Rewriting the textbook for precision medicine

Precision medicine puts the patient at the center of healthcare, using a variety of tools to develop tailored and targeted treatments and diagnoses.

Promising to “revolution” the modern medicine landscape, precision medicine requires an in-depth knowledge of the molecular underpinnings of healthy and diseased conditions. Advances in molecular biology technologies and bioinformatics platforms help provide this knowledge, providing researchers and clinicians with the tools to implement precision medicine approaches in various disease areas.

To date, oncology – the field of cancer research and treatment – has arguably seen the greatest benefit from precision medicine. However, pharmaceutical and biotech company AstraZeneca believes that precision medicine will “rewrite the textbook” for diagnosing and treating chronic diseases. technology networks Recently I had the pleasure of speaking with Mark ViddockD., Vice President of Diagnostic Development, Precision Medicine at AstraZeneca, to find out how the company rises to the challenge of delivering precision medicines for chronic diseases.

Molly Campbell (MC): Can you talk about some of the ways AstraZeneca actively pursues precision medicine?

Mark Viddock (MF): I think the interesting metric is that when we look at our portfolio, more than 90% of them have a precision medicine strategy. Precision medicine as a strategy And the As a discipline that really encompasses the full spectrum of drug research and development. This includes creating new goals – which require the use of the most advanced methods available – developing and pioneering new technologies and of course leadership to achieve better patient outcomes and a more sustainable healthcare system.

One area in which we have made significant progress is oncology. AstraZeneca has already achieved more than 50 regulatory-approved companion diagnoses across a variety of indications and across a variety of different sample types. This has made it possible to develop innovative targeted therapies and benefit millions of cancer patients worldwide.

Our work and success in oncology has virtually produced a ‘framework’ for which we can develop precise drug approaches for chronic diseases. However, we need to recognize that chronic disease is biologically complex, and highly heterogeneous in origin, so a major priority in the field is to explore ways in which precision medicine can be disseminated and used which increases our understanding of the disease and leads to patient improvement. Results.

The opportunity in the field of precision medicine is enormous, especially for chronic diseases. We are now in an era where, through precision medicine, we are rewriting the textbook for many indications, and ultimately changing the way we treat patients.

MC: Let’s talk more about tools and techniques. What are the key technological advances that help us understand the biology behind diseases, and harness that information to customize treatments?

MF: One of the main technological areas (of which AstraZeneca is a pioneer) is genomics research. Our in-house Center for Genome Research plans to sequence 2 million genomes by 2026 – which is, of course, not far away now. Using highly innovative bioinformatics analysis methods, the groups behind this project are looking for rare disease-associated variants. In doing so, they are discovering new biological insights into disease, discovering new therapeutic targets and characterizing diseases in a more granular — nearly molecular — or genetic way.

This creates opportunities for developing targeted therapies for different segments of a particular disease.

Key examples include the discovery of new targets in respiratory and immune disease, and cardiovascular, renal and metabolic research. One of AstraZeneca’s areas of interest is pulmonary fibrosis and group He previously published the discovery of a gene called SPDL1 It was identified in idiopathic pulmonary fibrosis.

The SPDL1 The gene encodes a protein known as “Spindly” that is responsible for sending signals during cell division. Previously, this gene was not described in relation to idiopathic pulmonary fibrosis. The identification of a new mechanism underlying the disease opens the door to new therapeutic discoveries.

In cardiomyopathy, the group also Post a result related to TTN gene. Both examples are prime examples of how genetic techniques can be used to enrich our understanding of disease. These publications were widely shared among the scientific community.

The TTN The gene encodes a protein called titin. Severed variants of the gene contribute to about 15-25% of cases of non-ischemic dilated cardiomyopathy, a condition in which the left ventricle is enlarged.

MC: Can you talk about the importance of biomarkers in precision medicine? How are they used to identify patients and develop targeted therapies?

