Precision Medicine and Complexity

摘要: The term “magic bullet” was introduced in 1900 by Paul Ehrlich who formed an idea that it could be possible to kill specific microbes (such as bacteria) cause diseases without harming the body itself – chemical specificity and his work led first antibiotic treatment of syphilis. Hope for chemically magic bullets would triumph again Precision Medicine Initiative launched 2015. It is based on dominant model carcinogenesis somatic mutation theory. a reductionist approach focused individual cell(s) while progress has been made, this narrow faced difficulties such tumor heterogeneity plasticity development cell resistance. Similar problems have observed field synthetic biology where there ‘inexplicable” failures molecular genetic devices function designed when tested vivo, i.e., new context. What missing intervention x context interaction abnormal (or synthetic) gene “intervention.” Conceptualizing cancer dynamic complex system emerges from microenvironment which embedded can help explain these observations. If correct, raises questions about possibility precision medicine other conditions well because behavior not entirely predictable. Moreover, nature systems makes moving targets sets limits degree we hope for. Understanding patient’s much should practiced physicians anything maybe more so. To truly appreciate requires heart head. This complexity patient care long humans need care, will doctors. silver or bullet continues used today sense optimism demands must recognize comes different forms vary caliber.