Precision medical treatments also bring the possibility of better equity in medical care. Generally speaking, medicines are developed, recommended, and prescribed based on how well they work for the average patient. However, thanks to certain biases in the American clinical research field, “average” tends to mean “white and male.”
American cancer drug trials, for example, generally include far more men than women, with breast cancer drug trials being the exception. For example, while women make up nearly half of lung cancer diagnoses, they make up less than a third of lung cancer clinical trial participants.
The problem with this disparity is that medications, in general, affect female bodies and male bodies differently. A drug that seems successful in clinical trials may only truly be successful in treating men, but doctors will still prescribe that medication to female patients who won’t see the same results. Likewise, a supposedly “unsuccessful” clinical trial may actually produce excellent results in majority female groups, and the bias toward male bodies may prevent women from receiving treatments that can work well for them.
Sex isn’t the only factor involved in clinical trial disparities. American clinical trials also lack representation among racial minorities. One ProPublica analysis found that clinical trials for cancer treatments often have little representation of Black patients, even when the cancer being studied disproportionately impacts Black people over other racial groups.
ProPublica gives the example of Ninlaro, a drug for the treatment of multiple myeloma. The drug was approved after a successful clinical trial. However, that clinical trial had a glaring issue:
One out of five people diagnosed with multiple myeloma in the U.S. is black, and African Americans are more than twice as likely as white Americans to be diagnosed with the blood cancer. Yet of the 722 participants in the trial, only 13 — or 1.8 percent — were black.
The study did not, therefore, examine whether Ninlaro may impact Black patients differently than white patients.
Just like sex-based underrepresentation, racial underrepresentation can keep some patients from getting the treatment that will work best for them. Overall, this “one-size-fits-all” approach to medicine doesn’t always work. The medical field needs more varied clinical studies to gain a more accurate perspective, and those variations should include the aforementioned factors as well as other underrepresented factors, like disability and sexual orientation.
Precision medicine may someday put an end to the “one size fits all” approach to healthcare. By taking genetic factors into account, it can provide more accurate predictions about which treatments will work best for specific patients. This approach will help doctors find the right treatments for their patients more quickly, and it will save many patients from the frustration of the “trial and error” method.