Imagine your physician being confident a certain medication will work and precious time for cancer treatment won’t be lost on something ineffective.
The expression “it’s in your genes” is taking on new meaning with personalized medicine, the future of health care. It means a person’s genetic code will reveal predisposition to diseases and, in turn, let physicians know which treatment approach to use with patients, based on their genetic composition.
With the possibility that state, local, and private funding may pave the way for Maine-based Jackson Laboratory to build a $710 million genetics research complex in eastern Collier County, Southwest Florida residents face the prospects of benefiting sooner from personalized medicine, local supporters say.
“It is really futuristic medicine, to design therapy based on the genetic make-up of the individual instead of taking a drug off the shelf,” said Dr. James Talano, a cardiologist in Naples. “It’s going to change the way we do therapy.”
Jackson’s plan is to build a personalized medicine institute on 50 acres on Oil Well Road that would be donated by Barron Collier Co.
Jackson scientists would perform computer-based analyses of a large collection of human genetic codes and how they relate to disease variations, said Mike Hyde, vice president for advancement with Jackson.
“A lot of what is proposed (for Collier) is a database with many, many people’s genetic information and medical history,” he said. “The idea here is to build an institute to investigate variation in human genomes and how those variations are connected to variations in disease.”
What’s transpired since the Human Genome Project in 2000, when the first human genome sequencing was completed at a $3 billion cost, and now is the dramatically reduced price to do a genetic sequencing.
“Today you can have a machine to sequence one person’s genome for $30,000 and do it in 20 minutes,” Hyde said. “New machines are coming out faster and cheaper so in the next three to five years, it will be comparable to the cost of going to the (emergency room) or comparable to an MRI.”
People interested in having their genetic code done can have a DNA sample collected in any doctor’s office with a cheek swab for sending to the lab. That means people interested in it wouldn’t necessarily have to come to Naples, he said.
At the same time, Jackson envisions developing a relationship with many medical facilities where patients with different medical conditions can be the source for DNA samples, he said.
Ultimately, patients from here and elsewhere could help with the development of drug therapies tailored to people’s genetic composition, for both disease prevention and treatment.
According to a PricewaterhouseCoopers analysis, the marketplace in the development of personalized medicine in 2009 was $232 billion and is projected to grow 11 percent annually to $452 billion by 2015.
The core market, such as diagnostic therapies and targeted therapies, is estimated at $24 billion alone and projected to grow 10 percent annually to $42 billion in the next five years, according to PricewaterhouseCoopers.
Dr. Allen Weiss, president and chief executive officer of the NCH Healthcare System, which has hosted several seminars with Jackson scientists and the local medical community, said NCH wants to be a partner with Jackson as a clinical site for patients who want to participate.
“We’ve been speaking with them three years now and as recently as three months ago and they are scheduled to come (this) week,” Weiss said.
Weiss said personalized medicine will transform medical care globally from a “repair shop to a prevention shop.”
Locally, it may be an opportunity for growth and change and for the NCH system to go to another level of maturity, Weiss said.
Other pluses if Jackson builds a center in Collier include the potential for local physicians to be part of research and it can be advantageous for recruiting new physicians to the area, Hyde said.
“Absolutely,” said Talano, the local cardiologist who participated in one of Jackson’s recent seminars in Naples about personalized medicine. “Having a research lab like that in our relatively small community shows we are not just a retirement community but a dynamic community who wants to stay healthy.”
Richard Akin, chief executive officer of Collier Health Services and board chairman of the Lee Memorial Health System in Lee County, said the better physicians get stimulated by research development.
The diverse nationalities among residents in Immokalee and some of the unusual diseases they face may be a draw for Jackson, Akin said.
Talano expects people will want to have their DNA sequencing done, especially if they have a family history of a disease and they want to be proactive against it. Breast cancer and women who are carriers of the BRCA1 or BRCA2 genes are prime examples.
Breast cancer patients who are gene carriers are given a different treatment therapy than those who are not, which is one of the early examples of how gene therapy is changing medicine, Talano said.
“Any oncologist will tell you the first thing they look at is if they are BRCA positive or negative,” he said.
Genetics research likewise has found that some heart patients with stents are carriers of a gene that prevents them from metabolizing Plavix, an anti-clotting drug, Talano said.
“Four percent of the population does not have the gene to metabolize Plavix and therefore they are more likely to clog off their stent,” he said, adding that an enzyme test can determine if someone has the gene or not.
“That test just came out recently in the last six months,” he said. “That is the result of gene therapy.”
A year ago, 37 products have been developed for treating patients as a result of advancement with personalized medicine and probably more since then, said Ed Abrahams, president of the Personalized Medicine Coalition, an independent nonprofit group in Washington, D.C., which was formed in 2004.
The expectation is the cost for one human genome sequencing will drop to about $5,000, Abrahams said, adding that development will accelerate personalized medicine.
“I think it’s a great development for Naples to put the community on the cutting edge of where medicine is going,” he said, referring to the potential Jackson facility.
“The research investment, by itself, creates good and high-paying jobs. The scientific research points the way to new solutions for current medical problems.”
__ Connect with health-care reporter Liz Freeman at www.naplesnews.com/staff/liz_freeman