Day two of the Individualizing Medicine 2014 Conference dispelled any notion of a conference on genomics being a gathering of humorless, stuffy scientists talking about the minutiae of genetic alphabet soup. Bob Dylan and Fifty Shades of Grey, Clint Eastwood and Dr. Seuss were intermixed in with informative talks that centered on the power of pharmacogenomics, the future, and challenges of the field.
Moderator Ceci Connolly introduced the morning’s first speaker, Mayo Clinic’s Richard Weinshilboum, M.D., as “an icon in individualized medicine.” In a fun, dynamic presentation, Dr. Weinshilboum referenced Dylan, “that great poet from Hibbing, Minn.,” when setting the stage for his talk on pharmacogenomics. “‘The times they are a changin’,’” Weinshilboum said.
He took the audience through the days of pharmacogenetics, therapy given one drug at a time—“That is so yesterday”—to today’s pharmacogenomics, looking at the whole genome, and predicted a future of pharmaco-omics, in which the whole range of “omics” combine to deliver better patient care. This “therapeutic revolution” has brought us to the point where we’re scanning the genome to try to cure, even prevent diseases.
“The future is not around the corner. It’s now.”
— Richard Weinshilboum, M.D.
A representative from the pharmaceutical industry, Lon Cardon, focused his talk around four main points: pharmacogenetics, drug repositioning, target validation, and electronic medical records. Target validation was the key point of his presentation. A late-stage failure, Cardon explained, which is where most of the failures occur, can take 12 years and costs $1 billion.
“We need to do a better job earlier with better target validation,” Cardon said. He challenged the genomics community to help the industry develop better drugs faster.
— MCCIM (@MayoClinicCIM) October 7, 2014
Lawrence Lesko, a former official with the FDA, talked about the critical role drug labels play informing the health care community. Lesko highlighted some of the recent history FDA drug labeling and how recent changes have started to include appropriate genomic information. Today, Lesko contents, “The regulatory framework for PGx in labels is mature, multifaceted and more transparent with many drugs.”
With his experience directing the Vanderbilt DNA databank BioVu, a discovery resource that includes more than 175,000 samples linked to an electronic medical records (EMRs), Dan Roden talked about the role of EMRs in assisting genomic research and leading to discoveries not possible through conventional means. A leader in linking genes to diseases through EMRs, Roden elaborated on how a biobank of large data is the perfect tool to make new discoveries.
“People think this will give them answers in black or white. It’s not about black or white. It’s all about Fifty Shades of Gray.”
— Dan Roden, M.D.
The afternoon started with three breakout sessions, including a lively talk on the controversial topic of predictive genomics. A Mayo Clinic researcher, a Direct-To-Consumer advocate with 23andMe, and an academician discussed the future of predictive genomics, the needs, the pitfalls, the costs. Other breakout sessions focused on genomics in cardiovascular disease, and clinical bioinformatics.
Rebecca Nagy brought to the IM Conference audience a first-hand look at the problems and challenges facing the genomic counselor. Genetic counseling is now becoming more genomic counseling. She talked about scope, approach and process that this change is dictating. The future is changing the role of the counselor, Nagy explained, but as we work out the process, “we have to make sure there’s not a lot of collateral damage for the patient in the process.”
The afternoon ended with a look at one of the true successes of genomic medicine: The Breast Cancer Genome Guided Therapy, known at the BEAUTY Study. Mayo Clinic’s Drs. Matthew Goetz and Judy Boughey explained the successes of the project and how they’re beginning the follow-up study, BEAUTY II.
After an exciting day looking at the future and power of genomics, hearing about the challenges, and being challenged to overcome the obstacles, people left the day knowing, as Tom Petty said, “Waiting is the hardest part.”
The 2014 Individualized Medicine Conference concludes tomorrow, October 8, which promises to be a last, exciting day of taking genomic medicine from promise to practice. If you’re unable to attend, follow along on Twitter at #CIMcon14.