Individualizing Medicine 2014: From Promise to Practice, was held in October in Rochester, focusing on how to translate the promise of genomic medicine into practice. Expert speakers, focused breakout sessions, real-life case studies and a poster session provided attendees with many opportunities to discover and discuss emerging topics in applied genomics. Speakers covered a range of medical subjects, from cancer and rare diseases to cardiovascular medicine and obstetrics.

A few speakers below took time to answer some questions about how genomics is already transforming care at Mayo Clinic and what the future holds for this exciting field:

 

Implementation of Drug-Gene Rules
Kelly Wix, Pharm.D., Pharmacy Services

Q: How will individualized medicine change the way you care for patients?

A: The more patient-specific information we have, the better we can weigh all of the options and provide the best treatment and care plan for that patient.

Q: What excites you about individualized medicine?

A: The ability to consider potential genetic interactions along with drug-drug interactions and organ function when determining and tailoring medication regimens is very exciting.

Q: What does individualized medicine mean for the future of Mayo Clinic?

A: Individualized medicine will contribute to keeping Mayo Clinic as one of the best care facilities in the world.

Q: When will we start to see the benefits of individualized medicine?

A: Genetic information is currently being utilized at Mayo Clinic, when available, to assist in care and treatment decisions.

Q: What do patients need to know about individualized medicine?

A: A patient’s genetic information is yet another weapon in the care arsenal [that] can be used to ensure safe and effective treatment.

 

 

Breast Cancer Genome Guided Therapy (BEAUTY) Study: Development of a New Model for Individualizing Breast Cancer Treatment
Judy Boughey, M.D., Surgery

Q: How will individualized medicine change the way you care for patients?

A: Individualized medicine will allow us to treat each patient differently, like each patient is a separate unique entity. Just as each patient has different personalities and different attributes, different stressors and different support systems, each person is unique in the type/extent of disease they develop, how it presents, how they respond to medications, which side effects they do and do not develop and the disease outcome with treatment. This moves us away from a one-size-fits-all treatment approach to a tailored approach that is the best for the patient.

Q: What excites you about individualized medicine?

A: It is truly a critical step in the right direction as medicine evolves. Knowing that a drug or a treatment works for this particular patient rather than on average it works for most patients with this disease will allow us to deliver better care to patients every day.

Q: What does individualized medicine mean for the future of Mayo Clinic?

A: Patient care will be more complex, vary from patient to patient and be less textbook medicine.

Q: When will we start to see the benefits of individualized medicine?

A: We are already seeing the benefits.

Q: What do patients need to know about individualized medicine?

A: Patients should understand that the focus of these advancements is to advance their care. It will improve their treatment options and hopefully increase the success of therapy and decrease the side effects of therapy and also potentially avoid overtreatment.

 

 

BEAUTY Study: Development of a New Model for Individualizing Breast Cancer Treatment
Matthew Goetz, M.D., Medical Oncology

Q: How will individualized medicine change the way you care for patients?

A: Oncologists have been practicing individualized medicine in breast cancer for some years based on well-conducted studies that identified that the estrogen receptor (ER) and HER2 were critical to achieving drug responses to hormonal based therapies and anti-HER2 based treatments, respectively. However, there has been an explosion of information that has allowed us to identify many previously unknown genomic and proteomic markers that alter drug response phenotypes. The hard part is determining which of these markers will pass the test for both analytical and clinical utility.

Q: What excites you about individualized medicine?

A: The most exciting part of individualized medicine is the ability to select the best drugs to optimize cancer treatment and reduce side effects. We also can prioritize the development of new drugs in subsets of patients resistant to standard drugs. It is critical to note that, in oncology, individualized medicine is not just based on somatic alterations, but based on both inherited (host) and somatic (tumor) variation. Therefore, a comprehensive approach is critical to achieving “individualization.”

Q: What does individualized medicine as a whole mean for the future of Mayo Clinic?

A: Individualized medicine fits exactly into the motto of the Mayo brothers who stated: “The needs of the patient come first.” If the needs of our patients truly do come first, then we will do everything possible to deliver “the right drug, at the right dose, at the right time.”

Q: When will we start to see the benefits of individualized medicine?

A: There already are numerous examples where specific drugs have been approved that work only a specific target. However, there is much hard work to be done, which will require resources, large teams of experts across many disciplines, and an unwavering dedication to achieve this goal.

 

Participation in clinical studies is imperative to implementing individualized medicine safely and effectively. Individualized care only comes about through well-conducted studies that result in validated biomarkers demonstrating analytical and clinical utility. It is critical that drug therapies are not delivered based on a test that has not demonstrated analytical and clinical utility. To do this correctly, will require carefully conducted prospective studies, such as the “BEAUTY Study,” wherein large teams work seamlessly back and forth between the bedside and bench.

 

 

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