Individualized Medicine: Mayo Clinic's Role
Individualized medicine continues to be a growing focus among the health community, in part because of the Precision Medicine Initiative that President Obama introduced in 2015. And here in Rochester, Mayo Clinic will play a large role in this initiative thanks, in part, to a federal grant it received to set up a large biobank containing millions of biologic samples.
Mayo Clinic is, of course, known worldwide for its high quality of care and its history of research and innovation. So it's no surprise that researchers are putting a substantial amount of resources into this cutting-edge area of science that is individualized medicine. Already, their research on genomics has proven beneficial to the study of various cancers and other rare diseases.
"Our researchers and physician scientists take a comprehensive, collaborative ‘team science’ approach, enabling us to quickly and seamlessly bring scientific discoveries from the lab to your doctor’s office," said Dr. Keith Stewart, director of Mayo Clinic’s Center for Individualized Medicine, in a statement we received for this report. "Mayo Clinic can provide you with answers you can trust and individualized treatments you can’t find anywhere else.”
To take the next step forward, and expand the use of individualized medicine for disease treatment and prevention, Mayo is investing heavily into education. The goal is to provide patients, students and professionals the tools and information they need to tailor the best possible preventative care and medical treatment.
Mayo selected for biobank
The All of Us program, also known as the Precision Medicine Initiative (PMI), is an initiative introduced by former President Obama to address individualized medicine advancements and research. As part of the initiative, Mayo Clinic was awarded a $142 million dollar grant from the National Institutes of Health (NIH), over five years, to set up a biobank here in Rochester. The program aims to enroll 1 million or more U.S. participants so researchers can better understand individual differences that contribute to health and disease.
"We wouldn’t buy a pair of glasses that doesn’t match our eyesight, and though plenty of people break their arms, everyone gets fitted for their own cast," Obama wrote for the Boston Globe in 2016. "Our health care should be customized for us.”
He further proposed the questions of: “what if we could just as easily match a cancer cure to a patient’s unique genetic code? What if medical experts could tailor [a treatment] for everyone’s body?”
In an interview with Dr. Timothy Curry, director of the education program for the Center of Individualized Medicine, he explained why Mayo was selected. “It turns out that Mayo Clinic had a really, really sophisticated, automated, robotic system, which was the biobank.”
The biobank is a storage space at Mayo Clinic that holds millions of samples from patients. As a result of the grant from the PMI, Mayo Clinic wanted to gather samples from 1 million people, according to Dr. Curry. These samples would be housed primarily in Minnesota, but some also in Florida in the event of a natural disaster here.
When speaking with Dr. Curry, he discussed how Mayo Clinic is not given preference for these samples because they house the biobank. Other organizations wanting to do research will also have access to this biobank of samples. They are currently in the process of collecting these samples.
Personalized care
“We already know it is making differences” said Dr. Curry in our interview. He told us that they have already seen progress in their research efforts on individualized medicine, specifically the advancements made in cancer research.
In an interview we conducted with Dr. Liewei Wang, she discussed the pharmacogenomics associated with individualized medicine, and she discussed Mayo Clinic’s efforts to sequence genomes to progress findings in oncology and endocrinology.
“The best scenario is to prevent a disease from ever happening," said Dr. Wang, a professor of pharmacology at Mayo.
Diagnosing rare diseases through individualized medicine / Video courtesy Mayo Clinic
One specific research effort that she discussed in detail during our interview was breast cancer, and exemplified Dr. Curry’s statement about individualized medicine advancements in cancer research. Dr. Wang said they already have FDA approved drugs to prevent breast cancer, but the use is limited because of the very real and serious side effects. Future work will include researching the ‘genetic risk’ to understand if the side effects are worth it.
Research is currently focused on answering three questions according to Dr. Wang, and those three questions are:
- Can we save money through individualized therapy?
- Can this help avoid side effects?
- Can we achieve better efficacy?
Dr. Wang believes that the pharmacogenetic research pertaining to individualized medicine will be implemented very soon. One of the things Mayo Clinic wants to try is implementing genetic information into electronic medical records to hopefully help aid and alert physicians about genetic information when prescribing medications to patients.
Right now, the scientific advancements are surpassing the technology available, and as Dr. Wang explained to us, Mayo Clinic is still lacking very strong IT support for the genotype sequencing and integration of individualized medicine. They still need computer programs and software to interpret and store the complex genomic sequences.
The importance of education
Mayo Clinic has set up the Center for Individualized Medicine, and one of their main goals is to educate. They have a mission to be able to educate and teach everyone including students, researchers, clinicians, and patients through education symposiums and curriculum.
According to Dr. Curry, his role in individualized medicine is important because, “education is crucial in translating individualized medicine into everyday practice. From the lecture hall to the hospital room, we are using innovative approaches to meet the unique educational needs of learners, whether they are patients, providers, researchers, or students.”
The center is trying to address and create a curriculum that helps educate students about individualized medicine. Courses such as genomics have always been a part of course curriculums, and people have known about variations in genomes. This curriculum is not just in Mayo Medical School, but it is also in other medical schools.
However, one thing that makes the Mayo Medical School unique in regard to individualized medicine education is that the Center for Individualized Medicine sets up a specialized course for students for one whole week, where they are completely immersed in individualized medicine.
“All day they were learning from people like Dr. Wang, hearing from me, going to the labs themselves, sitting in on when the physicians were actually discussing certain cases," said Dr. Curry. "So they get embedded into that whole system for that whole week.”
As Dr. Curry said, the education at the individualized medicine is funded primarily by “our grateful patients who have been either changed by this technology or they believe in it.” Some funding does come from federal grants that come in from research, and grants such as the Precision Medicine Initiative.
Mayo Clinic stills needs to figure out the best ways to educate medical professionals as well as patients, Dr. Wang said.
Questions/ Further Information
Every year the Center for Individualized Medicine helps put on a conference at the Mayo Civic Center, and more information on the upcoming conference can be found here.
If you have questions that remain about individualized medicine efforts at Mayo Clinic, there is a portal on their website to ask a question. Someone will respond to your specific question after submitting it here.
Drew Kerska is a junior at the University of Minnesota Rochester. After graduation, he plans to attend pharmacy school.
Cover photo courtesy Mayo Clinic
