Creating tools to identify optimal treatments for rheumatoid arthritis and breast cancer are focuses of the 2019 Gerstner Family Career Development Awards.
This year’s awardees are Elena Myasoedova, M.D., Ph.D., a rheumatologist at Mayo Clinic’s Minnesota campus and Bhavika Patel, M.D., a radiologist at Mayo’s Arizona campus. Both researchers seek to apply data centric approaches to medical care, sparing patients unnecessary complications and providing enhanced disease treatment.
Elena Myasoedova, M.D., Ph.D.: Predicting response to rheumatoid arthritis therapy
Dr. Myasoedova, rheumatology care is a family tradition. “My grandfather
and mom were both professors of rheumatology,” she says. “This is how
I became interested in improving outcomes for rheumatoid arthritis treatment.”
arthritis is a chronic autoimmune disorder that causes irreversible joint and
organ damage. Early, effective treatment is needed to avoid severe disability
and even death. The most commonly used rheumatoid arthritis medication,
methotrexate, is ineffective in 30% to 40% of patients. Methotrexate also must
be taken for three to six months before doctors can determine if it’s working,
and — if it isn’t — try something else, which imposes a costly delay for
window of opportunity for early treatment is about three months,” Dr.
Myasoedova says. “Without timely and effective intervention, we lose a lot
of momentum in attacking the disease.”
artificial intelligence, Dr. Myasoedova is building an algorithm that can
predict an individual’s response to methotrexate. The algorithm incorporates genomic,
clinical, sociodemographic and blood test data from people with early rheumatic
arthritis who have been treated with methotrexate.
and synthesizing all this information into a model is beyond the capabilities
of a regular statistical model,” Dr. Myasoedova says. “Artificial
intelligence is able to streamline that process and create a model to predict
the likelihood of therapeutic response.”
This work, undertaken in conjunction with the Center for Individualized Medicine Pharmacogenomics Program, is a pilot project that can potentially provide a foundation for studies of emerging rheumatoid arthritis treatments, including biologics and small molecule therapies.
“Eventually, I hope we will be able to create an artificial intelligence platform where, based on the patient’s bloodwork, we can match that patient’s characteristics to the medication that would be most beneficial,” Dr. Myasoedova says.
Bhavika Patel, M.D.: Shifting the paradigm for breast cancer treatment
for early stage or locally advanced breast cancer generally involves
chemotherapy or other medical treatment, followed by surgery and additional
medical therapy. Currently there is no precise way to determine whether each
additional treatment benefits an individual patient.
some patients, presurgical treatment kills all cancer at the tumor site — so it’s
unclear what benefit the surgery provides. After surgery, however, patients
whose tissue tests cancer-free might have residual tumor DNA in their bodies and
may benefit from additional treatment.
with breast cancer are often overtreated and sometimes under-treated, due to
the lack of biomarkers that could help personalize treatment plans,” Dr.
Patel says. “In recent years, overall survival for breast cancer has
improved tremendously. But we need biomarkers to accurately identify patients
with residual disease after surgery while sparing others who can safely skip
Patel’s research team is utilizing two such biomarkers. The first is a blood
test to detect residual tumor DNA circulating in patients’ blood after breast
cancer treatment. This state-of-the- art blood test — developed in
collaboration with the University of
and TGen, a translational genomics
research institute in Phoenix — was recently described in Science Translational Medicine. The second utilizes quantitative image analysis tools
to identify patterns and metrics detectable on breast cancer patients’ contrast-enhanced
imaging studies before, during and after treatment.
“Combined with imaging and clinical assessments, measurements of circulating tumor DNA can help guide treatment strategies in individual breast cancer patients, with the use of a fusion biomarker. We can potentially change the paradigm for breast cancer treatment,” Dr. Patel says. “Ultimately, the goal is that these biomarkers can inform personalized therapies, to improve breast cancer patients’ quality of life and avoid unnecessary treatments.”
Funding for the Gerstner Family Career Development Awards in the Center for Individualized Medicine is provided by The Louis V. Gerstner, Jr. Fund at Vanguard Charitable.
The awards are given each year to early-stage investigators to advance individualized therapies. Another goal is to promote a specialized workforce capable of moving individualized medicine from discovery into patient care.
The latest advances in cancer care
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