By AMERICAN HEART ASSOCIATION NEWS
When President Obama rolled out his $215 million “precision medicine” initiative, much of the world responded with a big “huh?” The concept sounded so whiz-bang futuristic that most people without serious medical training couldn’t wrap their heads around it.
But the future is now.
Precision medicine is a fast-growing approach to disease prevention and treatment that individualizes care by combining existing scientific research with detailed information about a patient’s individual genes, environment and lifestyle habits.
It is a breakthrough that can apply across all branches of medicine. While the White House precision medicine initiative is primarily focused on cancer, a multidisciplinary group of innovative thinkers gathered on Wednesday in Washington, D.C., to help set the research agenda when it comes to precision cardiovascular medicine.
Attendees at the American Heart Association’s inaugural Thought Leader Summit were attempting to plot a 20-year plan, setting goals and establishing priorities. The group also was working to establish what role the AHA should play in achieving those goals. The meeting attracted dozens of leaders in clinical research, and from federal health agencies and the pharmaceutical industry.
AHA Chief Executive Officer Nancy Brown said that the association realized years ago it needed to direct its research dollars into the field.
“We recognized this area of precision cardiovascular medicine needed a commitment from the American Heart Association, that we needed to take a leadership role,” she said. “We needed to bring the stakeholders together to define this vision and to extend some of our own resources in furthering this area.”
She noted the board two years ago unanimously supported a $30 million commitment to launch the Institute of Precision Cardiovascular Medicine, with a tentative pledge to commit another $30 million within another five years.
“From our point of view, we must show leadership in this field,” she said.
The summit is building upon work by the AHA’s Cardiovascular Genome-Phenome Study, which provides researchers with access to large volumes of genetic information and other biological and population health data from leading scientific studies.
The medical and clinical research communities increasingly have embraced precision medicine since the 2003 scientific breakthrough of the sequencing of the human genome. That milestone allowed experts to design specific medical treatments based on the DNA sequence of individuals.
One goal behind precision medicine has been to collect large troves of health data that researchers can crunch and analyze for patterns that might identify specific ways to diagnose and treat individuals.
Part of the summit’s purpose was to discuss how to start building the infrastructure for a data warehouse and where, said Elliott Antman, M.D., who will speak at the summit about “Big Data.”
“What we need is very sophisticated informatics that will pool the explosion of data that we’ve got already,” said Antman, professor of medicine at Brigham and Women’s Hospital, Harvard Medical School.
A bigger problem for precision medicine, however, may be grounded in sociopolitical issues, he said.
“Who is in charge of how we’re going to share the information? How are we going to protect individual privacy?” Antman asked. Security and privacy concerns will need to be addressed as researchers, including those in the government, seek access to genetic information for wider groups of individuals.
Antman said that while the research has a lot of promise – particularly for targeted, personalized treatment and prevention for heart disease and stroke – the advances will take time.
“This requires a lot of conversation, a lot of willingness to share. It also requires money and commitment,” he said. “What’s important here is to understand the time horizon over which this is going to take place is going to be measured in decades. It’s not the kind of work that’s going to be done in a year. There will be some small victories along the way, but one has to be patient here.”