEO of Bergman Clin­ics in Ger­many in August 2022 but gave the inter­view for this arti­cle while still the med­ical direc­tor and one of five man­ag­ing direc­tors for the Askle­pios Group. The diag­nos­tic process­es he refers to are part of treat­ment strate­gies based on mol­e­c­u­lar genet­ic test­ing for tumors. And they are clear­ly lead­ing to suc­cess­ful results at Askle­pios. “By com­bin­ing con­ven­tion­al chemother­a­py with new anti­body ther­a­pies we’re able to arrest tumor growth or even reduce the size of pri­ma­ry tumors,” reports Herborn.

Although many patients are still unfa­mil­iar with this type of treat­ment, they only rarely have reser­va­tions about it, says Her­born. “The vast major­i­ty are open to the new meth­ods.” Their con­fi­dence is rein­forced by the fact that Askle­pios does not assign them to one depart­ment alone. “Can­cer med­i­cine at our clin­ics is an inter­dis­ci­pli­nary affair.” The heart of the mul­ti­dis­ci­pli­nary team is the “tumor board,” con­sist­ing of experts from oncol­o­gy, radi­ol­o­gy, pathol­o­gy, radio­ther­a­py, and surgery. “They con­fer to make the best treat­ment deci­sions for each indi­vid­ual case.”

When the expert com­mit­tee selects an indi­vid­u­al­ized treat­ment, the first ques­tion for the for­mer Askle­pios man­ag­ing direc­tor has to do with fund­ing. “Per­son­al­ized treat­ments are often very cost­ly and gen­er­al­ly not includ­ed in stan­dard med­ical cov­er­age,” he notes. He there­fore either had to either nego­ti­ate with the insur­ance com­pa­nies or pur­sue the treat­ment as part of a study. “In such cases the phar­ma­ceu­ti­cal indus­try assumes the costs.”

The professor’s empha­sis on fund­ing might raise some doubts. Does that mean only patients who are pri­vate­ly insured will receive these effec­tive but expen­sive treat­ments? Might the rise of pre­ci­sion med­i­cine even lead to two diver­gent class­es of med­ical care? Her­born, how­ev­er, sees no rea­son to fear that the inno­v­a­tive treat­ments will acquire an elit­ist char­ac­ter. “Every­thing that’s avail­able and can be offered as part of good med­ical prac­tice is in fact on offer. Noth­ing needs to be democ­ra­tized or made any more acces­si­ble than it already is,” he declares.

With the new forms of treat­ment already offered at clin­ics on a reg­u­lar basis, 
Her­born is look­ing fur­ther into the future. “Over the next ten or fif­teen years I expect the new per­son­al­ized forms of treat­ment to be applied not only in oncol­o­gy but also to other dis­eases such as car­di­o­log­i­cal and cir­cu­la­to­ry con­di­tions.” Their treat­ment cur­rent­ly focus­es on risk fac­tors from unhealthy lifestyles that lead to high blood sugar or lipid lev­els. “A good way to sup­ple­ment this approach would be to deter­mine the ideal pre­ven­tive mea­sures on the basis of car­dio­vas­cu­lar pro­files.” 

“Gen­er­al­ly speak­ing, how­ev­er, we’re now devel­op­ing treat­ments that are con­sid­er­ably more tar­get­ed and pre­cise than has ever been pos­si­ble before.” These recent devel­op­ments are what ulti­mate­ly make the dif­fer­ence for the Har­vard pro­fes­sor. “Over the short or long term, we can assume that per­son­al­ized med­i­cine will become the stan­dard treatment.”

That being said, per­son­al­iza­tion will not pro­ceed at the same pace for all dis­eases. Stern expects the near future to bring advances for can­cer in par­tic­u­lar, but also more tar­get­ed approach­es for oph­thal­mo­log­i­cal and hema­to­log­i­cal dis­or­ders. “Patients will enjoy sub­stan­tial ben­e­fits in these set­tings where their med­ica­tions will be increas­ing­ly tai­lored to their respec­tive genet­ic make­up or the muta­tions from their spe­cif­ic type of cancer.”

There are a num­ber of hur­dles to clear, how­ev­er, before many per­son­al­ized treat­ments can achieve break­throughs and become wide­ly avail­able. Ariel Dora Stern speaks of an “insti­tu­tion­al mis­match” between FDA and EMA reg­u­la­to­ry frame­work con­di­tions on the one hand and research require­ments on the other. She advo­cates for what she calls “reg­u­la­to­ry inno­va­tion,” not­ing that “Our cur­rent med­ical prod­uct reg­u­la­tions are a prod­uct of the pre­vi­ous cen­tu­ry. They sim­ply no longer reflect the needs of the next gen­er­a­tion of prod­ucts or cut­ting edge prac­tices in ther­a­peu­tic research and devel­op­ment.” A good exam­ple is the need to set up plat­form stud­ies instead of tra­di­tion­al clin­i­cal tri­als. “Plat­form stud­ies focus on the over­all clin­i­cal pic­ture,” she explains. “They let us divide groups of patients into dif­fer­ent arms of the study based on bio­mark­ers and to test dif­fer­ent med­ica­tions at the same time. Because estab­lished reg­u­la­to­ry approach­es were not designed with such stud­ies in mind, get­ting them off the ground has been a con­sid­er­able challenge—despite the fact that they offer clear advan­tages for both patients and clin­i­cal investigators.”

