Progress in precision medicine means researchers in different disciplines have to work together. According to Beatrice Beck Schimmer, Zurich has what it takes.
Beatrice Beck Schimmer, the term “personalized medicine” suggests that in the future there will be therapies individually tailored to patients. Is customized treatment of this sort even possible?
Beatrice Beck Schimmer: It depends how you define it. What’s clear is that we’ll get better and more precise at identifying and defining groups of patients who respond to a specific therapy. For that reason, people now tend to talk of precision medicine rather than personalized medicine. It’s all about more precise diagnoses and therapies.
In what way will medicine get more precise then?
Colon cancer, for example, used to be seen as a uniform kind of tumor. With the new methods we have at our disposal, we now see that a colon tumor is by no means a uniform entity, but can be divided into many subgroups that differ in terms of treatment and prognosis. In other words, our focus has gotten much more differentiated.
What does precision medicine promise for patients?
The promise lies in the fact that it’s possible to address disease in a more targeted way. Certain types of cancer, for example, don’t respond to specific chemotherapies because there are one or more gene mutations that prevent this from happening. So the drug can’t trigger the desired effect. These patients used to undergo weeks and months of systemic chemotherapy to no avail. In some cases they had to put up with extremely unpleasant side effects without gaining any benefit. In the meantime their tumor may have gotten even bigger. In such cases, patients can benefit from the fact that diseases can be diagnosed much more precisely and treated accordingly.
With such good prospects, many researchers are very excited at the moment. Do you share their enthusiasm?
Absolutely. To move precision medicine forward it’s important for researchers and clinicians in very different disciplines to work closely together. This is why it’s so important to set up research centers and platforms. Interdisciplinary collaboration will also lead to new ideas. Good cooperation can make sparks fly, and make unexpected discoveries possible. As a hub for research encompassing UZH, the University's hospitals, and the ETH, Zurich has great potential. You’ll rarely find such a dense community of researchers in different fields in such close proximity anywhere in the world. .
Now UZH, ETH Zurich and the University's hospitals are planning a joint Center for Precision Medicine Research designed to become precisely this kind of platform for collaboration in precision medicine. What are your hopes for the new center?
The idea behind the Center for Precision Medicine Research is to systematically exploit the rich possibilities that exist in Zurich and promote close collaboration between basic, clinical and technology research. That will be an incredible gain for patients, but also for junior researchers and students. We’ll be systematically gathering and evaluating information and bringing the knowledge we gain back to the patient. The foundation for this will be the expertise of researchers, coupled with other resources such as patient data and samples, and additional infrastructure such as biobanks and technology platforms.
What do you expect this collaboration to achieve?
I think that in addition to boosting Zurich as a research hub, it will also help move precision medicine forward from a global point of view. Ambitious though it may sound, that’s our goal. We’ve jumped on board the precision medicine train, and now we should try to get to the very front so we have a say in where it's headed.
What’s in store for patients?
In the future we’ll be able to provide better diagnostics and more specific therapies for major diseases such as cancer, but also for metabolic disorders such as diabetes and autoimmune disease. Efforts to prevent certain diseases will be more effective and targeted as well. Precision medicine also has great potential when it comes to rare diseases. This is another area where we have to make progress and develop new therapies.
What are the major challenges?
Cost is certainly a factor to be considered. Precision medicine is expensive. Another challenge is handling patient data within the Zurich research hub and in collaboration with national and international centers. This raises a number of ethical issues connected with patient data privacy, for example.
Where do we currently stand in these terms?
Work is under way on solutions governing the way patient data are handled. We want individuals to benefit from the potential created by research on the basis of big health data sets without being harmed in the process.
The prospect of more precise therapies is encouraging. But as you mentioned, therapies of this type are also very expensive. Can we even afford precision medicine?
We can afford precise medicine more than we can afford imprecise medicine. It always boils down to the ratio of cost and effect: Even if a precision therapy is expensive, in the end it might turn out to be cheaper than an ineffective therapy. For example, many conventional therapies entail side effects. Patients suffer complications, and have to be hospitalized and treated with additional drugs to address these side effects. This means that precision medicine can help reduce costs because therapies are more targeted.
Where will we be in 10 years?
We’ll have taken a major step forward in terms of metabolic and autoimmune diseases, but above all in terms of cancer therapy. We’ll be able to treat certain diseases more precisely and successfully than we can at present. On the preventive side we’ll be able to use genetic and epigenetic data to tell people very precisely whether they should be choosing preventive therapy or changing their lifestyle to counter the risk of disease.
Will we be increasingly able to cure these diseases?
The more detailed our knowledge of these conditions, the more precise our data will be, and the sooner we’ll be able to find targeted therapies. Yes, I think prognoses will get better. That’s already the case for many forms of cancer.