Poor Drug Therapy Results Call for a More Personalized Approach

Jennifer Gibson, clinical phramacist, blogs about the future of personalized medicine in her One Size Does Not Fit All post on BrainBlogger. Gibson cites recent statistics showing that nearly half of all drug therapy proves ineffective. She continues on to explain that although genetic profiling and research are expensive up front, they can result in a more cost-effective and safe platform for drug therapy.

Researchers are coming closer and closer to solving these puzzles every day. The way a drug affects one patient may have the complete opposite effect on another–and it may have nothing to do with the type of disease being treated. These different results may have everything to do with the color of a patient’s skin, what part of the world they were born in or the genes that compose them. What do you think about this? Should health organizations start on a track of personalized medicine or do you think it’s still too early to invest?

To read the full blog post, visit: http://brainblogger.com/2009/11/30/one-size-does-not-fit-all/.

Need Personalized Healthcare Advice? There’s an App for That.

InformationWeek.com recently published an article on Keas, a startup company that syncs its subscribers’ electronic medical records with personalized healthcare advice. Through this service, patients are able to better understand their health data, set personal health goals and then make more informed decisions about their care. In the future, Keas even hopes for specialized applications for everything from exercise guidance to fertility monitoring. Will social media and online applications really play this big of a role in the future of health care? Dr. Clay Marsh, director of the OSU Center for Personalized Health Care, offers his comments on the new service below:

Clay Marsh, MD

The area of personalized health care is a disruptive innovation that will open up new commercial opportunities. Empowering the individual is a key element of personalized health care and this consumer-empowered medicine requires information technology, including internet-based information and social media-enabled resources, to put the right information in the right person’s hands at the right time. Integrated businesses like Keas meet an emerging need and opportunity by linking personal health records with the decision support tools to provide the information individuals need to make informed decisions about their health.

Click here to read the entire article online.

Ohio State Celebrates Research Day

In observance of Research Day initiated by ResearchMeansHope.org and the Association of American Medical Colleges, The Ohio State University is hosting a reception today from 4-6 p.m. at Ohio State’s Biomedical Research Tower, Room 115. This event will present the opportunity to enjoy refreshments, network with your colleagues and share your story with us. Take a moment while you are at the reception to tell us on camera what research means to you.

Those in attendance will hear remarks of appreciation from the following: Eric Fingerhut, JD, Chancellor of the Ohio Board of Regents; Caroline Whitacre, PhD, Ohio State’s Vice President of Research; Steven Gabbe, MD, Senior Vice President for Health Sciences and CEO of OSU Medical Center; Wiley W. “Chip” Souba, MD, ScD, dean of Ohio State’s College of Medicine; Clay Marsh, MD, vice dean of Research for the OSU College of Medicine, and Rebecca Jackson, MD, director of Ohio State’s Center for Clinical and Translational Science.

ResearchMeansHope.org is a coalition of concerned patients and the physicians and researchers of America’s medical schools, teaching hospitals, universities, research companies and organizations. Their goal is to ensure sustained, real growth in federal support for medical research funded by the National Institutes of Health. Only through significant, annual increases in medical research funding can the promise of medical research be fulfilled.

Personalized Medicine ‘Killer Apps’ Will Transform Care Model

The next major personalized medicine advances will create therapies that are so effective, consumers will demand system-wide change in the health care industry to gain access, the inventor of the DNA gene sequencer said today at The Ohio State University Medical Center’s Personalized Health Care National Conference.

Leroy Hood, MD

Dr. Leroy Hood, president of the Institute for Systems Biology, said personalized medicine’s first “killer apps” –therapies that will be nearly 100 percent effective based on patient genes and other individual factors – will drive the transformation of health care from trial-and-error effectiveness.

“The debate today really is centered on the past and present of medicine, rather than the future,” said Hood, speaking at the Transforming Health Care Through Personalized Medicine conference at The Ohio State University Medical Center. “Health care right now is so marginal you can really argue whether it’s worth it.”

Hood says he not only envisions faster and cheaper bulk patient data analysis supporting personalized medicine solutions within the next 10 years, but also home-based testing enabling individuals to check therapeutic response as often as they wish. “If you take Lipitor, why not test your genetic assays three or four times a week?” he said.  

Recent advances in understanding of the “blood fingerprint” providing a radically new means to identify disease and its interrelation with organ networks, and the superior predictive health understanding made possible by genetic testing within families vs. the general population, are among the current building blocks supporting next-stage personalized medicine advances, Hood said.

Dr. Clay Marsh

The Ohio State University Medical Center plans to collaborate with the Institute for Systems Biology to form the P4 Medical Institute, which will accelerate movement toward predictive, personalized, preventive and participatory health care through public-private partnership, said Dr. Clay Marsh, executive director of the Center for Personalized Health Care at Ohio State Medical Center. 

