A promising future does not easily disappear into thin air. This is certainly the case with the vision of personalised medicine. For many years, biomedical researchers have vaunted the potential benefits of their findings despite the fact that neutral observers do not think that personalised medicine will really take off within the next 15 or 20 years. Moreover personalised medicine is a controversial term. So what is the state of play right now?
A Centre for Translational Research and Personalised Medicine is currently emerging at the Faculty of Medicine in Mannheim, University of Heidelberg. The new centre is expected to boost the development of new therapies in cooperation with partners from Germany and abroad. The centre also works closely with the “French-German Advanced Translational Drug Discovery Center”, a unique, large-scale, cross-border research cooperation between French and German researchers.
Personalised medicine is the potential capacity to systematically use information about an individual patient in order to select or optimise that patient’s therapeutic care and tailor individual preventive treatments. Biomarkers need to be used as objective parameters in order to determine a patient’s individual risk profile. The role that features detected by genetic tests play in the causal mechanism of diseases and whether they are suitable starting points for preventive and therapeutic treatments is not always clear.
Thorough examination of the genome of cancer cells is essential for a better understanding of the disease and to improve treatment. Therefore, the German Cancer Research Center (DKFZ), with the support of the German Cancer Consortium (DKTK), will invest in the Illumina HiSeq X Ten Sequencing System, the world’s first and only platform to deliver full coverage human whole genome for less than 1000 Euros per genome with the power to sequence more than 18,000 genomes per year.
The medicinal adjuvant therapy of breast cancer is a good example of how important it is being aware that different patients metabolise drugs differently. This knowledge plays a key role in the prescription of effective drugs at the correct dose and in preventing adverse reactions and interactions with concomitant drugs.
Cellzome announced today that it has achieved the second milestone in its epigenetics alliance with GlaxoSmithKline. The milestone triggers a payment of an undisclosed amount from GSK and follows only two months after the first milestone was achieved.
Individual patients metabolise certain drugs in very different ways some patients metabolise drugs well and others do not respond at all. The difference in individual patients ability to metabolise drugs depends not only on environmental influences but also on genetic factors which means that the sequencing of the human genome has become a major prerequisite for the application of personalised medicine. In the following interview Dr. Jens Hoefkens head of Genedatas Expressionist Business Unit explains why next generation sequencing enables patients to be treated more efficiently and how information technology can contribute to identifying potential adverse drug effects at a very early stage.
Next-generation sequencing technologies are fast and effective. This is exactly the reason why the International Cancer Genome Consortium, of which the German Cancer Research Center is part, has set itself the goal of sequencing thousands of individual cancer genomes. Private companies also offer the possibility of sequencing genomes for private clients. It looks as if the problematic vision of “googling your genes” might become reality.
The issue of proper nutrition has become more centred on the individual there is growing recognition that nutrition needs to be adapted to an individuals specific way of life and requirements. In cooperation with its subsidiary the Institut für Angewandte Biochemie AG IABC Hepart AG a company based in the city of Kreuzlingen on Lake Constance develops dietary products food to help people lose weight and micronutrient preparations adapted to consumers individual requirements. The company also runs a clinic that offers special programmes to help people change their dietary habits.
Genetic testing is beginning to play an important role in personalised medicine and is indispensable for the diagnosis and therapy of many diseases. However, the preventive and diagnostic power of many genetic tests is still inferior to traditional diagnostic tests. In addition, commercial genetic tests do not always live up to the claims made about them.
immatics biotechnologies GmbH is a biopharmaceutical company wholly concerned with the development of advanced immunotherapies that are active against different types of cancer, including renal cell, colorectal, brain and gastric cancer. The company currently has a workforce of 80 at its headquarters in Tübingen and subsidiary in Munich. It capitalises on the know-how in the analysis of tumour cells and vaccine development gained through its intensive liaison work with the Department of Immunology led by Prof. Dr. Hans-Georg Rammensee at the University of Tübingen. This particular kind of precision technology is only available in Tübingen.
Malignant brain tumours do not often respond to promising new drugs. Researchers from Heidelberg have now uncovered a mechanism and a tumour marker that are linked to the development of this resistance. A “death receptor” might possibly indicate the chances of success of chemotherapy at the same time as providing new approaches for developing a new therapy for the successful treatment of brain tumours.
