(Press-News.org) NEW YORK (April 15, 2015) -- Technological advances are enabling scientists to sequence the genomes of cancer tumors, revealing a detailed portrait of genetic mutations that drive these diseases. But genomic studies are only one piece of the puzzle that is precision medicine, a Weill Cornell Medical College researcher writes in Nature. In order to realize the promise of this field, there needs to be an increased focus on creating robust clinical databases that include medical histories from patients around the country, which physicians can then use along with genomic data to tailor individual treatments.
In his commentary, published April 15, Dr. Mark Rubin, director of the Institute for Precision Medicine, posits that searchable databases that compile information from a wide range of medical centers would allow researchers and clinicians to look for patterns and trends in cancer across a large patient population. They could then better design studies and clinical trials, create personalized treatment plans and inform medical decisions so that each patient has access to the best care.
"With this vast clinical data, if we have a patient sitting in front of us who has a mutation that we've never seen before, we can ask the question - has anyone ever seen it before?" said Dr. Rubin, who is also the Homer T. Hirst III Professor of Oncology in Pathology and a professor of pathology and laboratory medicine. "With the development of big databases of clinical information, researchers will be able to say with certainty that there are, for instance, 12 people in the country who have this mutation and we think that they would benefit from a certain treatment."
Dr. Rubin points to the New York City Clinical Data Research Network (NYC-CDRN) as an archetype for this kind of massive database. The network, which is led by principal investigator Dr. Rainu Kaushal, launched 16 months ago with $7 million in funding from the Patient-Centered Outcomes Research Institute. It brings together 22 New York City health care systems and organizations -- including six medical centers -- to create a robust infrastructure where data from more than six million patients is aggregated.
The network's goal is to gather the dispersed pieces of medical data across metropolitan New York and incorporate them into an accessible system that will benefit patients, said Dr. Kaushal, who is also chair of the Department of Healthcare Policy and Research at Weill Cornell. Four of the six medical centers have already submitted their data, two are sending it shortly, and research queries are now coming in every day.
"For common conditions, getting broad data like this is phenomenal," she continued. "For rare diseases or mutations, it's even more valuable because you can get a significant sample size to study uncommon conditions."
Merging this centralized and de-identified clinical data with genomic information from individual patients will provide substantial benefits to researchers and clinicians beyond just treating the person in front of them.
"With big data, we're in a much better position to then make an argument to a drug company or to a clinical trial that this patient should be treated. We go from one patient with an unknown mutation to maybe finding that it's not common, but it's recurrent, and something that should be considered," Dr. Rubin said.
While combining this data holds huge promise, the investigators say, there are also significant challenges.
"Expense is certainly a roadblock," Dr. Kaushal said, "as is the will of institutions and the ability to find informatics experts who can make sense of the data in real time and funnel information back into the healthcare system so that physicians can act on it."
Just as noteworthy are challenges that stem from the fragmentation of the American healthcare industry, in which clinical data is scattered between multiple providers whose electronic systems often lack the compatibility to facilitate easy sharing of patient health records.
In his Nature commentary, Dr. Rubin calls for broad investment to create the infrastructure for big data projects like NYC-CDRN, even though there may not be immediate returns. While President Barack Obama's support of precision medicine, detailed in his new Precision Medicine Initiative and for which he's earmarked $215 million from the 2016 budget, is a good start, more funding is needed to fulfill the promise of this burgeoning field, Dr. Rubin said.
"We're going to make discoveries in year one and two, but this investment is going to have the biggest pay offs a few more years down the road," Dr. Rubin said. Then, after genomic and clinical data have been connected in a meaningful way, patients will reap the benefits of more targeted and better personalized care.
"It's empowering for patients with cancer who don't fit into the perfect scenario and have something that's readily treatable," Dr. Rubin said. "And for many people with cancer, that's where we are."
INFORMATION:
Weill Cornell Medical College
Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research from bench to bedside aimed at unlocking mysteries of the human body in health and sickness and toward developing new treatments and prevention strategies. In its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances -- including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, and most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. Weill Cornell Medical College is affiliated with NewYork-Presbyterian Hospital, where its faculty provides comprehensive patient care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. The Medical College is also affiliated with Houston Methodist. For more information, visit weill.cornell.edu.
Office of External Affairs
Weill Cornell Medical College
tel: 646.317.7401
email: pr@med.cornell.edu
Follow WCMC on:
Twitter, Facebook, and Instagram
The long-forecasted El Niño event of 2014/15 did not meet expectations. On March 5, 2015, the National Weather Service finally declared a "weak" event arriving several months later than expected, formally dashing predictions that we would see a major event on par with the monster El Niño of 1997/98 that would bring much-needed rain to California and other western states. Now, a team of researchers believes that they know why this year's event--and others like it--didn't live up to the hype.
