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Pathways to Discovery: Summer 2012

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The Future of Personalized Medicine Begins with 1200 Patients

A research study initiated at The University of Chicago (UChicago) Medicine is using genetic information to transform the way medicine is practiced.

The first-of-its-kind study, the 1200 Patients Project, is testing over three years whether genetic information is useful for physicians in guiding treatment decisions for their patients.

Under the current model of medicine, physicians might order a genetic test for their patients, but obtaining the results takes time. Or, physicians might prescribe several medications before finding an effective drug.

The 1200 Patients Project was designed to preemptively test patients a single time and retain the genetic information for use in developing personalized therapeutics over their lifetime. Pharmacogenomics, or the study of how a person’s unique genetic make-up influences their body’s response to drugs, is an important facet of personalized medicine.

Individualizing Medications
The 1200 Patients Project is the brainchild of the newly created Center for Personalized Therapeutics, which is directed by Mark Ratain, MD, the Leon O. Jacobson Professor of Medicine and UCCCC associate director for clinical sciences.

“I am grateful for the institutional and philanthropic support we have received that has enabled us to initiate this important project,” said Dr. Ratain.

The study began in January 2011 and, by April 2012, has already enrolled more than 700 patients.

Peter O’Donnell, MD, assistant professor of medicine and the principal investigator for the study, said,  Patients want their doctor to think of them as an individual, not a disease that’s being treated.”

When patients sign up for the study, they agree to submit a single blood sample. Each patient’s blood is tested for all known genetic markers that might predict their response or likelihood of developing side effects from hundreds of drugs, including chemotherapy agents and other medications prescribed to cancer patients.

Genomic Prescribing System
The results will then be received by a dozen UChicago Medicine physicians—including three who specialize in cancer—participating in the study as early adopters. Since no previous technology platform existed to easily interpret these findings, Dr. O’Donnell collaborated with the University’s Center for Research Informatics to build a genomic prescribing system that contains published pharmacogenomic information and integrates patient results.

The system uses both sets of information to generate an easyto-read summary. A doctor may thus avoid a “trial-and-error” scenario and, instead, choose the specific medication or dose based on the individual patient’s likelihood of response and or likelihood of adverse effects.

“Our idea is that maybe the doctor will treat the patient in front of them differently because they know something about their genetics,” said Dr. O’Donnell. “That is the ultimate goal of pharmacogenomics––to make medicines work better.”

Seeking Answers
Consulting the genomic prescribing system is an extra step for the physician. This study is examining whether or not such a process is feasible for use in routine patient care. The study will determine whether doctors can adapt to using the system regularly, as well as indicate whether using the system leads to improved treatment decisions.

“One of the most exciting aspects of this study is seeing how it could be integrated in routine care,” said Dr. O’Donnell. Although this is an initial study, Dr. O’Donnell and colleagues have already begun to think about undertaking more studies to understand how this new model of care will affect patient health outcomes.

Ernst Lengyel