Precision Delivery emerges as the third pillar of Precision Medicine

In this article, Dr. Avnesh Thakor, MD PhD from Stanford University, explores how Precision Delivery strategies can address the common challenges encountered when translating therapies from the laboratory to patient care. Many promising therapies fail to gain approval from regulatory bodies due to inadequate responses observed during clinical trials. This often stems from the methods of administration, which typically involve intravenous injections or oral intake. These conventional routes lead to widespread distribution of the therapy throughout the body, resulting in minimal amounts reaching the intended target cells. To enhance the effectiveness of therapies while minimizing side effects, Precision Delivery strategies aim to "spatially couple" therapies with target cells in vivo, allowing for more effective administration at lower doses and with reduced adverse effects.

Precision Delivery comprises three interconnected modules: (i) targeted delivery, which focuses on directly administering therapies into target tissues using techniques such as endovascular, endoluminal, percutaneous, and implantation methods; (ii) microenvironment modulation, which facilitates the movement of therapies across biological barriers and through tissue matrices; and (iii) cellular interactions, which optimize how therapies engage with target cells. While some straightforward delivery techniques are already in use, such as drug inhalation for airway diseases, injections into affected joints, and topical applications for skin disorders, advancements in bioengineering, polymer science, imaging, and additive manufacturing have led to the development of specialized medical devices and technologies. These innovations enable precise targeting and modulation of nearly any part of the human body, enhancing the ability of therapies to actively reach specific tissues. Although each module can independently improve therapy effectiveness, the synergistic benefits of combining two or even three modules still require validation through clinical studies.

The article also reviews strategies to overcome challenges associated with Precision Delivery, including technical considerations, patient variability, and access to specialized equipment. It discusses the importance of effective imaging and monitoring technologies for guiding therapy delivery and assessing outcomes, as well as the role of advanced techniques and artificial intelligence in optimizing delivery approaches. By utilizing data-driven methods, healthcare providers can tailor delivery strategies to meet the unique needs of each patient, ultimately enhancing the effectiveness of any therapy. Continuous advancements in imaging and monitoring technologies will be crucial in optimizing therapy delivery and improving patient outcomes.

Emerging therapies offer exciting opportunities but also face significant challenges in effective delivery. The integration of Precision Delivery into clinical practice has the potential to revolutionize how these therapies are administered, ensuring that patients receive the right treatment at the right location and at the right time.

See the article:

The Third Pillar of Precision Medicine — Precision Delivery

https://doi.org/10.1002/mco2.70200