Ariel Dora Stern doesn’t try to down­play the con­sid­er­able time and fund­ing required to set up a plat­form study. But she also says the advan­tages far out­weigh the dis­ad­van­tages. “This type of trail isn’t over after you’ve con­duct­ed the first series of tests—the plat­form struc­ture means that mean­ing­ful research can con­tin­ue even after spe­cif­ic clin­i­cal ques­tions have been answered. This means you can keep research­ing that dis­ease in a sus­tain­able way.” In addi­tion, dif­fer­ent sta­tis­ti­cal mod­els are applied that facil­i­tate dynam­ic analy­ses and there­by yield faster and more effi­cient results in a sta­tis­ti­cal­ly rig­or­ous manner.

Reg­u­la­tions are not the only fac­tors hold­ing up these stud­ies. The orga­ni­za­tions that con­duct plat­form stud­ies are designed as open sys­tems. In other words, they aren’t just a sin­gle enter­prise but instead can con­sist of mul­ti­ple par­tic­i­pants. “This type of setup is com­pli­cat­ed, of course, when you have com­peti­tors work­ing togeth­er,” observes Stern, who also cur­rent­ly holds a guest pro­fes­sor­ship at the Dig­i­tal Health Cen­ter of the Hasso Plat­tner Insti­tute in Pots­dam. Her solu­tion: “Start­ing a non-prof­it foun­da­tion or iden­ti­fy­ing anoth­er trust­ed, inde­pen­dent third party to coor­di­nate and run the study has proved to be a good way of build­ing trust. We have seen this, for exam­ple, in the work of the Glob­al Coali­tion for Adap­tive Research (GCAR) in the Unit­ed States.” Once a plat­form study is estab­lished, its infra­struc­ture makes the entry require­ments lower than those for launch­ing a tra­di­tion­al clin­i­cal trial. “This allows small­er biotech and phar­ma­ceu­ti­cal com­pa­nies study dis­eases and pop­u­la­tions that they may not oth­er­wise have inves­ti­gat­ed, and also cre­ates incen­tives to devel­op treat­ments for rarer diseases.”

Whether and when peo­ple can ben­e­fit from per­son­al­ized med­i­cine will depend on more than the research itself. Stern notes that although the new treat­ments are often very effec­tive, they can also be very expen­sive. “Each country’s health­care sys­tem will there­fore play a key role in pro­vid­ing access to these treat­ments.” Cur­rent approach­es to fund­ing the cor­re­spond­ing med­ica­tions in the USA can look baf­fling to Ger­man eyes. “Pay­ment mod­els there range from ‘drug mort­gages’ (where expen­sive treat­ments are paid off over time) to hav­ing the amount of reim­burse­ment depend on the suc­cess of the treat­ment.” Europe will cer­tain­ly be tak­ing a dif­fer­ent approach here, although inno­v­a­tive pay­ment mod­els are already being piloted.

For Had­ji­at, these dig­i­tal bio­mark­ers pro­vide rev­o­lu­tion­ary data when it comes to track­ing the pro­gres­sion of mul­ti­ple scle­ro­sis and other neu­ro­mus­cu­lar dis­eases. With Cleo and Konec­tom, he has already launched solu­tions that make patients’ lives eas­i­er using pre­cise­ly these tech­nolo­gies. Cleo, for exam­ple, pro­vides mul­ti­ple scle­ro­sis patients with daily sup­port, infor­ma­tion, tips, symp­tom track­ing, reminders, and other cus­tomized pro­grams. The down­load data shows how high­ly patients value this app: as of 2022, Cleo has been down­loaded over 600,000 times world­wide. The Konec­tom plat­form, in con­trast, focus­es on the improve­ment of neu­ro­log­i­cal dis­ease mea­sure­ment. It uses smart­phones and wear­able sen­sors to enable a much high­er res­o­lu­tion in the way we track, mon­i­tor, and mea­sure neu­ro­log­i­cal diseases.
Konec­tom takes into account the patient’s key neu­ro­log­i­cal func­tions, from cog­ni­tion to fine and gross motor skills.

