Leading the way for personalized medicine

[Music plays] I went in for my annual mammogram I was getting ready to leave and they said, ‘Wait just a minute, we found something suspicious.’ Shortly thereafter my worst fears were confirmed. It was breast cancer. I underwent eight rounds of chemotherapy, 16 rounds of radiation and had a lumpectomy. I learned about a clinical trial going on that would take my blood and make a vaccine specifically for me. Here we go. After the series of injections that I went through I’m cancer-free, I’m enjoying life as it was before, taking care of my animals. I’m very grateful for the study. For the past hundred years most of our treatments have been developed to treat the average person, which has generally been a man at about a hundred and fifty pounds. Personalized medicine means that we can take your genetic information and use that to design the best treatment for you as an individual. Washington University has been a leader in reading the genome. Now we are beginning to learn how to interpret the genome. And in the future we will be writing the genome, or editing the genome so that we’ll be able to develop designer drugs to suit an individual patient’s mutation. Siteman Cancer Center has been among the first to develop truly personal treatments. And we’ve done that through breast cancer vaccines that we pioneered here in clinical trials. We sequence the cancer, we design a vaccine and the vaccine is manufactured at Washington University School of Medicine. And when we administer the vaccine, it generates an immune response to attack the cancer. I think the future of breast cancer care is in prevention. We can use a personalized approach, understand patients’ genetics, some of their environmental issues, that we can use this knowledge and we can prevent breast cancer. We study Alzheimer’s disease and this is a disease of the brain. But it’s so hard to understand what is going wrong in these cells. And so what we do is we take a little piece of skin from people who have Alzheimer’s disease and we reprogram that into a cell that can be found in the brain. So then in the lab we can understand what’s going wrong and how we can treat those cells with different compounds or drugs that will fix those cells and make them healthy again. The future for treatment of patients with Alzheimer’s disease will be very different than it is now. We will be seeing people in their midlife, determining whether they’re going to develop Alzheimer’s disease based on their biomarkers, their genetics, their family history and then we will institute treatment to try to prevent the disease. People with diabetes are at risk for substantial complications. These can affect the eyes, the nerves, they can lead to strokes, they can lead to heart attacks and amputations. We’re already using novel blood tests that can help identify individuals at risk for the serious complications of diabetes. And by using these tests we can prescribe specific medications that prevent those complications in the future. The future is bright for people with diabetes. Here at Washington University we’re developing treatment strategies that can individualize plans that will decrease the suffering for one of the most common diseases in the United States. Obesity is a major public health problem. It’s abnormal to be lean in this country. But the reason why someone eats more calories than they burn up is different for each person. Obesity has adverse effects on every organ system in the body. But the most important complications of obesity are its metabolic complications, which cause diabetes and heart disease. And by understanding the complications that lead the diabetes and heart disease will go a long way in helping us break the link between excess body fat and those complications. We found that the tens of trillions of microbes that live in our gut, called the gut microbiome, contribute to two pressing global health problems: Obesity and childhood malnutrition. We would like to determine who will benefit most from therapies directed at the gut microbiome so that we can all live healthier lives. What is so appealing about the personalized medicine paradigm? It allows us to get the right treatment to the right patient, at the right time. The big win with more effective, targeted therapies is we improve the outcome for our patients, decrease the side-effects and in the end that will all lead to a lowering of the cost of health care. At Washington University we’re working together with unparalleled research capabilities to make personalized medicine a reality for the future. [Music plays]

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