Paving the way for the treatments of the future
Experts see great opportunities in the field of personalised medicine, but it will require the widespread exchange of patient data. This is one of the key lessons to emerge from this year’s Latsis Symposium at ETH Zurich. The researchers called on politicians to formulate data protection legislation so that it does not hinder progress in the field of personalised medicine.
Experts say that patient data should be pooled in large databases in an anonymous and standardised form, which they believe would be a promising potential development in the world of medicine. Interested researchers and treating doctors could then access and analyse the data. This would represent a big step forwards for basic medical research and the quality of treatment provided to individual patients in hospitals.
This hope is based on the new possibilities that molecular methods offer in the field of medicine: it has become affordable (and may become even cheaper in future) to determine the genetic make-up of patients, pathogens and tumour cells, and to identify the full spectrum of proteins and metabolites. Today, doctors have access to far more data on diseases than in the past. In addition, based on the molecular characterisation, they can assign individual diseases into ever-finer subgroups that may require different therapies.
The Latsis Symposium held at ETH Zurich over the last three days was attended by more than 200 scientists and aimed to address the opportunities and challenges presented by personalised medicine. The conference concluded with a public panel discussion yesterday evening.
Image gallery public panel discussion
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(all photos: IT'IS Foundation / Nicolas Chavannes)
Personalised medicine is already here
Personalised medicine remains a grand promise for the future – ultimately it is a long-term project for which experts want to lay the foundations today. But something else became clear at the conference, with Roger Stupp, Director of the Department of Oncology at University Hospital Zurich, telling the panel discussion: “We’re already using personalised medicine today.”
In terms of the diagnosis and treatment of HIV/AIDS, the expert conference also heard from computational biologist Thomas Lengauer, Professor at the Max Planck Institute for Informatics in Saarbrücken, who said that there are now two dozen different AIDS medicines for which therapy can now deploy individual combinations. The DNA of the pathogen is sequenced in patients suffering from AIDS. Doctors then use software and statistics to determine which combination of drugs will offer each patient the best therapeutic odds.
Wider exchange of data
In the field of cancer medicine, too, determination of the genetic blueprint of tumour cells plays an established role in diagnosis and therapeutic planning, as Mark Rubin explained. Rubin is a professor at Cornell University, where he leads the Institute for Precision Medicine, the first such institute in the world. He said that in many hospitals and countries, oncologists already meet on a regular basis to discuss treatment options for patients. For Rubin and other experts attending the symposium, an even wider exchange of patient data opens up enormous opportunities in the world of medicine and for cancer medicine in particular.
“Perhaps the most important conclusion to emerge from the three-day conference was that personalised medicine necessitates the widespread exchange of data, on a worldwide basis if possible,” said Holger Moch, Professor at University Hospital Zurich and Co-Chair of the Competence Center Personalized Medicine at the University of Zurich and ETH Zurich, as the conference closed.
Comparable to the Gotthard Tunnel
Rubin expressed the same view the day before: “The key to success will be to establish an infrastructure that allows large numbers of hospitals to exchange data.” However, he stressed that we must be aware that this is a major project, an investment in the future on a scale comparable with the planning and construction of the Gotthard Base Tunnel.
Such a comprehensive electronic health database would, he says, bring about improvements in the quality of healthcare: doctors treating a patient with a tumour with specific molecular characteristics could use statistical analysis software, if necessary, to incorporate past successes and failures from a number of patients with the same molecular markers into the therapeutic planning process.
Undue restrictions
Admittedly, as became clear at the panel discussion, the path towards a comprehensive health database is fraught with obstacles related to data protection and protection against misuse. Genome data could hardly be more personal: it is not only a unique characterisation of an individual, but can also be used to derive a huge amount of information in terms of their susceptibility to hereditary diseases.
However, the experts on the panel were of the opinion that current legislation in Switzerland and other countries applies undue restrictions to the field of medicine. In their view, it prevents the exchange of data that is so important for personalised medicine, imposing excessive regulation that currently represents the biggest obstacle to personalised medicine. As the panel explained, legislators want to protect patients, but the regulation also stands in the way of medical progress, which is, above all, in the interest of the patients. The panel heard from oncologist Stupp, who said that in everyday clinical practice he experiences great openness from his patients: “The patients want to make their contribution to research. A need for protection is imposed on us as doctors that does not correspond to reality. The legislation is lagging behind in this respect.”