During the inaugural Discover Feinberg lecture on May 14, three world‑class investigators from Northwestern University Feinberg School of Medicine discussed the incredible potential of precision medicine to improve the diagnosis and treatment of disease. Each described how they are incorporating precision medicine—in rheumatology, cancer, and sleep medicine respectively—into their research to transform patient care.
“Northwestern is not just a place where fantastic clinical care happens, it’s also a place where we train the next generation of physicians and scientists and make sure we’re generating the new knowledge that is going to lead to tomorrow’s cures,” explained Rex Chisholm, PhD, vice dean for Scientific Affairs and Graduate Education at Feinberg, the Adam and Richard T. Lind Professor of Medical Genetics, and moderator of the event. “With precision medicine, we can do that earlier and better.”
Precision medicine, sometimes referred to as personalized medicine, is a model for treating health and disease by considering a patient’s genes, behaviors, and environment. It’s the medical community’s acknowledgement of the fact that one size does not necessarily fit all.
The Right Person, the Right Drug, the Right Time
Many patients—and their physicians—are familiar with the frustrating process of finding medication to effectively treat their condition.
During the lecture, Harris R. Perlman, PhD, chief of Rheumatology in the Department of Medicine, shared a list of the many drugs currently available for rheumatoid arthritis, a disorder that affects up to 1 percent of the world’s population.
“Finding the right drug has been completely trial and error, a costly and time-consuming process,” said Dr. Perlman, also the Mabel Greene Myers Professor of Medicine. “We needed to find a different way to treat our patients.”
Dr. Perlman’s team tested a new precision medicine strategy: They took samples of patients’ cells from their afflicted joints through a biopsy and looked at the genes being expressed in those cells for abnormalities.
“We were able to identify a group of patients that looked completely different clinically, but by looking at the genes in their tissues, we learned that they all would respond to one specific treatment option,” Dr. Perlman said.
Leonidas C. Platanias, MD, PhD, director of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and his team use a similar process to find the right drugs for cancer patients through their OncoSET program (“SET” is short for sequence, evaluate, and treat).
“When we sequence patients, only 10 percent can be treated with available drugs,” said Dr. Platanias, who serves as the Jesse, Sara, Andrew, Abigail, Benjamin and Elizabeth Lurie Professor of Oncology. “So, in parallel we’re trying to develop new drugs using this genetic information, as we identify more and more abnormalities in the cancer genome.”
His team also is looking beyond genes and exploring how to incorporate additional actions taking place in cells into clinical decisions.
“We are building programs to take advantage of all this information—proteomics, metabolomics, immune monitoring—to develop precision medicine of the future,” Dr. Platanias said.
“There are molecular clocks in every cell in every tissue of our bodies controlling the timing of our physiological systems,” explained Dr. Zee, who is the Benjamin and Virginia T. Boshes Professor of Neurology. “When these clocks are misaligned with our sleep schedule and the light-dark cycle, the implications are vast.”
Disrupted circadian rhythm has been linked to many conditions, from diabetes and obesity to neurodegenerative diseases like Alzheimer’s disease, Dr. Zee shared.
“You can see how timing needs to be a top priority in precision medicine,” she said. “If you time treatment right, you can make it more precise, more effective, and with fewer side effects.”
Dr. Zee is currently involved in research to develop a blood test that will help physicians quickly identify a patient’s precise internal clock times compared to external time.
A Bright Future
While investigators still have much work to do to bring precision medicine to its full potential, the field is evolving fast. In fact, Dr. Chisholm was one of the scientists involved in sequencing the human genome for the first time back in 2003.
“The Human Genome Project cost $3 billion, took 13 years, and involved thousands of people working in labs all around the world,” he said. “Today, we have on Northwestern’s campus one machine that can read 1,000 genomes in 48 hours for around $800 each.”
He added, “Investment in new technology and outstanding scientists fuels the cutting-edge work you heard about from our three speakers tonight. Their research in precision medicine will help us diagnose diseases faster and more accurately and help us make better decisions about how we should go about treating patients.”
For more information about supporting precision medicine at Northwestern, please contact Lauren Pedi at firstname.lastname@example.org or (312) 503-4635.