“Our job is to deliver individualized medicine to the bedside of all our patients.” said Keith Stewart, M.B., Ch.B., to launch the fourth annual Individualizing Medicine Conference: From Promise to Practice in Rochester, Minn., home of Mayo Clinic.

“And this is the year of precision medicine, launched by President Obama in January in announcing the NIH Precision Medicine Initiative,” added Dr. Stewart, the Carlson and Nelson Endowed Director of the Mayo Clinic Center for Individualized Medicine.

For four days, from September 20–23, 2015, members of the public, clinicians, researchers, genetic counselors, and the genomics industry shared their experiences with individualized medicine — also known as precision medicine — and how it is being transitioned from the laboratory to the bedside of the patient. Precision medicine is no longer an alphabet soup of genetic code limited to the biomedical research community. It is now being used every day to improve patient care, to diagnose rare diseases, and to provide hope in the fight against some of the most difficult diseases.

Dr. Stewart believed that the 800 attendees from 31 states and 10 countries who traveled to Rochester for the conference had the knowledge, could create the technology, and provide the solutions to deliver on his belief that,

“In 20 years everyone will have opportunity to have their genome sequence,” he said.

The Hope of Individualized Medicine

The excitement was palpable when Dr. Stewart took the stage with conference moderator Cathy Wurzer, the host of Morning Edition for Minnesota Public Radio News, to establish a vision for the conference and for the future of individualized medicine.

“Individualized medicine is already providing profound changes in how we treat patients,” Dr. Stewart said. “It is offering hope to people who had no hope, it is prolonging lives, and allowing people to live better, heathier lives than ever before. Now, we need to build on these early successes so that every cancer patient, every child with a rare disease, every elderly person with Alzheimer’s disease has the opportunity to lead a rich and fulfilling life.”

Introductory Keynote Address: Dr. Gianrico Farrugia

Dr. Stewart’s predecessor as director of the Center for Individualized Medicine,  Gianrico Farrugia, M.D., now vice president at Mayo Clinic and CEO of Mayo Clinic in Florida, outlined some of the value that genomics has already brought to the practice of medicine in his introductory keynote address. Dr. Farrugia highlighted areas that can have the greatest impact on medicine today. He included:

1. Pharmacogenomics: preventing drug-related adverse effects
2. Microbiome markers to predict disease susceptibility and outcomes
3. Whole exome sequencing for undiagnosed diseases
4. “Liquid biopsies”: for cancer genome monitoring
5. Noninvasive prenatal testing for high risk pregnancy

When asked by Wurzer what the limitations are to individualized medicine, Dr. Farrugia said, “There are limits to everything. Our job is to ignore them.”

 

Day One Plenary Speakers: Drs. Patricia LoRusso and Stephen Friend

From Yale Cancer Center, Patricia LoRusso, D.O., a leading expert on drug development through clinical trials, brought over 25 years of expertise in medical oncology, drug development, and early phase clinical trial to her talk on the changing landscape of drug development in oncology.

Dr. Patricia LoRusso

“We have developed phenomenal tools,” Dr. LoRusso said. “But they’re still in their infancy. Only 3 to 5 percent of profiled cancer patients get a matched drug. Fewer than 2 percent were enrolled in clinical trials in 2012. We have to do better for our patients.

“We’re just now starting to win the war on cancer,” she added. “It’s not about curing advanced cancers: Prevention and early detection are a large part of winning that war.”

Stephen Friend, M.D., Ph.D., wrapped up the plenary session of the first day by asking the audience to rethink the paradigm for genomic research. From his Seattle-based Sage Bionetwork, he is reimagining the roles of individuals, researchers and technology in the research process.

“We encourage and support open sharing and collaboration of research data, information and knowledge,” Dr. Friend said. “This requires risk takers who aren’t satisfied with the old paradigms.”

 

Day Two Plenary Speakers: Drs. Stephen Quake, E. David Litwack and Edison Liu

Stanford University professor Stephen Quake, Ph.D., opened day two of the plenary session discussing what he calls “The Molecular Stethoscope.” Dr. Quake is applying his work in non-invasive prenatal testing for genetic birth defects to heart and lung transplant patients.

