Wednesday, October 24, 2007
Thanks to Technology Review from MIT yesterday. I was featured on the blog as part of their news scan. I will say that I am not so skeptical of pharmacogenomics tests as the lead indicates. In fact I advocate and use some tests already. But we must use them in a non-panacea way. Directed testing is the future of personalized medicine...otherwise we are just continuing shotgun, one size medicine.
I still maintain that the Connectivity Map in Broad will usher in a revolution of genetic studies. This has also been shown by a physician in Michigan. He took incurable cancers and used gene-chip analysis.
For each patient, he first identified certain genes associated with a favorable response to anti-cancer drugs, and then determined an individualized treatment plan according to these findings.
What was the outcome?
4 of 6 patients in this limited study did better than the statistical average...From the post at TFOT
Lester and Webb's experiment is unusual because oncologists don't tend to be enthusiastic about basing their treatment decisions on gene profiling, especially when it might involve pairing drugs together in a novel combination or using varied doses, Dr. Lester said. He added that to truly help patients the most, all potentially effective drugs and combinations must be matched up against the unique genetic profile of a patient's tumor. According to Dr. Lester, this kind of polypharmacy will become more common in cancer treatment and at the moment, the best way to deal with issues of effectiveness and toxicity of drug doses is to build a database of gene expression data and match it with patient treatment results.
This is an important concept slowly demonstrating some proof. We do need larger studies and even greater tumor/tissue banks, but this is heartening. What I want to point out is that the Van Andel Institute is becoming a hot-bed for personalized medicine. This is a trend that several academic centers are following. Some notable ones include T-Gen/ASU, VAI, MSSM(sort of), Cleveland Clinic, Duke, I could go on and on...... So the question remains....Will you have to go to an academic center for personalized medicine? Even more pressing....should you?
What happens if everyone goes to the academic center? Long waits.....
How will we translate these trials? Corporate Genomics?? Thanks to Venutre Beat we see that it
look's like the investor is catching on to this plan.
Navigenics’ market is intended to be people who are healthy and affluent. Customers will be charged between $2,000 and $3,000 to have nearly a million genetic markers tested on a gene chip manufactured by Affymetrix. But Navigenics’ site won’t release all of the data collected by the chip, only the designated panel of gene tests. The company plans to offer information and telephone support from genetic counselors, and a subscription to its service will last a year. “Your DNA will be on file, and we’ll test it against new findings,” says Amy DuRoss, Navigenics’ head of policy and business affairs.
Not a bad idea to the trained eye. To the untrained and non-genomic saavy it appears as if the will hold your data like a pack of meanies....
Helix Health of Connecticut type practices? There are not enough of us to go around and staff everywhere!
The Internet?? Tele-Genetics?? Who'll pay that bill other than the taxpayers? Skype would be smart to enter this market.
The Sherpa Says: I am scared that the reluctance of Oncologists is not endemic it is epidemic of MOST physicians. Why? Is it lack of insurance reimbursement? Is it lack of education? Is it a healthy dose of skepticism? I wish I had all the answers....Obviously no one does. But wouldn't it be neat to ask MDs why? I am still awaiting that survey......