“Academic medical centers and business need to be the leaders in transforming health care for tomorrow,” said Marsh. “The P4 Medical Institute is creating partnerships across the health care sector to speed implementation and access to a superior new care model.”

Caligiuri Lab Investigates Genetics of Cancer

Dr. Michael Caligiuri, director of Ohio State’s Comprehensive Cancer Center and CEO of The James Cancer Hospital and Solove Research Institute, discussed some of his cancer clinical trials and findings.

Dr. Caligiuri’s research lab focuses on research in leukemia, lymphoma and the human immune system. His studies currently include developing a vaccine to prevent lymphoma in organ transplant patients, studying natural killer cell biology, and working to target genetic defects in leukemia and lymphoma for curative therapies.  Although most of this research incorporates cancer patients, a good amount of the results can be applied to non-cancer patients–transplant patients, for example.

Dr. Goetz Explains that Different Patients Often Require Different Drugs for the Same Disease

Dr. Matthew Goetz, assistant professor of oncology and pharmacology at the Mayo Clinic, shared his pharmacogenomic research findings related to risks and occurrence of breast cancer. He explained that in order to truly personalize medicine, you must account for all possible theories and variables.  Goetz continued to say that although many believe pharmacology to be boring, it is a key component of the future model of care. Some may say, so this drug doesn’t work–why not just try another drug? It’s much more complicated than that.

Dr. Goetz touched on the variety of cases in his study in breast cancer patients, some with strange and perplexing results. When giving the same drug to multiple patients, each yielded a variety of different results. Some patients had successful reduction in tumor size, while others resulted in no change and some even experienced tumor growth as a result of the drug. Personalized health care is the answer to this, for lack of a better term, ’shot-in-the-dark’ type of therapy. If physicians can understand each patient’s biology and genetic makeup individually, they can better apply treatments and medications. This would therefore reduce health care costs and enable patients to receive much more efficient treatments.

Personalized Medicine: P4

Personalized medicine experts Dr. Clay Marsh of the Center for Personalized Health Care at the Ohio State University Medical Center and Dr. Leroy Hood of the Institute for Systems Biology speak about collaboration accelerating advances in the field.

The P4 Medicine Institute is a platform for academic and business personalized medicine collaboration.

Medco Health Solutions Plan Further Studies in Personalized Medicine Related to Generic Prescriptions

Felix Frueh is the vice president of R&D Personalized Medicine at Medco Health Solutions, a corporation that manages outpatient drug benefits on behalf of payers for more than 65 million Americans. Frueh claimed that in the field of personalized medicine, we need to know that someone is going to pay the bill.

Medco’s research found that 82 percent of the population would be willing to undergo genetic testing—the other 18 percent either didn’t want additional testing or did not want to participate in genetic research. The company plans to launch an additional 4-6 studies focused in personalized medicine, as it has a vested in genetic research related to generic prescriptions. Frueh explains that by increasing the number of generic prescriptions, costs of health care will directly decrease—developments in pharmacogenomic research will allow physicians to more widely prescribe these generics.

Ohio State’s CCTS Director Presents Hormone Study Linked to Disease Prevention

Dr. Rebecca Jackson, director of Ohio State’s Center for Clinical and Translational Science, highlighted the role of pharmacogenomics in her study on postmenopausal hormones in preventing diseases of aging and the Women’s Health Initiative.

The three major components of this initiative were to 1) conduct a raondomized, controlled clinical trial of promising, but unproven approaches to prevention; 2) develop and observational study to identify predictors of disease; and 3) create a study of community approaches to developing healthful behaviors. The findings of this study resulted in biomarker interactions leading to predicting and assessing health risks. Hormone testing resulted in identifying risk factors for diseases ranging from bone disorders like osteoperosis to breast cancer. Jackson explained that the current goal is to use this information to better target women in need of hormone therapy and improve the health of women as they age.

Larry Lesko Comments on the FDA’s Role in Personalized Medicine

Moderator Robert Bruggemeier, dean and professor of Ohio State’s College of Pharmacy, opened the floor for panel members to discuss pharmacogenomics in clinical medicine. 

Larry Lesko, director of the Office of Clinical Pharmacology at the Center for Drug Evaluation and Research with the Federal Drug Administration, begins his talk by making the FDA’s commitment to personalized medicine as a public health agency. He touched on the future focus of improving drug safety and its role in future healthcare policy, citing the FDA Amendments Act of 2007.

 Lesko explained that the dual mission at hand is to foster innovation and promote new initiatives under a critical path while developing and clearly articulating the standards for drugs and diagnostics. The organization takes a lifecycle approach to evidence to inform and support decisions—this goes for previous drugs and new drug development.

Moving forward, what else needs to be done? Lesko explained that ways to consensus on evidence are needed to support new drug approvals and relabeling of older drugs. He also believes that the FDA needs to develop more unambiguous drug product labels to enable actionable medical decisions and improve communication between CDER and CDRH on co-development and companion diagnostics.

Dr. Lesko’s entire presentation can be found here: