The skeptic: What precision medicine revolution?

Vinay Prasad is relatively young (35) and still climbing the academic ladder (he’s an associate professor of medicine at Oregon Health & Sciences University in Portland), but he has already established an outsize reputation as a “professional scold” for his sharp critiques of contemporary biomedical research, including personalized medicine. In commentaries in high-profile medical and scientific journals, and in a Twitter account with some 25,000 followers, Prasad has questioned the evidence (or lack thereof) to support the use of precision oncology, the practice of selecting drugs for patients on the basis of specific mutations in their tumors. He has also criticized the inflated cost of cancer drugs and the financial conflicts of interests bedeviling contemporary research.

Prasad brings several unique perspectives to the role of medical scold. Born in Euclid, Ohio, outside Cleveland, to an immigrant couple from India, he developed an interest in philosophy in college before attending medical school at the University of Chicago. As a practicing oncologist, the prolific Prasad has generated a boatload of peer-reviewed papers, gathering evidence to suggest, among other things, that genomic-based evidence hasn’t made much of an impact on cancer patients. As a sometimes prickly online persona, he has been faulted for unleashing expletive-laden putdowns but has also attracted a robust audience for what he calls “tweetorials,” which dissect the design of high-profile studies and the data they generate. In the following conversation with veteran medical writer Stephen S. Hall, he takes aim at “precision oncology,” the gaps in direct-to-consumer genetic testing, and what it really costs to bring a new drug to market.

The full MIT Technology Review article can be viewed at this link.