PILC 2011 Wrap-Up

Another Pittsburgh Lung Conference has come and gone, and once again, it’s been a huge success! On October 28 and 29, thirty-six speakers across eight scientific sessions came together to usher in a new era in personalized lung care. With an incredible 358 participants in attendance from all around the world, this year’s conference truly marked a breakthrough in the discussion and advancement of personalized medicine in lung disease. The conference was also one of great personal successes: in a poster ceremony, nine winners were selected from the fifty-five submitted entries, and two researchers received a judges’ award and a peer award.

Those who responded to exit questionnaires indicated strong satisfaction with the event. They particularly appreciated the distinguished speakers, the thematically-related sessions, the compelling discussions, and the immediate applicability of the knowledge they gained. This was not a conference of theory and speculation; participants were able to walk away with ideas they could use directly in their practice.  The vast majority agreed that their general medical knowledge and public health awareness had strongly improved as a result of the lessons they learnt at PILC 2011.

The PILC 2011 organizers would like to thank everyone who participated in this landmark event. This will be the final post for this blog, but it’s clear that the personalized medicine dialogue is only just beginning. We can look forward to a future where the ideas discussed at PILC 2011 have found widespread implementation.

Meet the Conference Co-Chairs

The 2011 Pittsburgh International Lung Conference Co-Chairs, Mark T. Gladwin, MD, and Naftali Kaminski, MD, discuss this year’s conference.

Personalized Medicine In The News

For years now, medical experts have advised our policy makers and enforcers to allocate funds and resources to the advancement of personalized medicine. And they seem to be listening: the FDA, for example, has recently listed “innovation in clinical evaluations and personalized medicine” as one of the top priorities of its new regulatory plan. But to what has all this talk amounted? Are the FDA and other government institutions actually, physically promoting this critical field?

The short answer is yes. Just last week, the FDA approved vemurafenib and an accompanying diagnostic test for the treatment of advanced melanoma. The drug only works for patients who have V600E mutations in the BRAF gene, so its introduction into medical practice indicates a deeper focus on the personalized healthcare. Meanwhile, the National Human Genome Research Institute has awarded 3 million dollars to the Mayo Clinic for the production of technology that will assess their patients’ genetic risk for heart attacks. The NHGRI has also granted 3.4 million dollars to Mount Sinai School of Medicine to develop genetic records of patients and determine their susceptibility to various diseases; it’s the largest study yet of personalized medicine in a clinical setting.

This is all part of a larger, four-year eMERGE initiative, backed by $25 million from the NHGRI and the NIH, to begin applying personal genomic information to personal treatment. The eMERGE network, consisting of seven institutions across the United States, has already identified genetic variants associated with conditions like dementia and diabetes, and it will examine the genetic foundations of 40 more diseases before it’s through. What’s more, the network will look into the concrete implementation of the results, working to ensure privacy protection for patients and dispel public concerns.

The efforts of the eMERGE network and similar research are vital to the translation of personalized care into a practical context for the common hospital. We must remember that the territory is still new, and like any new science, hurdles of expense, ethics, and education stand in the way of widespread adoption. Hopefully, as the government recognizes the role personalized healthcare has carved into the future, they will help the rest of society recognize in turn.

The End of One-Size-Fits-All

During this summer’s Lindau Meeting, an international summit of the world’s most renowned and polished minds, it was personalized medicine that stole the show. Nobel Laureates and “the world’s best young scientists of tomorrow[1]” discussed the revolutionizing implications that personalized medicine could have on healthcare.  While the bulk of PM news stories discuss the potential for personalized drug therapies and cures, Aaron Ciechanover, a Nobel Laureate in the field of chemistry, feels that the real advancements will come in the form of preventative medicine.

Ciechanover suggests that genetic profiles and an understanding of epigenetic modifications will shed light on the susceptibility to certain diseases. Knowing the likelihood of contracting a disease will encourage doctors and patients to work together to develop diet and lifestyle habits that may prevent the disease altogether. Unfortunately, this “crystal ball” use of personalized medicine is far from becoming mainstream, according to Ceichanover.  This effective concept of medicine and research is inherently expensive and is likely to be met with resistance in a country plagued by a fear of law suits.

However, there are signs that the “one size fits all” concept is being reconsidered in favor of the tailored feel of personalized medicine.  Dr. Floyd Russak of Denver, CO recently decided to shift his practice from primary care to personalized medicine. Doing so will prevent him from tending to 75% of his current patients and will require the remaining 25% to pay $1500 more annually.  However, he believes that 90 minute appointments, more personal contact, and the ability to make next-day appointments will increase the quality of the care he is able to provide.  The American Cancer Society is also receiving pressure from findings in personalized medicine that challenge the current mammogram guidelines for women. Dr. Steven Cummings, author of the recent Annals of Internal Medicine study on mammograms, suggests that breast density, not age or time, is the best indicator for mammogram frequency.

The day when everyone will have the means to obtain their genetic profiles and reap the benefits of personalized medicine may be far into the future. But, as Dr. Diana Petitti of Arizona State University Points out, “The model of one-size-fits-all… is an artifact of the past.”

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[1] http://www.lindau-nobel.org/AboutUs.AxCMS?ActiveID=1014

The Personalized Medicine Revolution

In 2000, researchers discovered that patients reacted differently to albuterol, a drug that relaxes muscles to treat asthmatic wheezing, depending on the makeup of their DNA. Of the four patterns that commonly occur in the β₂-adrenergic receptor gene, the drug worked very well with one, moderately well with two, and not at all with the last. These researchers hoped that, one day, “they [would] be able to match individual patients to different medications, using their DNA as guidance to improve the drugs’ effectiveness and to eliminate harmful side effects.”

Eleven years later, the human genome has been sequenced, governmental and private institutions have launched hundreds of personal healthcare initiatives, and scientists are closer than ever to developing treatment and prevention strategies tailor-made for the patient. That’s the essence of personalized medicine: medicine that responds to and predicts the needs of the individual, not the statistic. Clinicians are starting to realize that the one-size-fits-all approach to treatment just doesn’t work in a gene pool as diverse as the human population’s. They’re looking to a future where a genetic analysis of each patient means more effective medication for everyone. Imagine a hospital that can forever eschew trial-and-error drug therapy because they know exactly which drugs will work for whom with minimal side effects. Imagine a patient who can change his lifestyle to avoid a disease for which his genetics place him at risk. We’re already getting there, folks—it’s just a matter of time and research.

The proponents are rallying. Advocacy groups have fought and succeeded in making personalized medicine part of the language of Senate budget and policy discussions. Research centers, universities, and other academic institutions have pioneered study after study on personalized medicine’s unique potential. But there’s always more research to do. Most people associate personalized care with possibilities in treating HIV/AIDS or cancer, but it actually applies to a far wider breadth of diseases and conditions.  The 2011 Pittsburgh Lung Conference in October is all about personalized medicine—and how it can help in treating and preventing such pulmonary conditions as COPD, cystic fibrosis, alpha-1 antitrypsin deficiency and pulmonary vascular disease, among others. There, researchers involved in the latest and most exciting studies in personalized medicine will share ideas on its capacity to revolutionize healthcare for people suffering from those diseases and disorders. On this blog, we’ll lead up to that event with the latest news in personalized medicine policy, research, and implementation as it relates to the lung. We’ll also update with profiles of speakers at the conference who are spearheading the effort to make personalized care a permanent standard of our medical landscape.

Whether you’re attending the conference or just trying to keep up with current news, be sure to stop by here every so often and let us know what you think. We look forward to covering many months of progress and discovery ahead of us!