Precision Medicine Improves Survival without Increasing Costs

Today at the American Association for Cancer Research (AACR) Precision Medicine Series conference in Salt Lake City, Intermountain Precision Genomics Medical Director Lincoln Nadauld, MD, presented research from his recently published abstracts:

Background

Intermountain Cancer Genomics uses DNAnexus as the bioinformatics platform for the center’s next-generation sequencing-based panel to guide targeted treatment in cancer patients. Intermountain’s cancer panel comprehensively profiles tumors and DNA mutations. Instead of blindly throwing chemotherapies at the patient, the Intermountain test finds actionable variants of the tumor sample by which oncologists can prescribe a medication/therapy that directly targets the cancer gene.

Precision Medicine vs Standard Chemotherapy Study

The focus of Dr. Nadauld’s talk was on the results of Intermountain Cancer Genomics clinical cancer genomics program, which was established to assess outcomes and costs with the implementation of precision cancer medicine. They conducted a cohort study of 72 patients with metastatic cancer of diverse subtypes. The outcomes of 36 patients treated with Intermountain’s cancer panel were compared to 36 control patients who received standard chemotherapy.

Doubling Progression Free Survival

The findings from this study were astounding. Patients receiving precision cancer medicine nearly doubled their progression free survival rate (23 weeks vs. 12 weeks).

Extending a patient’s life for 12 weeks may not seem significant, but patients enrolled in the program were very sick, with no promising treatment options remaining. The life of one patient, who was expected to live for only 6 weeks, was extended to 18 months on the targeted therapy. During that time, he was able to see his daughter go on her first date, an experience that would not have been possible without Intermountain Precision Genomics.

No Increase in Cost

Not only did the Intermountain cancer panel enable identification of treatments that significantly improved survival for patients with advanced cancer, but the study also found that costs were essentially identical for precision cancer medicine vs. standard chemotherapy treatment. This defies the common industry perception that precision medicine increases the cost of treatment. Although previously viewed as a final option to consider when other treatments had failed, this information about the cost and effectiveness of precision medicine for cancer treatment has led to service requests and sample submissions from oncologists treating patients at all stages of metastatic disease.

What’s Next?

The goal of Intermountain Cancer Genomics is to allow all patients to have access to precision medicine. Initially piloted internally, Intermountain has now made their genetically targeted therapeutic approach accessible to other providers via their web portal. Intermountain is on a mission to create a huge database to correlate tumor genome data with treatment protocols and clinical outcomes. This database will ultimately be a valuable resource where physicians, clinicians, and researchers can learn from each other.

DNAnexus Role in this Story

Intermountain Cancer Genomics uses DNAnexus as the bioinformatics platform for its next-generation sequencing-based panel that produces the information required to guide targeted treatment selection. The DNAnexus platform enables Intermountain Cancer Genomics to run its bioinformatics pipeline in the cloud, providing unmatched computational power, cost, scalability and access to genetic testing and data. DNAnexus worked together with Intermountain to develop a cloud-based bioinformatics pipeline that translates raw data into interpretable variants. With DNAnexus, Intermountain can scale up quickly and is able to share its cancer testing tools and datasets securely outside of its healthcare group, offering a network of cancer resources to physicians and patients everywhere while advancing genomic discoveries. Read more.

Obama’s Precision Medicine Initiative: DNAnexus is There

David Shaywitz_White HouseLast week, President Obama held a meeting unveiling details about the Precision Medicine Initiative, an audacious research effort to revolutionize how we practice medicine and ultimately improve human health. At the center of this bold new initiative lies a huge new biobank containing electronic medical records and genetic information on more than a million Americans. Our very own Chief Medical Officer, David Shaywitz, joined the other personalized medicine stakeholders at the White House to weigh in as President Obama made the historic announcement. You can read David’s own first hand account of his visit to the White House here.

Developing cures for complex diseases is incredibly complicated, and the President’s initiative requires long-term vision. Already, the underlying sentiment seems to be that the reality of genomic medicine is here today, in the case of cancer, and targeted therapies are becoming increasingly common. But the realization of a more complete understanding of human genetics, one that will drive discovery and improve human health, requires deep, accurate, and accessible integration of genomic and phenotypic data from millions of people.

The development of a US biobank will require three distinct executional elements: creating, integrating, and analyzing complex data sets. Each of these elements presents unique and difficult challenges, but experience tells us that none are impossible. President Obama’s Precision Medicine Initiative calls for national implementation of solutions very similar to those developed by DNAnexus in collaboration with Regeneron Genetics Center and Geisinger Health System, and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE), Baylor College of Medicine’s Human Genome Sequencing Center (HGSC), and other partners.

 

Robert Plenge, Heidi Rehm, David Ledbetter, Robert Nussbaum, waiting to enter White House (Photo: D. Shaywitz)
Robert Plenge, Heidi Rehm, David Ledbetter, Robert Nussbaum, waiting to enter White House (Photo: D. Shaywitz)

A cloud-based genome informatics and data management platform like DNAnexus combines state-of-the-art security with fluid data sharing among researchers, providing a collaborative environment that facilitates and promotes insight and discovery. And that’s exactly what the White House is betting on. These are exciting times, and we are thrilled to be participating, alongside our partners, at the front lines of innovation and policy.