Precision Medicine: Between Self-Tracking and Tailored Therapies

That enthusiasm for individualized approaches is not a new phenomenon is underscored by the research landscape. As early as the 1990s, individual researchers pursued such ideas before the technical possibilities matured. In 2015, then-US President Barack Obama launched a Precision Medicine Initiative, which further accelerated the field with substantial funding.

In oncology, the approach has already left visible marks. For a long time, cancer was regarded primarily as an organ disease: colon, lung, or prostate cancer were named after their site of origin and treated uniformly with surgery, radiation, and chemotherapy. Already in the 20th century, a finer classification began, for example when microscopic slides separated small-cell from non-small-cell lung cancer and Hodgkin from non-Hodgkin lymphomas. Cell biology methods later made it possible to distinguish forms of breast cancer whose growth is driven by the hormone estrogen.

Cancer: From Organ Finding to Molecular Profile

Today, according to information from oncology, more than a dozen variants of lung cancer are known that can be distinguished by specific driver mutations—genetic alterations that transform healthy cells into cancer cells. Stefan Fröhling, head of the Department of Translational Medical Oncology at the National Center for Tumor Diseases (NCT) in Heidelberg, sees clear progress in diagnostics and therapy over recent decades, particularly through genetic methods. "Depending on what the biological profiling of the disease reveals, you can select your medications and no longer proceed with a one-size-fits-all chemotherapy," says Fröhling.

Differentiation is also growing in metabolic diseases. Diabetes, classically divided only into type 1 and type 2, can now be classified—based on new analyses—into five subtypes using combinations of diabetes genes and clinical symptoms. Michael Roden, who conducts research at the German Diabetes Center at the University of Düsseldorf, sees this as an opportunity to tailor therapy more precisely. At the same time, he warns: "Unfortunately, the evidence is still quite poor there," when it comes to what treatment for the individual subtypes should specifically look like. Today, more than 100 different diabetes genes are known, each of which explains only a small part of individual risk.

Diabetes and Cystic Fibrosis: Genes as Guides

In monogenic diseases, the genetic lever is more direct. Cystic fibrosis, for example, arises from a defect in the CFTR gene, which produces thick mucus and primarily damages the lungs and intestines. Around 2,000 different mutations in the CFTR gene are known and are divided into six classes, each requiring different therapies. Cardiovascular and metabolic diseases, meanwhile, are shaped by lifestyle and more complex genetic patterns, making it harder to translate genetic findings directly into therapies.

A radical example of self-tracking comes from Michael Snyder, director of the Center for Genetics and Precision Medicine at Stanford University near San Francisco. Snyder, who according to available information is 71 years old, has been getting whole-body MRI scans every six months for more than 15 years and regularly provides blood, stool, and urine samples. Through multi-omics analysis, he simultaneously monitors his genome, transcriptome, proteome, metabolome, and microbiome—summarized as the "Snyderome." For continuous data collection, Snyder wears four smartwatches and two smart rings that record his body functions.

Self-Tracking on One's Own Body

Snyder draws a fundamental conclusion from his data: "Modern medicine is broken." Doctors, he says, often check only a few blood values and base therapies on population averages. "They try this and that and see what sticks," he criticizes of the usual approach. His counterpoint: "Yet we are all individuals. We respond differently to medications, environmental influences, and pathogens," says Snyder.

In Heidelberg, despite all skepticism, Fröhling sees the potential to treat far more precisely in the future—but on the basis of solid clinical studies. Personalized oncology, in his assessment, could then avoid some of the burdens of standard chemotherapies. For the diabetes field, Roden emphasizes that the step from genetic differentiation to a robust therapy recommendation is still pending, as meaningful studies are lacking.

The trend toward individualization is also making its way into obesity therapy. Katharina Timper, director of Clinical Nutritional Medicine at TUM Klinikum Rechts der Isar, states the goal clearly: "Individualized obesity therapy is the future," says Timper. The Association of Research-Based Pharmaceutical Companies (vfa), according to available information, speaks of more than 70 additional obesity drugs currently being researched worldwide.