“I realized that a heart transplant is really just a genome transplant,” Dr. Quake said. “The same principles should apply to any solid organ transplant.”

Federal regulations of next generation sequencing and how it related to the president’s Precision Medicine Initiative was the topic of E. David Litwack, Ph.D., from the U.S. Food and Drug Administration (FDA). Dr. Litwack cited four barriers to President Obama’s Precision Medicine Initiative being successful:

• Studies for variants don’t have enough participants;
• Data and information are contained in silos and not shared;
• There are different interpretation from lab to lab of the same results;
• And FDA regulations for genomic testing need to be modernized.

“How do we drive innovation, be actively involved in data sharing, but also protect patients?” Dr. Litwack said. “That's our mission at the FDA. We want to work with the industry to get past these barriers.”

Systems genomics in cancer medicine was the focus of the talk by Edison Liu, M.D. At Jackson Laboratory, Dr. Liu and his team have studied genetic disruption in cancer cells. “We’ve always thought there was a driver and then passive mutations, but now we know there are driver mutations and backseat driver mutations, as well.”

Dr. Liu also called for the field to develop and train experts who can interpret a patient’s genome test—like medicine did when it trained radiologist to interpret images.

Closing Keynote Speaker: Dr. J. Craig Venter

The conference plenary session was brought to a close by genomic pioneer and occasional contrarian J. Craig Venter, Ph.D., CEO and co-founder of Human Longevity, and the first human to have his whole genome sequenced. Dr. Venter didn’t disappoint.

He announced his plans to offer clients whole exome sequencing for $250, “about the price of their monthly Comcast cable bill,” and outlined how Human Longevity is ramping up from currently offering 3,000 tests a month to 10,000 a month. Much like President Barack Obama’s Precision Medicine Initiative, Dr. Venter said he has plans to sequence one million genomes by 2020.

When moderator Cathy Wurzer asked Dr. Venter if he planned to work with the government to comingle the two databases, he answered, “Unlikely. I think this notion that you can have genome sequences from public databases is extremely naive.”

And echoing Dr. Stewart’s opening remarks, Dr. Venter closed with, "We’re about to embark on “the most exciting decade in genomics.”

In his conference recap, Alexander Parker, Ph.D., associate director of the Center for Individualized Medicine, said, “We need to keep the conversation going if we’re going to make progress in delivering better care to the patient with individualized medicine. We don't want to practice bench to bookshelf; we want to practice bench to bedside.”

Concurrent Sessions and Focus Sessions

The afternoon concurrent sessions focused on issue-specific topics in genomic research. Breakout sessions covered a range of subjects, from the role of individualized medicine in value-based care to the genomics of dementia. Other topics included bioethics, epigenomics, clinical RNA sequencing and gut microbiota. Intense discussions followed the presentation of detailed research in cancer treatment, whole exome sequencing, and the future of patients on a diagnostic odyssey. Industry representatives shared their ongoing research and latest initiatives.

The final day of the conference featured focus sessions on a wide range of topics, including functional genetic strategies for clinical diagnosis and treatment, epigenomics, metabolomics, and pharmacogenomics.

In all 125 experts from around the world came together to share their research in genomic medicine, voice their excitement and concerns, and encourage their peers and colleagues to push themselves further and faster to bring better treatment options to patients.

The conference also featured an active social media campaign, an exhibitor’s hall, and a poster session.

Making a Difference for the Patient

Caer Rohrer Vitek, conference director and CIM educator summed up the four days when she said,

“It’s exciting to see a record number of healthcare professionals from around the globe who came to learn and to share about how precision medicine is making a difference for patients right now.

“In addition to four exciting days of individualized medicine and the chance for everyone to network with people doing amazing research,” she added, “conference attendees reported that Rochester offers great hospitality, dining and socializing as well as world class health care.”

Conference Videos Coming

Speaker videos from the Individualizing Medicine Conference 2015: From Promise to Practice will be appearing soon on the conference website.

Save the Date

The Individualizing Medicine Conference 2016 is scheduled for October 5-7, 2016. You won’t want to miss it. After all, it is the time to transform medicine.

 

 

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