The goal of Had­ji­at and his team at BDH: to use tech­nol­o­gy to address patient needs in a goal-ori­ent­ed man­ner and drive the change toward a more patient-cen­tered and bet­ter care. Dig­i­tal bio­mark­ers play a major role in this endeav­or: they not only allow peo­ple to track and bet­ter man­age their own dis­ease but also enable their neu­rol­o­gists to mon­i­tor progress more accu­rate­ly and with high­er res­o­lu­tion from afar, all thanks to technology.

Cen­tral to such solu­tions is smart­phone sen­sor tech­nol­o­gy, which helps to con­tin­u­ous­ly gath­er rel­e­vant health data. If crit­i­cal pat­terns emerge, neu­rol­o­gists are alert­ed and can help their patients at an early stage if nec­es­sary. Accord­ing to Had­ji­at, the poten­tial of the new tech­nol­o­gy thus aris­es from obser­va­tion of con­di­tions that progress slow­ly and the pos­si­bil­i­ties of this tech­nol­o­gy to pre­dict clin­i­cal con­di­tions before they occur.

Yacine Had­ji­at is cer­tain that dig­i­tal health appli­ca­tions will soon be part of the med­ical stan­dard. But sim­ply trans­fer­ring solu­tions from the offline to the online world is not enough, he says. After all, he notes, dig­i­tal health and tech­nol­o­gy offer a much greater promise: “Through dig­i­tal health, for the first time, we have the pos­si­bil­i­ty of trans­lat­ing new tech­ni­cal capa­bil­i­ties into tan­gi­ble health solutions—that’s some­thing com­plete­ly new.” Had­ji­at notes that he will have reached his goal when the dig­i­tal health hype sub­sides, and dig­i­tal solu­tions and appli­ca­tions have become an inte­gral com­po­nent for med­ical stan­dards of care. “Or, to put it anoth­er way, when dig­i­tal health is the sta­tus quo.”

Per­son­al­ized med­i­cine is a pas­sion for Baars. In her view, it’s nei­ther a niche nor an add-on to estab­lished meth­ods of treat­ment, but rather the essence of med­ical care. It already helps many patients today, and can offer more effec­tive and less ardu­ous forms of treat­ment to those diag­nosed with can­cer and rare con­di­tions. What may sound like a break­through to many peo­ple is just the begin­ning for Baars. “We’re talk­ing about a rev­o­lu­tion here,” she says. “The tremen­dous increase in com­pu­ta­tion­al capac­i­ties and glob­al con­nec­tiv­i­ty is what will real­ly unleash the full power of per­son­al­ized medicine.”

Pre­dic­tive bioin­for­mat­ics and machine-learn­ing mod­els make it pos­si­ble to gath­er mil­lions of data points from the real world. These can be patient data, clin­i­cal data, lab­o­ra­to­ry tests, genomics or imag­ing. Com­pil­ing these data is just the first step. “Data alone can’t save a sin­gle life,” notes Baars. True med­ical progress, she adds, lies in ana­lyz­ing and learn­ing from these com­pre­hen­sive data points, detect­ing pat­terns, and mak­ing action­able insights acces­si­ble for physi­cians and patients inde­pen­dent of their geo­graph­ic loca­tion. No two can­cer patients are the same. So, no two treat­ments should be either.

The aim is not only to pro­vide more tar­get­ed treat­ments, but to redesign the health­care sys­tem to make it more intel­li­gent. “Togeth­er with Var­i­an, the lead­ing can­cer-care com­pa­ny that we acquired last year, we’re lever­ag­ing logic and arti­fi­cial intel­li­gence to build a com­pre­hen­sive oncol­o­gy ecosys­tem that trans­forms work­flows.” For exam­ple, the path from diag­no­sis to treat­ments can be accel­er­at­ed from weeks to hours. For patients, hos­pi­tal providers, and soci­ety this makes a huge dif­fer­ence. In Baars’s view, we need to move beyond the cur­rent sys­tem of “sick care” and final­ly attain actu­al “health care.” As she puts it: “We have the tech­nolo­gies and the exper­tise, but if patients don’t have access to solu­tions, then it’s miss­ing its pur­pose. The data we gath­er in the course of per­son­al­ized med­ical care will enable the shift towards early detec­tion and pre­vent peo­ple from devel­op­ing these con­di­tions in the first place.”

Per­son­al­ized med­i­cine is not mere­ly a mat­ter of refin­ing a few parts of the old sys­tem. The vision inspir­ing Baars is one of transformation—organizing life­sav­ing infor­ma­tion and mak­ing it acces­si­ble for every­one to give more patients access to per­son­al­ized treat­ments, when and where they need them.