A new study published online April 13, 2015, in the journal Nature ...
Neuroscientists at NYU Langone Medical Center have discovered how the powerful brain hormone oxytocin acts on individual brain cells to prompt specific social behaviors - findings that could lead to a better understanding of how oxytocin and other hormones could be used to treat behavioral problems resulting from disease or trauma to the brain. The findings are to be published in the journal Nature online April 15.
Until now, researchers say oxytocin -- sometimes called the "pleasure hormone" -- has been better known for its role in inducing sexual attraction and orgasm, ...
Previous studies have suggested that pulses of icebergs may have caused cycles of abrupt climate change during the last glacial period by introducing fresh water to the surface of the ocean and changing ocean currents, which are known to play a dominant role in the climate of many of Earth's regions.
However, new findings by scientists at Cardiff University present a contradictory narrative and suggest that icebergs generally arrived too late to trigger marked cooling across the North Atlantic.
Abrupt climate change, characterised by transitions between warm and cold ...
COLUMBIA, Mo. - Invasive pests known as spruce bark beetles have been attacking Alaskan forests for decades, killing more than 1 million acres of forest on the Kenai Peninsula in southern Alaska for more than 25 years. Beyond environmental concerns regarding the millions of dead trees, or "beetle kill" trees, inhabitants of the peninsula and surrounding areas are faced with problems including dangerous falling trees, high wildfire risks, loss of scenic views and increased soil erosion. Now, a researcher from the University of Missouri and his colleagues have found that ...
Irvine, Calif., April 15, 2015 -- While recent reports question whether fish oil supplements support heart health, UC Irvine scientists have found that the fatty acids they contain are vitally important to the developing brain.
In a study appearing today in The Journal of Neuroscience, UCI neurobiologists report that dietary deficiencies in the type of fatty acids found in fish and other foods can limit brain growth during fetal development and early in life. The findings suggest that women maintain a balanced diet rich in these fatty acids for themselves during pregnancy ...
California man Mike May made international headlines in 2000 when his sight was restored by a pioneering stem cell procedure after 40 years of blindness.
But a study published three years after the operation found that the then-49-year-old could see colors, motion and some simple two-dimensional shapes, but was incapable of more complex visual processing.
Hoping May might eventually regain those visual skills, University of Washington researchers and colleagues retested him a decade later. But in a paper now available online in Psychological Science, they report that ...
NEW YORK (April 15, 2015) -- Weill Cornell Medical College investigators tried to validate a previously reported molecular finding on triple negative breast cancer that many hoped would lead to targeted treatments for the aggressive disease. Instead, they discovered that the findings were limited to a single patient and could not be applied to further clinical work. This discovery, published April 15 in Nature, amends the earlier work and underscores the importance of independent study validation and careful assay development.
The earlier - and now dispelled - study, ...
GAINESVILLE, Fla. -- Oxycodone-related deaths dropped 25 percent after Florida implemented its Prescription Drug Monitoring Program in late 2011 as part of its response to the state's prescription drug abuse epidemic, according to a team of UF Health researchers. The drop in fatalities could stem from the number of health care providers who used the program's database to monitor controlled substance prescriptions.
"Forty-nine states have prescription drug monitoring programs of some kind, but this is the first study to demonstrate that one of these programs significantly ...
COLUMBUS, Ohio--The unassuming piece of stainless steel mesh in a lab at The Ohio State University doesn't look like a very big deal, but it could make a big difference for future environmental cleanups.
Water passes through the mesh but oil doesn't, thanks to a nearly invisible oil-repelling coating on its surface.
In tests, researchers mixed water with oil and poured the mixture onto the mesh. The water filtered through the mesh to land in a beaker below. The oil collected on top of the mesh, and rolled off easily into a separate beaker when the mesh was tilted.
The ...
April 15, 2015 - Most people who attempt suicide make some type of healthcare visit in the weeks or months before the attempt, reports a study in the May issue of Medical Care, published by Wolters Kluwer.
The study also identifies racial/ethnic differences that may help to target suicide prevention efforts in the doctor's office and other health care settings. The lead author was Brian K. Ahmedani, PhD, LMSW, of Henry Ford Health System, Detroit, Mich.
Health Visits May Provide Chances for Suicide Prevention
Using data from the NIMH-funded Mental Health Research ...