TherapySelect Dr. Frank Kischkel is an innovative biotechnology company based in Heidelberg, Germany, with a special focus on the development, validation and application of diagnostic tests for cancer patients. The company’s proprietary CTR-Test® uses patients’ cancer cells to determine the tumor’s susceptibility to treatment with cytostatic drugs. This knowledge helps identify ineffective drugs prior to treatment as well as reduce adverse drug effects and costs.
The move towards personalised medicine has made considerable progress, in particular in the field of oncology, where it is leading to the close integration of diagnostics and therapy as well as to the development of profitable new business models, some of which have controversial exclusive legal claims.
The German Cancer Research Center (DKFZ) and the National Center for Tumour Diseases (NCT) have jointly initiated the Heidelberg Center for Personalised Oncology (HIPO) which provides cancer patients with high-throughput genetic and molecular analyses. In anticipation of the upcoming World Cancer Day on 4th February 2013, the potential of high-throughput genetic and molecular analyses in improving cancer therapy was presented at a workshop held in Heidelberg on 17th January 2013.
The exome is the part of the genome that is formed by exons i.e. the DNA regions that code for proteins and other functional products. Though comprising only about 1 of the total genome the majority of disease-causing mutations occur in the exome. Selectively sequencing the coding regions of the genome is quicker than whole-genome sequencing. Therefore exome sequencing plays an important role in the diagnosis of genetic diseases and cancer. Konstanz-based GATC Biotech AG has designed InViewTM 1-Week Exome Diagnostic an exome sequencing service with the worlds fastest turn-around time.
Bioinformaticians, human geneticists, molecular biologists, oncologists, pathologists, lawyers and theologians are all participating in the project “Ethical and legal aspects of the total sequencing of the human genome” (EURAT) being carried out at Heidelberg University’s Marsilius Kolleg. The project partners are developing a common viewpoint and working out solutions for problems arising from the possibilities of total genome sequencing.
Vaccines that prevent infection with cancer-causing viruses are already available. Moreover, the development of therapeutic vaccines for the treatment of a number of other cancers is well under way. These vaccines not only prevent the development of cancer, but also treat early stages of cancer. Antigen-armed antibodies have long been used in vaccines against infectious diseases, and can now also be used for treating cancer.
Since January 2015, Tübingen has been home to a Centre for Personalised Medicine (ZPM). Twenty-three institutes and hospitals have joined forces to improve diagnosis of disease and develop individualised treatments for patients with a variety of diseases. In parallel, the centre also develops new diagnostic strategies. This means, for example, that data derived from the analysis of the entire genetic material of cells, proteins and metabolic processes are taken into account when stratifying patient therapy.
A biomarker-driven personalised therapeutic approach to lung cancer is possible – this is the conclusion reached by the BATTLE trial. The preliminary results of the trial were summarised by scientists from the Thoraxklinik at Heidelberg University Hospital in the May 2011 issue of “Clinical Investigation”.
cytena GmbH, a start-up company which was spun out from the Department of Microscystems Engineering (IMTEK) at the University of Freiburg in 2014, has developed a device that enables single cells to be deposited safely and gently using a single-cell printer called cy-Clone. Once processed, the cells can be used to study tumour heterogeneity and to create clonal cell lines for producing antibodies.
Prof. Dr. Günter Finkenzeller, head of the Research and Tissue Engineering Laboratory in the Department of Plastic and Hand Surgery at the Freiburg University Medical Centre, and Dr. Peter Koltay from the Department of Microsystems Engineering (IMTEK) at the University of Freiburg, are being given German Research Foundation (DFG) funds for a period of three years to develop a 3D printing technique for functional bone tissue containing blood vessels. The production of living tissue is of great interest for organ replacement therapy and in pharmaceutical research where efforts are being made to reduce the number of animal experiments.
Thanks to improved diagnostics and therapy, today’s cancer patients can live considerably longer than patients several years ago. Nevertheless, some cancers, especially the strongly metastatic ones, are difficult to treat. Therapies targeting immune cells or cancer stem cells could potentially improve the current situation. The early detection and classification of tumours is crucial for the successful treatment of the disease, and molecular diagnosis involving biomarkers and genome analyses are important for personalising cancer therapy.
The scientists Jochen Hoffmann, Dr. Guenther Roth, and Prof. Dr. Roland Zengerle from the Department of Microsystems Engineering (IMTEK) at the University of Freiburg can copy simultaneously 100.000 different DNA sequences in a so called picowell array that has the size of a one cent coin. The new method holds promise to advance the personalised medicine.