Geisinger Health System announced this week that it’s working with Regeneron Pharmaceuticals (NASDAQ: REGN) in a project to use genetic samples from more than 100,000 volunteers to identify and validate associations between genes and human disease. The move reflects Geisinger’s efforts to advance genomic analysis from the research stage to the point where it is used in treatment decisions.
In a phone interview, Geisinger Chief Scientific Officer David Ledbetter told MedCity News that the collaboration with Regeneron marks a critical point in its effort to find a funding partner to help advance its genetics program which has been slowly growing for the past 20 years.
Ledbetter was director of the division of medical genetics at Emory University in Atlanta before he joined Geisinger three years ago. Since then he has assembled a team of more than 15 faculty members including genetic specialists, bioethicists and genetic counselors. Geisinger opened a biobank in 2006.
The vision of the five-year program is that it will provide Geisinger with tools to foresee disease before the onset of symptoms, diagnose chronic and potentially fatal conditions before it’s too late to intervene and determine how best to optimize health for each patient. Ledbetter highlighted some priorities and considerations for the program.
What do patients and their families want? “We are in an ongoing discussion with patient populations beyond what is clinically relevant today,” said Ledbetter. “What is the correct ethical framework? What is the appropriate way to partner [with patients] to benefit health and wellness?” He added that it supports the idea that patients should own their data. On the other hand, there are practical issues of handing people terabytes of hard drive they would be unlikely to use.
Evaluating candidates for surgery: Currently in discovery mode, a predictive test for obesity to determine who would benefit from bariatric surgery and who would not is being developed at Geisinger. Although everyone loses weight from bariatric surgery, Ledbetter noted, some genetic data indicates that people with a particular allele tend to regain it. Holistic sequencing: No matter how healthy or asymptomatic a patient may be, it’s possible that the genomic data will lead to physicians identifying people at high risk for developing colon cancer or breast cancer. “We want to get it to a point where we not only feel comfortable [conducting] the genetic test, but also feel comfortable informing the patient,” Ledbetter said. He added, “This team we have assembled is designed to ensure that we do this in an ethical manner.” It’s expecting the study will find people at risk for developing cancer and would use genetic counselors to convey that information to clinical providers, Ledbetter said.
The collaboration will also allow Geisinger to do much longer longitudinal research to determine when and how genetic information can help with early diagnosis to provide the right treatment for the right patient.
