February 12, 2009

UCSF Center Tackles Issues Surrounding Customized Health Care

Kathryn Phillips, PhD

As health care becomes increasingly custom-tailored and medical interventions are determined by a patient’s genetic makeup, a crucial question emerges: How can personalized medicine be used in a way that is at once efficient, effective and equitable? That question forms the foundation of UCSF’s new Center for Translational and Policy Research on Personalized Medicine (TRANSPERS), which was launched in 2008 with primary funding from the National Cancer Institute (NCI). It is the first NCI-funded center to focus on health policy issues related to personalized medicine. The center’s opening coincided harmoniously with the election of a president who has expressed a strong interest in using the study of genomics to better treat and prevent disease. While still in the Senate, President Barack Obama sponsored the Genomics and Personalized Medicine Act, and though that bill failed, his presidency is expected to usher in a new era of “genetically enabled health care,” said Kathryn Phillips, PhD, the TRANSPERS center’s founder, director and principal investigator. The TRANSPERS center aims to be a key player in that process by bringing together government agencies, patient advocacy groups, scientists and academics. Together, these stakeholders will explore issues such as how patients and health care providers make decisions about using personalized medical tests or drugs, and how to ensure that underrepresented minorities and the uninsured receive equal access to personalized care. “There have been 350,000 studies of gene-disease associations published [in medical journals], but only 2 percent of National Institutes of Health funding currently focuses on how to use those associations to improve health outcomes and policies,” Phillips said at the TRANSPERS center’s kickoff symposium on personalized medicine on Feb. 5. The center has already caught the eye of many state and national health policy experts, who say it will play an important role in advancing the conversation about personalized medicine. “TRANSPERS has an exciting opportunity to impact national health policy,” said Paul Billings, MD, PhD, a keynote speaker at the symposium and a member of the Secretary’s Advisory Committee on Genetics, Health and Society, which advises the US Secretary of Health and Human Services on matters related to the use of genetic technologies. For now, the TRANSPERS center will target two specific study areas – breast cancer and colorectal cancer – as a jumping-off point, Phillips said. One initial TRANSPERS research project will attempt to determine the most efficient way to use expensive tests such as gene expression profiling to determine a patient’s risk of breast cancer recurrence. Another project will focus on Lynch syndrome, an inherited genetic mutation that increases an individual’s risk of colorectal cancer. Researchers will explore whether the family members of someone with this mutation would want to know that they are at higher risk for cancer, and whether they would change their behavior if found to be at risk. In addition to funding from the NCI, the TRANSPERS center has received grants from the Blue Shield of California Foundation, the Aetna Foundation and the US Department of Veterans Affairs.

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