Accord­ing to Baars, this new approach will reduce ill­ness and suffering—while also sav­ing a great deal of money. For exam­ple, many cases of can­cer today are not diag­nosed until they have reached the most advanced stage or have already spread. Suit­able treat­ments at this point are not only dif­fi­cult but also like­ly to need mul­ti­ple dif­fer­ent inter­ven­tions, increas­ing side effects for patients. This means longer hos­pi­tal stays for patients and also high­er expens­es for health­care sys­tems. “If we can diag­nose can­cer at an early stage, we can real­ly cure patients and it doesn’t cost as much,” she explains.

In order to reach patients early on, patient-sup­port­ing tools such as dig­i­tal twins and multi-dis­ci­pli­nary oncol­o­gy plat­forms will play an ever greater role. A patient dig­i­tal twin inte­grates clin­i­cal data from dis­parate sources—and turns them into a vir­tu­al rep­re­sen­ta­tion of the patient that can be used to free up physi­cians’ time and run sim­u­la­tions to reveal future health sce­nar­ios. When algo­rithms detect crit­i­cal pat­terns, the cor­re­spond­ing tools will not only alert peo­ple but also tell them where in the health­care sys­tem to go for a check-up. “Com­bin­ing a dig­i­tal twin, AI tech­nol­o­gy, and per­son­al­ized care enables us to achieve the best pos­si­ble out­comes for patients,” says Baars. This is based on the patho­log­i­cal and mol­e­c­u­lar specifics of their tumors, imag­ing char­ac­ter­is­tics, treat­ment his­to­ry, and evi­dence-based treat­ment options in dis­cus­sions with physi­cians and providers. “The chal­lenge here is to redesign our sys­tems around patients,” she says.

Here is where Baars’s argu­ments come full cir­cle. “I envi­sion a world with glob­al­ly con­nect­ed per­son­al­ized health path­ways designed to drive effi­cien­cies and deliv­er world-class treat­ment along the can­cer con­tin­u­um to increase impact where it mat­ters most: help­ing patients,” she says. The huge vol­umes of data need­ed to help patients with tai­lored treat­ments can only be gath­ered by holis­ti­cal­ly con­nect­ing patients, physi­cians, gov­ern­ments, and indus­try in a true team effort through dig­i­tal solu­tions on an inter­na­tion­al scale, she believes. In short: the bet­ter we col­lab­o­rate and the greater num­ber of peo­ple who ben­e­fit from pre­ci­sion treat­ments, the more things will improve for every­one. This, then, is also a pow­er­ful impe­tus for coun­tries with advanced health­care sys­tems to make pre­ci­sion med­i­cine acces­si­ble to every­one on the planet.

One of the key take­aways from the inter­views with experts is that med­ical infor­ma­tion and dig­i­tal­iza­tion will both play con­sid­er­ably greater roles in the con­text of per­son­al­ized med­i­cine. “We rec­om­mend that phar­ma­ceu­ti­cal and med­ical tech­nol­o­gy com­pa­nies expand their data strate­gies and invest in rel­e­vant new prod­ucts and ser­vices,” says Hipp. If this new mar­ket is to offer oppor­tu­ni­ties for devel­op­ment, trans­mis­sion of at least (semi-) anonymized data will have to be stream­lined. “It’s cru­cial to have secure data man­age­ment that also enables inno­v­a­tive break­throughs,” says Hipp. The aim here has to be a “new bal­ance” that fos­ters research and inno­va­tion to pro­mote human well-being while also pro­vid­ing the high­est degree of data pri­va­cy. As he notes, “This might not be a con­vinc­ing approach for absolute­ly every­one, but we shouldn’t over­look the fact that some inno­v­a­tive health start-ups have already left Ger­many to pur­sue research and health­care inno­va­tions in other parts of the world.”

The new meth­ods will bring fun­da­men­tal changes to the phar­ma­ceu­ti­cal indus­try. Med­ica­tions are cur­rent­ly pro­duced in large num­bers for broad groups of patients. By con­trast, pre­ci­sion med­ical approach­es require the man­u­fac­ture of indi­vid­u­al­ized med­ica­tions that address diag­nos­tic details or even inte­grate patients’ cell mate­r­i­al into the pro­duc­tion process­es. “These indi­vid­u­al­ized means of pro­duc­tion, which in some cases will sure­ly be decen­tral­ized, will place new demands on logis­tics and tech­ni­cal sys­tems that com­pa­nies will have to meet,” says Hipp. In his view, strate­gies from the auto­mo­tive industry—such as the “smart fac­to­ry” principle—can serve as guides for phar­ma­ceu­ti­cal companies.

It is by no means clear which com­pa­nies will be able to take the lead in the new field of per­son­al­ized med­i­cine. Patients will be the win­ners in any case, accord­ing to Roman Hipp. “They can expect faster and more pre­cise diag­nos­tics and more promis­ing treat­ments, includ­ing the prospect of actu­al cures.”