Editorials

Staking a claim to the future with big-data medicine

A lab technician sorts frozen DNA saliva samples at the Kaiser Permanente Division of Research in Oakland for a massive precision medicine project with the University of California, San Francisco. UC San Francisco has been at the forefront of the revolutionary and data-heavy field.
A lab technician sorts frozen DNA saliva samples at the Kaiser Permanente Division of Research in Oakland for a massive precision medicine project with the University of California, San Francisco. UC San Francisco has been at the forefront of the revolutionary and data-heavy field. pkitagaki@sacbee.com

One of the most exciting and intriguing recent medical advances has been the development of tests that can analyze a person’s genetic makeup and then design a treatment tailored for that person’s disease.

Precision medicine, as this field is known, holds great promise. For example, rather than classifying all cancer tumors primarily based on the tissue’s origin – say breast, or prostate – doctors are now able to classify tumors based on analysis of genetic mutations within that tumor. They can then prescribe specific treatments designed for that particular mutation rather than broad-based drugs.

But researchers believe scientists have only scratched the surface of what this field has to offer. For example, researchers are now able to grow multiple copies of a person’s tumor in the lab and then treat those tumors with different drugs before picking the one that works best, a technique that could one day be refined and used routinely. And that is only one of the possibilities.

That’s why a new precision medicine initiative announced last week by Gov. Jerry Brown and the University of California is so important. The project, to be led by the University of California, San Francisco, will explore how the university can use its network of medical schools, computer scientists and other resources to aggregate patient data to better inform the research.

Like stem cell research, precision medicine holds tremendous promise – and tremendous potential for hype, waste, false starts and unrealistic expectations. But Brown’s approach is informed and judicious, and the nation has learned to look to California to take the scientific lead.

For example, the California Initiative to Advance Precision Medicine represents a modest investment by the state – just $3 million – that the governor and the university hope to leverage into more money from private and academic sources.

The initiative will develop two demonstration projects in research areas where the university already has expertise. Just as important, the project also will bring together experts in medicine, technology, privacy and ethics to explore the best ways to gather data from patients while still respecting personal privacy.

President Barack Obama earlier this year announced a national project to compile genetic data and health information from more than 1 million Americans and then draw on that vast trove of information to study how well treatments work for people with particular genetic mutations.

But that project will involve such a massive amount of data that it will have to be stored on multiple servers and then accessed remotely by researchers. Some observers fear that this will make personal health information vulnerable to hackers. And many patients have declined to participate in early projects of this kind because they fear insurance companies might obtain the data and use it to discriminate against them.

These and other concerns will have to be addressed if we are to realize the enormous potential precision medicine has to offer. It’s a balancing act in which California scientists are uniquely poised to contribute.

The University of California has been on the cutting edge of precision medicine from the beginning. It’s only appropriate that the governor and the university are taking this step to ensure that the school, and the state, remain leaders in a field that could transform the way we diagnose and treat disease.

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