Duke University Medical Center and the Center for the Advancement of Genomics launch genomic-based prospective medicine collaboration

Rockville 29 May 2003The Center for the Advancement of Genomics (TCAG) and Duke University Medical Center (DUMC) have signed a formal collaboration to create the first fully-integrated, comprehensive practice of genomic-based prospective medicine. Through this new collaboration, Duke and TCAG plan to generate predictive and prognostic data on specific diseases that can aid both doctors and patients in the earlier detection and better treatment of these illnesses.

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The groups signed a Memorandum of Understanding which outlines the details of the Duke/TCAG genomic-based prospective medicine collaboration. Detailed planning between Duke and TCAG medical, scientific, technology and bio-ethics teams is under way to determine specifically how genomic technology can best be applied clinically to improve health.

This includes focused research in genomic predictors of cardiovascular, haematologic and infectious diseases; the design of future clinical practice models including personalised health planning; and strategies to tackle ethical and legal issues that will arise as a result of advances in genomics. Initially funded internally by both organisations, TCAG and Duke will seek outside funding through government grants, foundations and philanthropic donations.

"One of my reasons for wanting to sequence the human genome more rapidly was to get to this point in history where genomics could begin to be used to better understand and potentially treat or prevent human disease", stated J. Craig Venter, Ph.D., president and chairman of TCAG. "We are delighted to collaborate with Duke in this endeavour, given its pre-eminence in the fields of clinical medicine and research."

"The collaboration between TCAG and Duke is the first extensive step toward my long-term goal of enabling everyone to participate in the genomics revolution, which has the power to transform our lives. This is a basic research collaboration that may take several years to see results, but it is a necessary first step toward a time when all of us can use our genomic information to better understand our future health outcomes."

Ralph Snyderman, M.D., chancellor for health affairs and president and CEO of Duke University Health System, stated: "Duke, in its commitment to utilise the best tools available to create better models of health care, is proud to partner with TCAG and its president, J. Craig Venter, to lay the groundwork for using genomics to provide a new kind of personalised health planning to promote health and prevent disease. We call this prospective health care."

"Genomics can revolutionise our ability to predict an individual's health risks and response to therapy. With TCAG's state-of-the-art genomic sequencing and informatics research facility and genomic research and policy capabilities and Duke's world renowned medical practice, clinical research capabilities and know-how, along with its university-wide Institute for Genomic Sciences and Policy led by Dr. Huntington F. Willard, we feel confident this collaboration will lead to important advances towards improving health care for all."

Dr. Venter also outlined how this collaboration will spur innovation and lower costs of DNA sequencing technologies. "TCAG scientists continue to work toward the goal of a $1000 genome in our new Venter Science Foundation Joint Technology Center (JTC), a 60.000 square foot, high-throughput DNA sequencing centre. Through this collaboration we will be able to refine the current state-of-the-art of sequencing while continuing to work with developers of rapid new DNA sequencing technology so that we can realise this goal. Only by lowering the cost of sequencing can we make genomics a viable tool in large-scale clinical research and medical care."

"The current American health care system is driven more by tradition than by scientific principles and is inherently wasteful", stated R. Sanders Williams, M.D., dean of the Duke University School of Medicine. "By incorporating scientific advances, such as genomics, into new models of prospective health care delivery, we can improve outcomes while controlling costs."

According to Dr. Willard, director of Duke's Institute for Genome Sciences and Policy, "TCAG's genomic scientific expertise coupled with their state-of-the-art genome sequencing and informatics capacity perfectly complements our Institute, which studies both genome discoveries and their applications to society, including health policy."

The Duke/TCAG genomic-based medicine collaboration has several initial goals:

  • To integrate high-throughput DNA sequencing technologies and state-of-the-art analysis with distinctive medical expertise by re-sequencing and genotyping the relevant genetic material including genes and regulatory regions of selected patients from Duke's clinical population. These are patients who have been well characterised through detailed retrospective medical records. By sequencing the DNA of this patient population and associating these profiles with phenotype and disease outcomes, TCAG and Duke researchers plan to correlate genetic variations to disease states to be able to initiate preventive steps or earlier treatment of disease.
  • To focus initially on major disease areas, including cardiovascular, haematologic and infectious diseases, as well as cancer.
  • To create a futuristic personalised health plan and medical record including genomic information to predict health risks and outcomes from therapy.
  • To leverage the unique high-end computing centre that TCAG is currently building as part of its next generation, high-throughput DNA sequencing centre, the JTC, that is slated to open in June 2003 with 100 ABI 3730XL automated DNA sequencers, which will allow for an initial ability to sequence 45 billion base pairs of DNA per year. TCAG and Duke along with several technology partners will create unique computing, storage, database and software solutions to manage and mine the massive datasets that will be generated through the genomic medicine collaboration.

Duke and TCAG see this collaboration as an opportunity to enable preventive or prospective medicine to become reality. Medical care is currently focused on treating chronic disease after it occurs. According to the National Center for Health Statistics there are currently more than 40 million Americans under the age of 65 with no health insurance. Thus, a large portion of individuals in the United States fails to receive even an early-stage diagnosis for many diseases.

Overall, health care inflation continues to rise precipitously. In 2000, total health care expenditures in the United States were $1,3 trillion, more than any other industrialised nation in the world. Hospital care, physician services, and prescription drugs accounted for most of this total spending. The health care system in the United States is in need of a new paradigm to change this inflation rate. In contrast, genomics potentially provides an invigorating solution to accelerating the advent of preventative or prospective medicine and thus lowering the cost of health care.

"The vision for this collaboration includes creating a partnership in translational genomics that generates meaningful information to help patients and physicians make better and earlier decisions in diagnosis and treatment of disease. The partnership will be unique through its ability to integrate high throughput genomics technology and analysis with distinctive medical expertise and a commitment to an economically viable and socially responsible system of health care delivery", the partners stated.

The Center for the Advancement of Genomics is a not-for-profit genomics policy and research centre dedicated to advancing science and medicine through education and enlightenment of the general public, elected officials, and students. TCAG will seek to better understand evolutionary issues, broad social and ethical issues such as race as a social concept rather than a scientific one, and combating genetic discrimination. TCAG will also focus on the public issues associated with biology and genomics in mitigating greenhouse gas concentrations and biological energy production.

Duke University Medical Center is dedicated to providing patient care, professional education and biomedical research. It includes Duke University Hospital; Duke University School of Medicine; Duke University School of Nursing; the Private Diagnostic Clinic, PLLC; and one of the largest biomedical research enterprises in the United States.


Leslie Versweyveld

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