1. Rosen, Steven T. MD

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Cancer, diabetes, and other life-threatening diseases put day-to-day life in perspective. Suddenly, minor inconveniences become less significant and getting better becomes the sole focus. When patients are diagnosed with a chronic or life-threatening illness, they want choices and access to the newest and best care available. Yet, many treatments are designed for the "average patient," which leaves some patients searching for another solution. That's where precision medicine comes in.

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Precision medicine, which has emerged as a primary approach for disease prevention and treatment for complex health conditions, uses individual variations in genes, environment, and lifestyle to develop diagnostics, prognostics, and therapies to target, treat, and monitor patients' conditions. The medical management of chronic and life-threatening illnesses has been evolving toward precision medicine for a number of years, but making personalized medicine accessible is not something one institution can accomplish on its own.


In 2015, the Cancer Moonshot program was launched in an effort to achieve 10 years of progress, in preventing, diagnosing, and treating cancer in 5 years. Since then, federal funding has been prioritized to address these aims. Through advances in research, technology, and policies that empower patients, the program will enable a new era of medicine in which researchers, providers, and patients work together to develop individualized care.


Genomic Research

Inspired by the Biden Cancer Moonshot program's commitment to developing new cancer technologies, City of Hope, Duarte, Calif., and Translational Genomics Research Institute (TGen), a non-profit organization in Phoenix dedicated to unlocking the genetic components of both common and complex diseases in adults and children, recently formed an alliance to fast-track the future of precision medicine and speed translational research for patients.


City of Hope is a pioneer in the fields of bone marrow transplantation, hematologic malignancies, and selective solid tumors. TGen is a leader in genomic analysis, bioinformatics, and applications to cancer drug development. Together, City of Hope and TGen are transforming the way we diagnose, treat, and prevent cancer and other life-threatening diseases by accelerating the speed with which scientists and medical staff convert research discoveries into clinical benefits for patients.


In 2013, AJ Patel-age 47-was diagnosed with stage IV lung cancer. After researching his options for care, Patel visited Karen Reckamp, MD, Co-Director of the Lung and Thoracic Oncology Program at City of Hope, who conducted a brain scan that revealed the tumors had spread to his brain.


During surgery to remove the tumors in his brain, doctors took a tiny swatch of Patel's tumor tissue for genetic analysis. Tests revealed Patel had genetic alteration called ROS-1, which is found in only 1 percent of cases of non-small cell lung cancer.


In January 2014, Patel started personalized treatment with an experimental drug called crizotinib and, by the summer, his tumors had shrunk dramatically. "My 6 centimeter mass went down to less than 1," said Patel. "Today, at the age of 50, I'm living a phenomenal life."


Future of Precision Medicine

As evidenced by Patel's survivorship story, precision medicine is the future of cancer care. Alliances like those of City of Hope and TGen are good news for patients because they will lead to more clinical trials, guided by tumor profiling and genetic testing; help speed the bench-to-bedside continuum to improve patients' quality of life; and, ultimately, find cures for cancer and other life-threatening diseases.


In short, precision medicine gives clinicians new tools, knowledge, and therapies to select which treatments will work best for which patients. Early successes in the field of precision medicine have shown that insights into the molecular machinery of a cancer cell can lead to therapies that target tumor cells, while largely sparing normal cells. Furthermore, the potential long-term benefits of precision medicine research are simple:


* wider adoption of collecting patients' genetic and other molecular information as part of routine medical care;


* improved ability to predict which treatments will work best for specific patients;


* better understanding of the underlying mechanisms by which various diseases occur;


* improved approaches to preventing, diagnosing, and treating a wide range of diseases; and


* better integration of electronic health records in patient care, which will allow doctors and researchers to access medical data more easily.



STEVEN T. ROSEN, MD, is the Provost, Chief Scientific Officer, Director of the Comprehensive Cancer Center and the Beckman Research Institute for the City of Hope, Duarte, Calif.

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