For nearly a decade, the idea of “Precision Medicine” or similar variations like “Personalized Medicine” has been touted as the penultimate achievement of the Human Genome Project. Conceptually, this makes sense: once we figured out the DNA sequence, it stood to reason that we would be able to find the mutations that cause disease and develop therapeutics targeted to those mutations. Ultimately, we could use that information to intervene beforesomeone developed a disease, through lifestyle changes, nutrition, or medicine. But 15+ years after the celebrated end of the Human Genome Project, scientists are still uncovering the secrets hidden in our DNA and in most places, Precision Medicine is still a work in progress.
However, there are a number of medical centers around the country where Precision Medicine is closer to reality and genomic profiling is standard of care for some cancers and disorders. For example, in cystic fibrosis, the drug Kalydeco (ivacaftor) works for patients who have certain mutations in the CFTRgene. In cancer, identifying if a breast cancer patient has a BRCAmutation or a lung cancer patient’s tumor has an EGFRmutation can help doctors give the patient a more accurate prognosis or identify the best medication to treat the cancer. In my book, MoneyBall Medicine: Thriving in the New Data-Driven Healthcare Market, I described new clinical trial designs that are based on a tumor’s mutation, rather than where in the body the cancer originates. These trials, called ‘basket trials’ group patients with a variety of cancer types together because they have the same genetic mutation driving their cancers.
Despite some well-publicized successes, many oncologists and other specialists are overwhelmed when it comes to integrating massive amounts of genomic data. New technologies are working to change that. Barrett Rollins understands the challenges and the promises of Precision Medicine better than most. Rollins, the Chief Scientific Officer at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School, is working to create the technological infrastructure that will support Precision Medicine. He sees a future of healthcare where genetic tests are as common as any other blood test and where genomic data is integrated into an EHR that works for the physician to identify relevant clinical trials and suggest the optimal treatment regimen for a patient, instead of the overwhelming data deluge facing providers today.
In Episode 18 of the MoneyBall MedicinePodcast, Dr. Barrett Rollins from Dana-Farber joins me as we discuss his role as the Chief Scientific Officer, where Precision Medicine is at today, and how he sees it evolving over the next several years as technologies advance. Join me for the MoneyBall Medicine Podcast!