Abstract
Chris Anderson, Editor in Chief
Much is made of health disparities in the United States, and the causes are multivariate involving some combination of lack of access, socio-economic status, lack of health insurance, diet, and lifestyle. The unfortunate reality is that like most of life, when it comes to healthcare—at least in this country—there are haves and have nots.
This contrast is especially stark in cancer care, where those fortunate enough to live within shouting distance of an urban center or top-notch academic medical center can get the best care, including precision cancer treatments guided by genomics. It’s a level of care that is simply not available to the majority of cancer patients. And while the catchphrase “the democratization of cancer care” rolls off the tongue with the latest gee-whiz advance in genomic-guided precision treatment, too many people—including myself—blithely discuss this so-called democratization without a thought to what that practically entails.
That’s not the case with it comes to Ed Liu and has team at The Jackson Laboratory (JAX), and the affiliated Maine Cancer Genomics Initiative (MCGI). Liu, who joined JAX as CEO in 2012, has led a transformation of the organization, most notably the creation of The Jackson Laboratory for Genomic Medicine opened three-and-a-half years ago in Farmington, CT.
With MCGI, Liu has made clear his intentions. “My view was that unless we had a regulatory-compliant unit that brought our technologies to the most proximate place of human contact, the clinic, we would forever be an ivory tower,” he says.
The first investment of $12 million dollars from JAX, in conjunction with a private foundation grant of $8.4 million, established MCGI. Its mission: to work with all the hospital systems and oncologists in Maine; provide free cancer genomic testing to 1,800 cancer patients; build an educational and consultative framework for genomic medicine; and create an IT and technology backbone to deliver it all to oncologists and their patients, regardless of location.
The five-year initiative is set to conclude in 2021 at which time MCGI will have collected data not only on the health outcomes of patients and the economic benefits of making genomic testing an integral part of cancer care, but also data on the doctors and how the tools MCGI provided transformed their practices.
The clinicians, Liu said, “are not just recipients, but participants in an enterprise. Our study is not just the delivery of the product—this test to the patients—but the doctors themselves are also test subjects.”
In short, the initiative hopes to discover methods of mitigating disparities in cancer treatment, in a broad geographic area, and across a range of socio-economic populations, leveraging both diagnostic and telemedicine technologies. If successful, the model could be deployed in other areas across the country.
This is what democratization of cancer care could look like.