Trillion market! Precision medical industry ushers in golden age

1 Definition of precision medicine Precision medicine is known as the future of medical treatment It is a new method of disease prevention and treatment that takes the differences of personal genes, environment and living habits into account It is a new medical concept and medical model developed on the basis of individualized medical treatment, with the rapid progress of genome sequencing technology and the cross application of biological information and big data science Its essence is to analyze, identify, verify and apply biomarkers for large sample population and specific disease types through genomic, proteomic and other advanced technologies and medical technologies, so as to accurately find the causes and treatment targets of a disease, and accurately classify different states and processes of a disease, so as to finally achieve a goal for disease and specific patients The purpose of sexual precise treatment is to improve the benefit of diagnosis, treatment and prevention of diseases 2 In 2006, the concept of precision surgery was first proposed, and then it was used in the fields of tumor radiotherapy, gynecology and other medical fields In 2015, the Ministry of science and technology held the "national precision medical strategy expert meeting" and established the China precision medical strategy expert group A total of 19 experts formed the national precision medical strategy expert committee, and planned to invest 60 billion yuan by 2030 Figure 1: at present, in the development process of precision medicine, China's gene sequencing, PCR and antibody drugs account for more than half of the companies, with a total of 1395 companies (up to 2017), mainly distributed in China's economically developed and southeast coastal areas, and the development trend of enterprises is gradually centralized Figure 2: regional distribution of precision medical enterprises in China 3 Development figure 3: gene sequencing service is the main factor driving the growth of market scale With the maturity of gene sequencing technology, the cost of gene sequencing is decreasing year by year, which will improve the penetration rate of gene sequencing services and promote the market development At present, the application of gene sequencing technology is mainly scientific research and clinical medicine The application of clinical medicine mainly focuses on reproductive health and tumor diagnosis With the improvement of market acceptance and penetration of gene diagnosis, the market space of this application direction will be further expanded From a technical point of view, gene detection mainly includes in situ hybridization (ISH), polymerase chain reaction (PCR), gene chip and gene sequencing, and its development has roughly gone through four stages The first stage is genetic disease diagnosis based on in situ hybridization in 1980s FL uorescence in situ hybridization (FISH) technology was first used in prenatal diagnosis in the United States In 1993, fish technology was allowed by the American Medical Genetics Association for prenatal auxiliary diagnosis This technique can locate and analyze abnormal genes, and is widely used in the detection of clinical chromosomal abnormalities However, due to its complex operation and high cost, its application scope is very limited The second stage is molecular diagnosis based on PCR technology, especially real-time quantitative PCR and digital PCR The technology is sensitive and easy to operate, but the flux is not high At present, PCR is widely used in the clinical diagnosis of infectious diseases, genetic diseases and tumors Real-time fluorescent quantitative PCR is the most commonly used in clinical, and the accuracy of digital PCR is high, which has become the research hotspot of PCR technology The third stage is multi index, high-throughput gene detection based on gene chip The technology has high flux, high accuracy, high sensitivity, but low flexibility At present, gene chip technology is mainly used in prenatal diagnosis, infectious diseases, genetic diseases and so on The fourth stage is based on the application of gene sequencing technology in non-invasive prenatal testing (NIPT), genetic tumor screening and tumor individualized medication guidance In 2017, Illumina launched its latest generation sequencer novaseq, which is expected to reduce the cost of human genome sequencing from $100 million to $100 At present, the third generation gene sequencing technology, represented by single molecule sequencing and nanopore sequencing, is being applied In addition to gene sequencing technology, targeted therapy is also an important part of precision medicine, including molecular targeted drugs, antibody drugs, cell immunotherapy, stem cell therapy, etc., especially in the tumor market The development of precision medicine in China will benefit more than 10-20 million cancer patients every year The market space of personalized drug guidance for cancer alone will exceed 100 billion yuan, regardless of early prevention diagnosis and back-end drug development 4 The development trend high-throughput sequencing has great value in the future application of tumor immunotherapy On the one hand, gene detection based on ngs can predict the efficacy of immunosuppressive drugs such as PD1 in patients by detecting the corresponding indicators, study the drug resistance and super progress in the treatment process, and evaluate the prognosis On the other hand, the gene detection kit based on ngs has been put on the market continuously, which further expands the clinical application of gene detection, and its technology can cooperate with immunocytotherapy and personalized tumor vaccine to achieve real individualized treatment In general, the progress of precision medicine has brought about a number of major discoveries and new treatment methods based on the specific characteristics of individual tumor gene files These theories provide medical professionals with the information needed to determine the best treatment option Along with the progress of genomics technology, these information will be further mined, and promote the choice of preventive health care measures and life style of people who may suffer from a certain disease from a genetic perspective.