Personalized Medicine—A Tall Mountain

5/11/09

Despite an avalanche of new genomic information, the slope upward to applying it widely in medicine looks steep. This picture was laid out bluntly by biology pioneers Walter Gilbert and George Church at Xconomy’s biotechnology forum on Thursday, April 30. They saw big problems with both investment and public awareness. Their remarks were particularly striking to me because I’m currently writing a history of the genome project for Basic Books of New York.

Both panelists have been associated with Harvard for decades. Gilbert, now a photographer and investor, is the inventor of a Nobel-prize-winning DNA sequencing method in the 1970s and co-founder of what is now Biogen Idec. Church, also a pioneer in sequencing and advisor to and founder of several companies in the field, is best known lately for his Personal Genome Project.

Public participation, according to Church, is vital to spreading genomic medicine widely. Millions of patients and their doctors, he said, must be educated to see the relevance of genetic factors in illness. Then they must demand such information, help obtain it in the detail needed to give power to genetic tests, and use the results.

Gilbert focused on the now-classic dilemma of personalized medicine. This is the reluctance of large drug companies to study and push genetic stratification of patients into those likely or unlikely to benefit from a particular drug or dosage. Perhaps, he said, insurance companies would see the point of finding out whether a cancer patient would be helped by a treatment that costs $50,000 a year.

Both saw needs to go around existing systems. The investment system, Gilbert said, is “broken.” Venture capitalists, and many company founders, now demand an exit in three to five years. “It’s hard to put money in for 20- to 30-year periods.” This is a major obstacle to … Next Page »

Victor McElheny, a science writer at MIT and Xconomist, is the former president of Cambridge at Home, one of the national network of Villages. Follow @

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