Research Day speaker: Move genetic discovery to medical practice
Cancer, cardiovascular illnesses and most other common diseases now have multiple medications that may work – yet none of them work on more than half the patients, keynote speaker Howard McLeod, PharmD, told an audience gathered for the 2013 USF Health Research Day Roy H. Behnke Distinguished Lectureship.
“So when prescribers are faced with choosing a medication to give a patient, which do they pick?” said McLeod, who directs the Institute for Pharmacogenomics and Individualized Therapy at the University of North Carolina-Chapel Hill. “They often make their decisions based on familiarity with drugs they know best.”
That’s because there is no way to predict with great certainty whether a patient will respond to a drug very well, somewhat, not at all – or perhaps even adversely. The result, for many patients, is a time-consuming, sometimes costly, trial-and-error approach to finding the right drug at the right dose.
McLeod is a prominent researcher in the emerging field of pharmacogenomics, which explores how variations in our individual genetic makeup influence how we react to drugs. The institute he leads is working to integrate personalized into medical practice by providing the tools and tests for physicians to identify patients at high risk for toxic side effects as well as those likely to benefit from a particular treatment.
During his Research Day presentation, McLeod focused on the need to harness the growing body of information obtained from DNA analysis to attain comprehensive and more meaningful understanding of which genes are important in guiding drug therapy.
Easy-to-use informatics solutions must be in place before clinicians and pharmacists can broadly apply complex information about the multitude of genetic variations, and other factors interacting with genetic makeup, to select and dose medicines, McLeod said. Some progress is being made. For example, he said, there is now an iPhone app, called iWarfarin, that can help determine the optimal initial dose of warfarin, a widely-prescribed anticoagulant drug, based on an individual’s genetic signature. “It’s not as fun as Angry Birds, but almost,” McLeod quipped.
McLeod challenged academic medicine to be more proactive about translating genetic discovery into applied knowledge that will mean safer, more cost-effective care for patients. “We get the grants, do the discovery, validate findings, publish papers… but then what? Are we creating the science that will help grandma?”
Stephen Liggett, MD, vice dean for research at the USF Health Morsani College of Medicine, said that McLeod’s relay race analogy of progressing from basic science discovery to validation to implementation of research and incorporation into medical practice was a good one.
“If at any one of those points, your institution or group of collaborators doesn’t pick up the pace and move the baton forward, then it’s possible all that work will not come to fruition,” said Dr. Liggett, who joined USF Health to lead the university’s personalized medicine and genomics research.
USF, known for its innovation, will move forward with implementation, Dr. Liggett said. Our relay race, he added, “could be helped along by hospital partners willing to be adventurous with us” in tackling the complex challenges and issues of pharmacogenomics and personalized medicine.
Photos by Eric Younghans, USF Health Communications