Pathologist Mark Rubin, M.D., is named to direct this early effort to adapt diagnostic and gene sequencing technologies to support personalized medicine
Following several years of experience with whole genome sequencing of tumors, two premier medical institutions announced their intent to move to the next step and establish an institute to support precision medicine. A prominent pathologist was named to head up this new institute.
Weill Cornell Medical College and New York-Presbyterian Hospital established a new, cutting-edge translational medicine research facility. It is called the Precision Medicine Institute and will use patients’ unique genetic profiles to develop individualized approaches for treating prostate cancer.
“This institute will revolutionize the way we treat disease, linking cutting-edge research and next-generation sequencing in the laboratory to the patient’s bedside,” stated Mark Rubin, M.D., in a Weill Cornell press release announcing formation of the new Institute.
World-famous Prostrate Cancer Researcher to Head Institute
Rubin’s groundbreaking research in molecular biomarkers and his co-discovery of two of the most common mutations in prostate cancer: TMPRSS2-ETS rearrangements and SPOP mutations, led to landmark discoveries that revolutionized the understanding of prostate cancer’s molecular underpinnings.
He is also Vice Chair for Experimental Pathology, Director of Translational Research Laboratory Services, the Homer T. Hirst III Professor of Oncology, and Professor of Pathology and Laboratory Medicine at Weill Cornell.
Rubin is one of the principal “Dream Team” investigators in the multi-institutional, $10-million, Stand Up 2 Cancer research program, which is employing next-generation sequencing to address treatments for advanced prostate cancer and the future the direction of clinical trials.
Goal of Institute is Move Research Knowledge to Patient Care
“The Institute for Precision Medicine will enable our doctors to tailor effective treatments for individual patients and also predict the diseases that are likely to affect patients long before they develop,” noted Steven J. Corwin, MD, CEO of NewYork-Presbyterian Hospital.
Research Aims to Give the Sickest Patients a Second Chance
“The idea [is] that we’re going to look for very specific alternations or mutations that are seen in an individual’s tumor and target therapy so that it really caters to that one specific case,” said Rubin, in an interview conducted by Glimcher. “We’ll interrogate their whole genome using next-generation sequencing and identify what has occurred that now allows their tumor cells to grow and [if] we can inhibit them at that point,” he added.
Rubin also noted that this approach offers an opportunity to provide patients who have failed common treatments another chance. By interrogating patient genomes using next-generation sequencing, physicians can identify genetic alterations that explain why common treatments failed and devise effective alternative therapies, he explained.
Genomic diagnostics is moving into practical use due to recent technical breakthroughs that have made genome sequencing quick and relatively inexpensive, pointed out Rubin. He stated that sequencing a human genome today costs about $5,000 and takes just a few days.
New Institute Will Support Genomics Sequencing and Biobanking
The Institute will leverage three resources to facilitate what it characterizes as “groundbreaking precision medicine research:”
• genomics sequencing,
• biobanking, and,
Glimcher said that Weill Cornell and NewYork-Presbyterian are investing in state-of-the-art technology to conduct sequencing; to maintain an expansive biobank for all patient specimens and tissue samples; and utilize dedicated bioinformaticians to analyze patient data, search for genetic mutations and other abnormalities, and to identify new treatments for targeting the disease.
Rubin said, in an interview conducted by Glimcher. “I think that the insights we’re gaining are really at the very, very beginning, because as we start sequencing—going from a 100 genomes to a 1,000 and then to many thousands—we’re going to start to understand what are the recurrent alterations that, perhaps, are targetable, so we will be identifying new drugs that will be able to target the disease.”
The translation of genome research to clinical practice will occur very rapidly– within the next year, he predicted, noting that there are a number of scenarios in which a patient being treated for aggressive prostate cancer fails their treatment. In these scenarios, genome sequencing will be required to determine an informed next step.
He stressed that collaboration will be essential to achieving the Institute’s goals. “The team science element is absolutely critical,” he stressed, pointing out that it allows the handoff from discovery to clinical implementation to occur much more rapidly. More importantly, Rubin said, is that the whole team is talking and learning about why patients are responding or not responding. He noted that the Stand Up 2 Cancer Prostate Cancer research group already provides the Institute collaboration with several other leading institutions.
“We’re in an extremely exciting phase of research because now we’re decoding all of what the cells are, all of the messages that are coming through cells,” continued Rubin, who was one of the first researchers to take a critical look at “junk” DNA. “We’ve almost completely ignored the mutations that are occurring in these areas. This is an opportune time to take sequencing data…and ask the question: ‘What is occurring in these areas that we should focus on?’”
Cancer Care in Academic Medical Centers Engages Pathology in New Ways
Work of this Institute and other similar facilities springing up in academic medical settings around the country will eventually impact pathologists and clinical laboratories everywhere. As personalized medicine becomes the status quo, sequencing patients’ genomes will become routine and medical laboratories, guided by pathologists, will need to develop tests based on each patient’s unique genetic profile.
– Patricia Kirk