In weight loss, GLP-1 preparations such as semaglutide have come to the fore in recent years. They mimic the gut hormone "glucagon-like peptide-1," which dampens hunger and appetite and enhances the feeling of satiety. Semaglutide as an active ingredient is approved by the EU Commission in tablet form as Wegovy, making it Europe's first oral therapy with this active ingredient for weight control. In clinical trials, adults with obesity or overweight taking oral semaglutide reduced their weight by an average of about 14 percent after 64 weeks, provided they simultaneously followed a calorie-reduced diet and exercised more. The Wegovy injection achieved weight reduction of up to 19 percent over 72 weeks, depending on the study.

Obesity: Tablet Instead of Injection

The injectable active ingredient is administered once weekly, and the timing relative to meals does not matter. The tablet, by contrast, must be taken daily according to precise rules: in the morning on an empty stomach, with a little water, and afterward no eating, drinking, or other medications for at least 30 minutes. The reason: if semaglutide is swallowed unprotected, stomach acid and enzymes break down the active ingredient and render it ineffective. The tablet therefore contains a special excipient that buffers acid, reduces enzymatic breakdown, and facilitates absorption through the stomach lining.

In April 2026, orforglipron was approved in the United States under the trade name Foundayo—a GLP-1 tablet with a different chemical structure that does not require strict intake rules. Jens Aberle, an endocrinologist at the University Medical Center Hamburg-Eppendorf who himself participated in the orforglipron study, points out that 90 percent of those surveyed would prefer to take medications as a tablet rather than an injection. An injection with the active ingredient retatrutide, which acts on three hormone receptors simultaneously, achieved an average weight loss of more than 30 percent after two years at the highest dose, according to the manufacturer. Approval is expected in 2027.

Wegovy in tablet form is approved exclusively for adults; the injection is already approved from age 12. The medication is indicated from a body mass index of 30—that is, for obesity—or from a BMI of 27 when weight-related comorbidities such as high blood pressure, type 2 diabetes, or sleep apnea are present. Common side effects are gastrointestinal complaints such as nausea, diarrhea, constipation, or vomiting. Less frequently, gall bladder problems or inflammation of the pancreas may occur. Aberle also warns that the use of these substances—whether tablet or injection—must always be medically indicated and supervised by a physician. Wegovy remains, even in tablet form, a prescription medication for a chronic disease and not a quick trick to shed a few kilos.

That data alone do not yet constitute therapy also applies to another example from the facts: archaeology and medicine meet in ancient Egyptian Dahshur. A research team led by bioarchaeologist Zeinab Hashesh from the University of Beni Suef examined the mortal remains of six members of the royal family who lived approximately between 1850 and 1700 BCE, including four royal sisters, another princess, and a king. The mummies were long considered lost until they were rediscovered in 2020 in the basement of the Egyptian Museum in Cairo. The study was published in the journal Frontiers in Environmental Archaeology.

The analysis revealed a hard life: signs of infections and malnutrition, with five of the six individuals showing various malformations of the spine. In Princess Ita, for example, the researchers diagnosed spina bifida occulta in the sacral region. The research group interprets the accumulation of developmental disorders as a possible indication of close parental kinship. Ita likely died between the ages of 28 and 34, her sister Khenmet in her late 30s or at 40, and the younger Itaweret between 20 and 34. Further tests, such as isotope analyses, are planned to allow more precise statements about the malnutrition of those affected.

Looking Back: Illness and Health in Ancient Egypt

The finds also shed new light on the role of women at court. Princess Ita's sarcophagus contained jewelry but also a club, a whip, and an ornate dagger with gold, carnelian, and lapis lazuli. Ita also showed pronounced muscle attachment sites on her upper body, indicating regular use of weapons such as clubs or daggers. Weapons are an unusual grave good in women's burials, and even with queens they are usually interpreted