Building on modern research techniques that have made it possible to decipher the genetic code, detect slight genetic differences between patients and determine how those affect the way the body metabolizes drugs, physicians are beginning to be able to select more appropriate treatments for individual patients. Research to make such tools broadly available remains in the early but promising stages, institute leaders said.
“Much of the future of health care is in personalized medicine, meaning more precise targeting of the right medication to the right patient at the right time,” said David Flockhart, M.D., Ph.D., who has been named director of the institute.
“We believe it should lead to cost benefits – it clearly will be better for patients,” said Dr. Flockhart, Harry and Edith Gladstein Professor of Cancer Epidemiology and Genetics and director of the Division of Clinical Pharmacology.
“The Indiana Institute for Personalized Medicine is a not only a logical extension of our academic mission but is also part of our strategic plan to be a global leader in translational medicine,” said David S. Wilkes, M.D., executive associate dean for research affairs at the IU School of Medicine.
Some of the earliest examples of personalized medicine have come in the field of cancer treatment. Oncologists now can test a breast cancer patient’s tumor to determine not only whether it is the type that is stimulated to grow by the hormone estrogen, but whether it is a subtype that can be treated with hormone therapy or another type that requires chemotherapy. Cardiology, pediatrics and obstetrics also will be important areas of focus for the institute, said Dr. Flockhart.
“To identify more precisely which drugs are likely to be more effective — or less effective and more toxic — will have a substantial impact on optimizing health care delivery and rationally curbing costs. In no discipline is this more keenly needed than in cancer care where drugs can be extremely costly and toxic,” said Patrick J. Loehrer Sr., M.D., director of the IU Simon Cancer Center.
IU scientists have been working on related research for at least a decade, but creating an institute “allows you to really jump start research and raise the level participation of an institution in both the laboratory and in the clinic, in a broad range of research interests,” Dr. Flockhart said.
For example, Janet Carpenter, Ph.D., R.N., professor in the School of Nursing and a member of the institute, sees personalized medicine playing a key role in improving the treatment of menopause.
“About 6,000 American women enter menopause every day yet personalized medicine has not been well-integrated into their health care,” she said. “The institute will play a very important role in ensuring that women receive the most appropriate and effective menopausal symptom management therapies.”
Mathew Palakal, Ph.D., associate dean for graduate studies and research at the School of Informatics noted that “research in personalized medicine spans a broad spectrum from systems biology to nanomedicine to gene therapy. Our research in such areas as systems biology, biological network analysis and proteomics, along with our graduate programs in health informatics and bioinformatics, will enable informatics and the School of Informatics to play a significant role in the success of the institute.”
“This science will enable physicians to prescribe the right medicines at the right dosages and intervals to maximize efficacy and prevent unwanted toxicity. It should be a very exciting next 10 years of research,” said D. Wade Clapp, M.D., chairman of the Department of Pediatrics.
“Personalized medicine will make a significant and immediate impact in the care of patients with heart diseases,” said Peng-Sheng Chen, M.D., director of the Krannert Institute of Cardiology.
In addition to Flockhart, the institute’s leadership will include associate directors Lang Li, Ph.D., associate professor of medical and molecular genetics and associate director of the IU Center for Computational Biology and Bioinformatics; Jamie L. Renbarger, M.D., assistant professor of pediatrics, of medicine and of obstetrics and gynecology; and Bryan Schneider, M.D., assistant professor of medicine and of medical and molecular genetics.
The institute’s mission is to conduct research, train new specialists in personalized medicine and promote the translation of scientific discoveries into new more precise therapeutics for patient care.
Training new experts will be supported by the new Brater Scholarship in Personalized Medicine, which will provide funds for research to young physicians in medical fellowship training programs at the school of medicine. The first three fellows to receive Brater scholarships will be selected this summer.
To help move scientific discoveries to patient bedsides, the institute will have a panel of IU scientists who will advise researchers on steps to take to move their research beyond the laboratory stages. The advisory panel, with 21 members initially, will be chaired by Dr. Clapp.
The institute also has an external advisory board with five members:
Caryn Lerman, Ph.D., Mary W. Calkins Professor of Psychiatry and interim director of the Abramson Cancer Center at the University of Pennsylvania
Dan Roden, M.D., assistant vice chancellor for personalized medicine at Vanderbilt University
Robert S. Epstein, M.D., M.S., president of advanced clinical science and research at Medco Health Solutions Inc.
Shiew-Mei Huang, Ph.D., deputy director, Office of Clinical Pharmacology, Center for Drug Evaluation and Research at the U.S. Food and Drug Administration
Russ B. Altman, M.D., Ph.D., chairman of the Department of Bioengineering, Stanford University.