Abstract
Chris Anderson, Editor in Chief
In this issue, two stories point to the progress of precision medicine, and it is progress that falls outside the original vision 15 years ago that the path to precision medicine would be focused primarily on genomic information.
The first is our cover story, “Clinical Combinations” (see page 18), which dives into the research and growing use of phenotypic data in conjunction with a patient's genomic data to help suggest more precise methods of treatment for patients. Pharmacogenomics is perhaps the furthest along the path of using data to better help understand how a patient's genotype affects the way they will respond, either positively or negatively, to specific drugs, but there are other efforts underway to combine the use of these distinct, but related data sets to help improve care.
Perhaps one area that has hindered genotype-phenotype research has been the past difficulty of combining data from electronic health records (EHRs) and genetic information to allow care providers to house these data in one place. But as smaller companies have sought to provide forms of solutions for this barrier, signs are the big EHR companies may finally be getting on board.
Epic, after taking some heat a few months ago for supporting legislation that would essentially help it maintain its stranglehold on patient records, has recently announced partnerships to integrate genomic information. And startup company Seqster, which recently received an investment from Takeda, believes it has created a platform that solves the patient data-genomic data interoperability roadblock.
Also this month, is a story I wrote about Epic Sciences “Comprehensive Approach” (see page 24) and its push to become a leading player in liquid biopsy-based diagnostics. The company, which has a unique and powerful visualization technology to identify circulating tumor cells (CTCs) in a blood sample—and a CTC-based approved prostate cancer AR-V7 test—has embraced a multianalyte approach to its current diagnostic development program in breast cancer.
Now, instead of relying exclusively on the identification and analysis of CTCs, the company has listened to clinicians who noted that a combination of information obtained from CTCs and from ctDNA would provide them with the most complete information of a patient's cancer to guide the best treatment.
As Epic CEO Lloyd Sanders puts it, companies like Epic and those in the ctDNA space “doubled down” on optimizing their technology in an attempt to squeeze out additional information that the technologies couldn't deliver. Treating them as complementary—instead of competing—technologies and bundling them into one diagnostic seems to have put Epic in a leading position to deliver on the potential liquid biopsies as a testing platform today for metastatic disease and perhaps, in the future, as a tool for monitoring adjuvant therapy to help find patients most likely to have a recurrence.