Precision Medicine

Dr. Dan Roden

Damon Hostin

On this week’s episode I talked with two healthcare leaders who are experts in precision medicine. One, Dr. Dan Roden, is one of the leading researchers on pharmacogenomic testing and its impact on patient outcomes at Vanderbilt University. His work, along with colleagues at Vanderbilt and nationally, is contributing to the growing body of evidence supporting the value of personalized care. The other was Damon Hostin, Administrative Vice President, Precision Medicine, at Catholic Health Initiatives, an organization that is an early adopter among health care systems putting precision medicine into action in their hospitals. Their two perspectives give insight into the “Why’s” and “How’s” of implementing precision medicine within our healthcare delivery model.

After obtaining his MD and completing internship, Dr. Dan Roden went to Vanderbilt where he trained in Clinical Pharmacology and Cardiology, and has been a faculty member there since. His initial career focus – that he has maintained – was studies of the clinical, genetic, cellular, and molecular basis of arrhythmia susceptibility and variability responses to arrhythmia therapies.

Over the last 10 years, Dr. Roden has led Vanderbilt’s broader efforts in pharmacogenomics discovery and implementation. He is principal investigator for the Vanderbilt sites of the National Institutes of Health’s Pharmacogenomics Research Network (PGRN) and the National Human Genome Research Institute’s Electronic Medical Records and Genomics (eMERGE) Network. He directs the Vanderbilt DNA databank BioVU, a discovery resource that as of spring 2014 included >175,000 samples linked to deidentified electronic medical records. He is a leader in Vanderbilt’s PREDICT project that since 2010 has been preemptively embedded pharmacogenomic variant data in the electronic medical records of >14,000 Vanderbilt patients; as of April 2013, PREDICT displays information on 5 drug-gene pairs and delivers point of care decision support when a target drug is prescribed to patients with variant genotypes.

Prior to joining Catholic Health Initiatives, Damon was a clinical business lead for Complete Genomics and Strategic Diagnostics. Earlier, Mr. Hostin served as VP of Scientific Operations for GenVis Labs, a genetic diagnostic company purchased by Pfizer in 2008. At Actinium Pharmaceuticals, Hostin managed alliances and licensing for the development of oncology therapeutic candidates. Earlier he served as Team Leader of Sequencing, at Celera Genomics- where he was co-published on the Human and Drosophila genome papers in Science as well as contributed to the launch of the commercial genomic database. Mr. Hostin’s education includes undergraduate studies at Tulane University; Master’s studies at Harvard University; and certificate programs at The Institute for Genomic Research, the NIH, and Wharton.

In its discussion of the Precision Medicine Initiative Cohort Program, the National Institute of Health states, “Far too many diseases do not have a proven means of prevention or effective treatments. We must gain better insights into the biological, environmental, and behavioral influences on these diseases to make a difference for the millions of Americans who suffer from them. Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. While some advances in precision medicine have been made, the practice is not currently in use for most diseases.

That’s why on January 20, 2015, President Obama announced the Precision Medicine Initiative® (PMI) (link is external) in his State of the Union address. Through advances in research, technology and policies that empower patients, the PMI will enable a new era of medicine in which researchers, providers and patients work together to develop individualized care.

The President called for $215 million in fiscal year 2016 to support the Initiative, which includes several components with efforts from across the federal government. Of this total proposed budget, $130 million was allocated to NIH to build a national, large-scale research participant group, called a cohort, and $70 million was allocated to the National Cancer Institute to lead efforts in cancer genomics as part of PMI for Oncology.”

Special Guests:

Dr. Dan Roden, MD, Professor of Medicine and Pharmacology, Assistant Vice Chancellor for Personalized Medicine, Vanderbilt University