MF: I think the room for opportunity for precision medicine in all of the pathological indications AstraZeneca is exploring is huge. It will enhance our ability to rewrite the medical textbooks that clinicians use to understand, diagnose, and treat diseases.

how to do that? An essential aspect of precision medicine is the identification of predictive biomarkers, which is achieved through insights collected using genetic studies and other means. Predictive biomarkers provide the opportunity to include appropriate patients in our clinical trials and to develop targeted concomitant diagnoses and the most appropriate treatment approaches.

In those disease areas where we already have several targeted treatment options available, we have also identified biomarkers for patient selection. one example in Non-alcoholic steatohepatitis where The second example is IL33 – a cytokine seen and elevated in many different indicators, from asthma to diabetic kidney disease and even in COVID-19.

These are the areas in which the biomarker—and the scientific research surrounding the biomarker—helps us to identify the right patients, allowing us to guide where our targeted therapies will have the most beneficial clinical outcomes.

MC: Can you talk about the importance of collaboration in precision medicine? How does AstraZeneca pursue collaborative projects?

MF: AstraZeneca works in in a very collaborative waywith many collaborations established across each of the different research spaces in which we choose to work.

We must develop scalable and universally accessible companion diagnoses that are not only compatible with targeted therapies but are analytically and clinically validated and patient-proven. We’ve built global partnerships to deliver these marketable tests, which truly allow maximum access to patients. It also ensures that these diagnostics are used consistently within regulatory requirements in whatever part of the world they will be used.

Through one of our collaborations with Almac, we develop and validate accompanying diagnostic tests to select patients across a variety of different clinical trials for a range of therapeutic areas, such as chronic kidney disease and respiratory disease. This is a powerful framework that we can adapt for use with other ongoing collaborations, like we’ve worked with Roche Diagnosticsamong other things.

In terms of challenges, when you’re an innovator, you drive somewhere and create information that “rewrites the rulebooks” and “rewrites” the ways treatments are derived, of course there are going to be some challenges. I think we can all agree that health is a fundamental right that we must fulfill All access, and should be comprehensive and tailored to the individual. We believe precision medicine will be a vital part of this offering, improving health and improving health equity. We need discussions to ensure that all healthcare systems can fully adopt this approach into clinical practice, which is achieved through interactions, partnerships, and participation in seminars and summits. We recently spoke at the Global Health Summit, and AstraZeneca, along with groups of external leaders across different diagnostic organizations, aims to talk through policy and consider ways we can help bring new approaches to the clinical community and healthcare structures.

MC: Looking at the future of precision medicine, what are the main priorities in precision medicine for AstraZeneca? What do you imagine this space would look like in 10-15 years, for example?

MF: The more we use precision medicine in the field of chronic diseases, and the more science really begins to discover how these complex chronic diseases derive and their etiology, the more we can search for new therapeutic approaches.. We can identify appropriate patient groups for prognosis to target treatments, and ultimately, this will lead to much better patient outcomes in the long term.

How will it look in the future? I think the main focus is the question: How do we bring new diagnoses into clinical practice? How do we bring accurate medicine to the patient? The future is about patient comfort. One day, it would be great if we could bring molecular diagnostic devices into the home, so patients can monitor their illnesses as they happen. This will include introducing digital advances – such as advances in artificial intelligence (AI) – into various areas of precision medicine. how to do that? How do we use digital media to elicit actionable diagnostic data, whereby patients can take a diagnostic test in their own setting, and that data is then shared with their treating physician to enable decisions and discussions to be held for the benefit of patients? These will be important considerations.

Much of the future looks to the further development of the scientific understanding of chronic diseases, combining everything we have learned in precision medicine and maximizing outcomes for patients. The future of precision medicine is about getting a deep understanding of chronic diseases at the molecular, genetic or metabolic level, in a way that we are really able to make sure that the patient is at the center of it all, and that they can. Enjoy the benefits and convenience of precision medicine in the future.

Mark Viddock, Vice President of Diagnostic Development, Precision Medicine at AstraZeneca spoke to Molly Campbell, senior science writer for Technology Networks.

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