Ohio State’s push into personalized medicine: Q&A with Clay Marsh

Helping lead Ohio State’s foray into personalized medicine is Dr. Clay Marsh, director of the Center for Personalized Healthcare (CPHC).

If the promise of personalized medicine ever comes to fruition, Ohio State University Medical Center looks well-positioned to reap the rewards.

Five years ago, OSU established the Center for Personalized Health Care, which is dedicated to education and research to advance personalized medicine. Earlier this year, OSU joined the Seattle-based Institute for Systems Biology to create the P4 Medicine Institute, another organization aimed at advancing the field.

While a standard definition of personalized medicine may be hard to come by, the term generally refers to tailoring patients’ treatment regimens to their own genetic and molecular signatures. The concept is important because some estimate that about half the amount spent on prescription drugs in the U.S. is wasted because, for various reasons, certain drugs simply don’t and won’t work on certain patients.

It’s no secret why anyone in the healthcare industry would want to move into personalized medicine — the field is expected to attract more and more dollars in the future. The worldwide pharmaceutical, medical device and diagnostics segment of the market is $24 billion and growing at 10 percent a year, according to a report from PricewaterhouseCoopers.

Helping lead Ohio State’s foray into  personalized medicine is Dr. Clay Marsh, director of the Center for Personalized Healthcare (CPHC). Marsh is an internist who specializes in research into the causes of advanced lung disease. He joined OSU’s faculty in 1993 and became the CPHC’s executive director about a year ago.

Marsh spoke with MedCity News about what needs to happen for personalized medicine to become more widespread, Ohio State’s efforts to commercialize research in the field, and how he defines personalized medicine.

Q: Why do you feel that it’s important for OSU to be a leader in personalized medicine?

A: I think it’s important that Ohio State focus on this area because the potential is there to have things much better for the people in our health system. The problem is it’s too expensive, the quality isn’t consistently good enough and the convenience of finding the right care when you need it is lacking. Our current system focuses on disease-based care but the game-changer will be to help people stay healthy.

Q: Do you envision a time in which the vast majority of medicine in the U.S. is “personalized”? When might that happen?

A: Yes, a good friend of mine said once that we’ll be successful when “personalized medicine” is just referred to as “medicine,” and I agree with that. We want to more precisely understand who needs the right treatment at the right time, and eventually be able to use diagnostics to stratify people into more precise populations to prevent them from getting sick. That is where many fields are going, but cancer is probably the most advanced. It’s about becoming much more precise and it’s about creating processes so that the same great care is administered everywhere.

Q: Is there any research you can tell us about at the CPHC that’s close to being commercialized?

A: We certainly have a variety of intellectual properties that have been submitted and are at some levels being approached by companies. For instance, we’ve created several drugs through the college of pharmacy that have been acquired by a company looking to use this as a new approach to cancer. Arno Therapeutics acquired new anti-cancer drugs created by Dr. Ching-Shih Chen and is testing these agents in clinical trials.

Additionally, work from our laboratory found that we all have small pieces of cells circulating in our blood that contain genetic material called microRNA, which can be monitored and may be a barometer of health and change in disease. Caris Life Sciences, a company in Dallas, acquired this technology and has marketed new molecular diagnostic blood tests to diagnose cancer using this technology.

Q: The promise of personalized medicine has been well-documented, but do you see any drawbacks associated with the field?

A: One of the challenges for the field is to agree upon what personalized medicine means. There are a lot of different definitions. To some, personalized medicine means genomic medicine. Others might see it as patient-centered medicine. We believe that ultimately for personalized medicine to be effective, it has to consist of systems of care. We believe that new care models need to be process-based and need to be scalable and portable so more precise strategies and consistent delivery of the best care models are experienced by all.

Q: Why did OSU join the P4 Medicine Institute?

A: The partnership combines the excellence in research and technology of the Institute for Systems Biology (ISB) with the excellent patient care and deep resources of Ohio State. Together we will create and test programs that can be scaled to answer the problems of healthcare in our country. As a reflection of the partnership, pilot programs are under way at OSU to bring medicine to people where they live and technologies created by ISB are being brought to the patient-care environment.

Specifically, Ohio State has created pilot approaches to patients with chronic disease and also for people who are healthy to understand how we can coordinate our care better for people in their homes and communities, and how we can define health and wellness to help people avoid these chronic illnesses. The concept that’s being followed is that health and disease is a product of genes times environment times behavior where the study of genes includes both sequencing of DNA, assessment of epigenetics  (the controls or turn on/turn off signals of DNA), which are influenced by a person’s environment  (exercise, nutrition, sleep, biological rhythms, air and toxins) and behavior  (stress, optimism and spirituality). Understanding the complex and dynamic interaction between our DNA, the signals that control our DNA and the environment and behavior of individuals determines our health status.