Using Precision Medicine to Treat the Long Arc of Disease

In the past year, there have been tremendous advancements in precision medicine, and the big upfront investments are starting to come to fruition, according to panelists at the 37th Annual J.P. Morgan Healthcare Conference, held January 7-10 in San Francisco, California.

A decade ago, discussions around precision health were looking at a future that still seemed far away, but now, there’s a path and it’s here, said Kevin Conroy, chairman and chief executive officer of Exact Sciences Corporation. These tools are now enabling providers to identify cancer very early in a patient, which couldn’t have been possible 10 years ago.

Chad Robins, chief executive officer and cofounder of Adaptive Biotechnologies Corporation, added that the definition of precision medicine is evolving with these advances. While precision medicine applies to almost every disease, it got started with cancer, which is unique to each person. Adaptive is now partnering with Genentech to design a truly personalized therapy to look at a specific person’s cancer and the immune response to the tumor.

He provided the analogy of purchasing a suit. Before personalized medicine, it was like buying a suit with no sizing. Now, with different biomarkers, it’s like finding the right size on the rack. With personalized medicine, a suit can be custom designed and tailored for each individual person.

“That’s, I think, what we’re trying to do with respect to treating each cancer patient with a targeted, unique therapy on the therapeutic side, and really on the diagnostic side, as well,” Robins said.

Adaptive is also partnered with Microsoft to improve diagnostics and help physicians diagnose diseases earlier.

Historically, precision medicine has been focused on the time at or after diagnosis, but now the industry is looking at “the long arc of disease,” said Othman Laraki, chief executive officer of Color Genomics. People are prediabetic for years before they have diabetes, and people with the BRCA gene are precancerous for years before getting cancer, he explained.

“One of the interesting shifts that’s happening is starting to look at the continuum of disease and using that information to define that full distribution of risk over time,” Laraki said. “Not waiting until someone has a foot in the grave before we start treating them, but really thinking about it as that long-term arc.”

Laraki also predicted that eventually, people will get a genetic sequencing at least 50 times in their life, not just once. The key, though, is engaging with the consumer to get such widespread adoption, Conroy said.

Exact Sciences has the colon cancer screening test Cologuard, and Conroy explained that the company has continued growing sales through television advertisements that educate consumers about Cologuard and tell them to ask their doctor about the test.

“Unless you engage with the consumer, it’s really hard to break through and change the behavior of physicians,” he explained.

Laraki added that 90% of the challenges in healthcare involve managing data and getting necessary behaviors. He highlighted how Color Genomics has worked with self-insured employers to provide its genetic test to employees, and there has been tremendous uptake once these tests are made available.

Echoing Conroy, Laraki explained that growth in use of Color Genomics’ test has entirely been driven by direct-to-consumer engagement where employees are opting to use the test instead of waiting for their doctor to tell them to do it.

“If you make it simple and convenient, people really don’t want to die of cancer or heart disease, it turns out,” he said.