Combining Whole Genome Sequencing with Clinical Care

Mana Chandhok:
Hi everyone. Welcome to this podcast from Cambridge Healthtech Institute for the Next Generation Diagnostic Summit which runs from August 23rd to the 26th in Washington DC. I'm Mana Chandouk, an Associate Producer. We have with us today our speaker, David Bick, the CMO at HudsonAlpha Institute for Biotechnology from the Health and Wellness Genomic Screening Symposium. David, thank you for joining us.

David Bick:
Thank you, Mana, for having me join you in this podcast.

Mana Chandhok:
HudsonAlpha researchers were involved in Nick Volker's miraculous story as he was the first person to be saved by whole genome sequencing. Can you elaborate on how this has helped to bring genomic medicine into clinical care?

David Bick:
Yes. The story of Nick Volker was very exciting at the time, and also a little scary I will tell you being the first. One of the things that happened almost immediately after Nick and finding his diagnosis and moving ahead with bone marrow transplant in him which really saved his life, is the hospital, the Children's Hospital of Wisconsin, really realized that this was a life-saving technology. This being back in 2010, you would think, wow, that's pretty forward-looking by these folks at the Children's Hospital. It really was. They agreed to start a genomics medicine program which we ran for a couple of years. It made quite a number of very important diagnoses.

What was really interesting at the time, and a lot of people may not recall this, we published that case about Nick in December of 2010. In May of the following year, Francis Collins, who's the head of the NIH, highlighted the case during his Senate testimony in May of 2011 which is pretty amazing. In addition, the NIH at that time elected to put significant budget dollars into moving genomics from a research entity into the clinics. It was not long thereafter that a number of laboratories around the country moved genomics out of the research space and into the clinical space.

Mana Chandhok:
What will be the biggest challenges in the future for institutions that want to integrate genomic technologies into their laboratories?

David Bick:
Yes. Moving genomics not only from the research area into the laboratories is one area. In addition, there's a lot of interest in moving genomics from the laboratory and from the regular clinical care of patients who are ill, but moving it into health and wellness programs and into preventative medicine programs. In fact, the tools that institutions need to move genomics out of the laboratory and use it in routine care and, in fact, in wellness and preventative medicine programs, a lot of those tools are already there. For example, in the area of disease there are genetics clinics throughout the country. Those clinics have now avidly taken up the use of whole genome and whole exome as an important tool when they've run through the usual process for looking for diseases in patients with unknown conditions. They'll use these tools to now move beyond the kinds of testing that they had in the past.

The other thing that's very interesting, the very new thing which we're going to talk about at this conference, is the fact that, as I mentioned, wellness programs and preventative medicine programs are starting to take this up as well. For most of us, we've heard about or seen in virtually every city in the United States health and wellness programs at major hospitals. You can be in New York or Baltimore, Cleveland, Boston, all around the country and you'll find that major medical centers have already developed often what's called an executive medicine program, for example. They're going to start adding this technology to what they're already doing.

If you think about it, laboratories already know how to carry out whole genome and whole exome sequencing for individuals with illnesses. These same laboratories around the country have already started to develop programs that allow individuals, at the patient's request, to have their genome sequenced. What's wonderful about this is that these are individuals who might not have a condition at this point, but they're interested in questions like, "Am I at risk for certain conditions?" For example, many people have heard of the breast cancer genes BRCA 1 and 2. Some individuals will have family history and be interested in pursuing that. In addition, we could find out if someone is a carrier for a medical condition.

One of the things that the physicians really like about these genomic tests is that we can look at pharmacogenetics. We can help the physicians know what medicines are going to be reasonable to prescribe. For these patients, even though they're not ill at this point, having stored away this genomic information is of great help to both the patient, should they become ill with something in particular, but their physician who can use the information in genomics. The other thing about genomics, which is very exciting, is once you have sequenced someone's genome you have all the information. You can dip into that information as often as you like.

Mana Chandhok:
We are very much looking forward to the Next Generation Diagnostic Summit. As a speaker and an attendee, what are your goals and expectations for the meeting?

David Bick:
During the summit, I'm going to be speaking in the session on health and wellness genomic screening. This session is really devoted to personal genomic sequencing for health maintenance and genome-based care. My goals really are three. One is to highlight that, for rare disease diagnose where people are ill, this technology is now well-accepted and is being used by geneticists and physicians all over the country. Another area which I'm known to highlight is the area of cancer. We know that more and more physicians are using the cancer's genome to help them choose medications for that patient.

What I'm going to focus on a good portion of my time is really the rest of the population. What about the rest of us who are not sick at this point but really want some information about our genome that could help our physicians. I'm going to focus on how can the use of whole genome sequencing be useful to patients? I'm going to try and give some examples of where we've actually started to use this technology in people who are otherwise healthy, and how interacting with their physicians around this information has been very much appreciated.

In terms of what I think attendees can come to expect is I would think they would be able to come away, I hope they'll come away, with an understanding of how we use this information when they have patients who are ill. Also, how these tools can help physicians personalize healthcare for all of the rest of us. For the rest of us, also, to do things that can optimize our own personal health.

Mana Chandhok:
We are very much looking forward to the Next Generation Diagnostic Summit. As a speaker and an attendee, what are your goals and expectations for the meeting?

David Bick:
That was David Bick of HudsonAlpha. David will be speaking at the Health and Wellness Genomic Screening Symposium at the upcoming Next Generation Diagnostic Summit taking place August 23rd to 26th in Washington DC. I'm Mana Chandouk. Thank you for listening.