News

Why we need precision medicine—now

Thursday, September 1, 2016

Jessica M. Bibliowicz, chairman of the Board of Overseers of Weill Cornell Medicine, penned a piece for The Hill's Congress Blog about precision medicine featuring Meyer Cancer Center/Englander Institute doctors Mark Rubin and Himisha Beltran. 

Photo of Drs. Rubin, Sboner, Beltran and ElementoTeam approach: Drs. Mark Rubin, Andrea Sboner, Himisha Beltran and Olivier Elemento The launch of President Obama’s Precision Medicine Initiative is putting a cutting-edge approach to research and patient care on the map.  Academic medical centers have been pioneering the development of precision medicine for more than a decade—and now it’s time for the biopharmaceutical industry to get deeper in the game.

The goal of precision medicine is simple: to offer individual patients exactly the right medical care at the right time, by taking their genes, lifestyle, and environment into account.  However, making that vision a reality will require a significant investment of brainpower, technology, and capital.

The federal government thinks it can be done.  The President’s Precision Medicine Initiative was created to the tune of $200 million in fiscal year 2016—a timely vote of confidence that comes on the heels of twelve years of declining government funding for medical research.  Soon a million or more volunteers will be recruited to join a massive national cohort and share their genetic and health data with researchers at academic medical centers and community health organizations.  Information gleaned from this unprecedented study has the potential to revolutionize the way we treat conditions ranging from diabetes to schizophrenia.

At Weill Cornell Medicine, where I serve as chairman of the board, initial efforts have focused on people with cancer.  Patients with advanced disease, who have often run out of other options, come in for DNA sequencing at the Englander Institute for Precision Medicine.  This extra layer of information has prompted doctors to try drugs and combinations that might not have been considered before: an individual with bladder cancer receives a breast cancer drug because of her genetic makeup, for example.  Increasingly, patients are able to beat the odds and live longer, fuller lives, but there are still hurdles to be overcome. 

Institute director Dr. Mark Rubin and Dr. Himisha Beltran, who leads clinical activities, studied a group of 97 patients and found that more than ninety percent had genetic mutations that could potentially be treated with existing or experimental drugs.  However, only five percent could actually access the medications that were recommended.  The others were unable to enroll in the appropriate clinical trial or to use approved drugs in off-label ways.

That’s where the biopharmaceutical industry can really step in.  

“Universities excel at identifying biological targets for new drugs and at pinpointing the patients who are more likely to respond to specific treatments.  Industry excels at making drugs and can partner with academia to help implement large-scale clinical trials to test them,” explained Dr. Beltran.  “To get more patients to benefit from precision medicine, we need to work together so that promising drugs end up in the right hands and clinical trials are enrolling the right subsets of people.”

Universities and drug companies have a long history of collaborating to develop medicines that have saved and improved the lives of countless individuals.  According to Dr. Francis Collins, head of the National Institutes of Health—the country’s biggest source of funding for medical research—these alliances are key to introducing new therapies at a faster pace.

“Medical advances that benefit the public generally arise from NIH-funded biomedical research only if actual products are developed and brought to market—and partnerships with the private sector are essential for this translation to succeed,” Collins wrote in a commentary.

All signs indicate that precision is the future of medicine.  According to the Tufts Center for the Study of Drug Development, thirteen percent of drugs on the market in 2015 had information about genetic markers on the label, up from ten percent just five years earlier.  Leading biotech and pharmaceutical companies predict that their investment in individually tailored therapies will increase by one-third over the coming five years.

That gives us reason to hope.  As President Obama’s term draws to a close, perhaps his greatest legacy will be in healthcare and the visionary initiatives he has advanced in this arena.  Hope defined his first campaign for president—and remains a fitting touch point for everyone who has ever been affected by disease.

“Precision medicine is all about patients,” Dr. Rubin said.  “Working together with government, with industry, and with the community, academic medical centers are looking for better ways to care for individuals—really just you and me—when we get sick.”