President Barack Obama this morning unveiled the Precision Medicine Initiative he’ll include in his 2016 budget request to a White House East Room audience packed with federal science leaders, academic researchers, patient and research advocacy groups, congressional guests, and drug industry executives. By and large, they seemed to cheer his plan to find ways to use genomics and other molecular information to tailor patient care.
After poking fun at his own knowledge of science—a model of chromosomes made from pink swim noodles “was helpful to me,” he said—Obama explained what precision medicine is: “delivering the right treatments, at the right time, every time to the right person.” Such an approach “gives us one of the greatest opportunities for new medical breakthroughs that we have ever seen,” he added. He went on to describe the $215 million initiative, which includes new support for cancer genomics and molecularly targeted drug trials at the National Cancer Institute (NCI), and a plan to study links among genes, health, and environment in 1 million Americans by pooling participants in existing cohort studies.
“So if we have a big data set—a big pool of people that’s varied—then that allows us to really map out not only the genome of one person, but now we can start seeing connections and patterns and correlations that helps us refine exactly what it is that we’re trying to do with respect to treatment,” the president explained in his 20-minute speech, flanked by a red-and-blue model of the DNA double helix.
In the room were various patients, from Elana Simon, a young survivor of a rare liver cancer who has helped sequence her cancer type, who introduced the president; to towering former basketball great Kareem Abdul-Jabbar, who apparently takes targeted therapy for his leukemia; and cystic fibrosis patient William Elder, a 27-year-old medical student and guest at the State of the Union address who takes a new drug aimed at the genetic flaw underlying his form of the disease.
Representative Diana DeGette (D–CO), who has been working on 21st Century Cures, a plan to speed drug development, and Senator Lamar Alexander (R–TN), who has similar aims, were also present.
Sitting in the front row were the two lieutenants who will carry out the bulk of the precision medicine plan: National Institutes of Health (NIH) Director Francis Collins and NCI Director Harold Varmus. Another attendee was Craig Venter, who led a private effort to sequence the human genome in the late 1990s that competed with a public effort led by Collins. (Fifteen years ago, Venter sat in the same room with Collins when President Bill Clinton announced the first rough draft of the human genome.) Venter is now CEO of a company called Human Longevity Inc. that aims to sequence 1 million participants’ genomes by 2020—a new private competitor to Collins’s federal cohort study, perhaps.
Many other genome-medical biobank projects at academic health centers and companies are clamoring to be part of the 1 million–person cohort study. NIH will begin to explore which studies to include at an 11 to 12 February meeting (agenda here) that will also examine issues ranging from data privacy to using electronic medical records.
Amid all the hoopla, one prominent human geneticist in the audience offered a cautionary note. David Altshuler, who recently left the Broad Institute for Vertex Pharmaceuticals in Boston, which makes Elder’s cystic fibrosis drug, warns that although the new 1 million American cohort study may uncover new possible drug targets, it will be 10 to 15 years before any such discoveries lead to a successful drug.
“This is the first step,” Altshuler says. “No amount of genome sequencing would ever lead to a new medicine directly.”
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*Correction, 2 February, 10:30 a.m.: An earlier version of this story incorrectly stated that Elana Simon’s treatment involved tumor sequencing.