Signals Winter 2014

SIGNALS Genome BC News | Winter 2014

ContentsFeature Story | Message from the President & CEO | Profile | Partnerships In Action | News & Announcements

Countries around the world are experiencing continuing increases in healthcare costs driven by ageing populations, chronic care patients, costs of new drugs, challenges due to complications of adverse drug reactions and lack of treatment efficacy, all compounded by ageing infrastructure in hospitals and clinics. Technological advances and innovative interventions are required to both stabilize costs and improve population health. Genomics is leading the way to developing diagnostic tools (such as blood tests) and patient-tailored medical treatments. It is anticipated that improved early diagnosis and treatments will address many of these challenges.

Here in BC we have areas of leadership in adopting new technologies in healthcare and we are working to become a centre of personalized medicine in Canada. We have the technology, talent and tenacity to foster a powerful shift in the healthcare system. We already see evidence that a genomics-based approach works to treat disease better, as evidenced by the BC Centre for Excellence in HIV/AIDS (see feature in our Partnerships in Action section). BC has many advantages that can contribute to excellence in personalized medicine:

• A population of 4.6 million who have universal access to publicly funded healthcare with a single- payer system;

• A well-educated and health-conscious population;

• A critical mass of researchers, physicians and healthcare providers keen to make genomic and personalized medicine approaches a success;

• A single medical school with connections to many communities and healthcare organizations, allowing rapid communication of personalized medicine practices;

• One of the world’s leading genome sciences centres, the Michael Smith Genome Sciences Centre, which can rapidly sequence and interpret tumour and normal genomes;

• An excellent record in biomedical research that is now maturing to the point where translation to clinical practice is a reality;

• Emerging schools of population and public health in our universities; and

• A networked and centralized system of care in key disease areas (e.g., cancer, transplantation, pediatric ailments, cardiac, renal and infectious diseases) with strongly integrated research and education components.

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BC: THE “PERSONALIZED MEDICINE” PROVINCE

The research projects will examine:

• Personalized treatment of lymphoid cancer: British Columbia as a model province (Joseph Connors, BC Cancer Agency)

• Viral and human genetic predictors of response to HIV therapies (Richard Harrigan, BC Centre for Excellence in HIV/AIDS, St. Paul’s Hospital)

• Reducing stroke burden with a hospital-ready biomarker test for rapid TIA triage (Andrew Penn, Victoria General Hospital)

• Clinical implementation and outcomes evaluation of blood-based biomarkers for COPD management (Don Sin, St. Paul’s Hospital, PROOF Centre for Excellence)

These projects offer significant opportunities to incorporate personalized medicine tools into clinical practice. Operational challenges like big data sets, linking electronic medical records and real-time applications are significant – but collectively we have the champions and the capability to provide the answers!

The focus on personalized medicine is not just ours. In addition to Genome BC, the province boasts several academic health centres linked to clinical practice, and the broad academic collaboration illustrated by the Personalized Medicine Initiative (PMI). In the last year Genome BC has launched four large-scale applied research projects focused exclusively on determining how genomics-based research can contribute to a more evidence-based approach to health and improving the cost-effectiveness of the health-care system. These projects were awarded funding through Genome Canada and Canadian Institutes of Health Research “2012 Large-Scale Applied Research Project Competition in Genomics and Personalized Health”. Results of the competition were announced last year with four BC-based projects worth $32 million to the province.

We already see evidence that a genomics-based approach works to better treat disease better, as evidenced by the BC Centre for Excellence in HIV/AIDS.

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BC: THE “PERSONALIZED MEDICINE” PROVINCECont’d from cover

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MESSAGE FROM THE PRESIDENT & CEO

FROM HIV TO LNG, PARTNERSHIPS ARE CLEARING THE PATH TOWARDS SOLUTIONS

Partnership is an essential component of personalized healthcare—moving a concept through the continuum of discovery research to translational medicine requires both investment and collaboration. In 2001 and 2002 Genome Canada’s Competitions I and II funded basic research projects with Genome BC that, at the time, were large, complex projects that brought new methods and technologies to the genome sciences by combining local, national and international expertise. In 2003, Genome Canada hosted a competition focused on the development and application of genome sciences tools to improve the prediction, prevention, and treatment of human diseases for individuals and populations (the Applied Human Health competition or AHH). Six BC-based projects were approved for funding under this competition, with a three-year investment of $44.1 million coming from Genome Canada, Genome BC and others.

To facilitate the translation of knowledge into the clinical setting, Genome BC launched the Translational Program for Applied Health in 2007. The program funded the additional work in BC required to further develop applications resulting from three AHH research projects. Following this Genome BC launched the Genomics and Health: Personalized Medicine Program in 2010 with funding provided by the Government of BC and others, as part of Genome BC’s 2010-2015 strategic plan, to build on several initiatives of strategic importance to the province that expand existing capabilities in the translation of discovery science to everyday life.

In 2012, BC was awarded 24% of federal funding dollars, and over $32 million in total project funds, in Genome Canada’s Genomics and Personalized Health competition.

Due in part to investments from the Province of BC over the past decade; BC is able to compete so successfully on the national and international stage. Each of the four recently funded projects (see our cover story) allowed us to enter into meaningful partnerships with new groups and most importantly with users of the research applications.

Partnerships were also high on the agenda during a recent trade mission to China and Korea, where I accompanied the BC delegation. The main purpose of the mission was to discuss liquefied natural gas (LNG), but our visit to Beijing also coincided with the signing of a memorandum of understanding (MOU) by delegates from the BC Centre for Excellence in HIV/AIDS (BC-CfE) and the National Centre for AIDS/STD Control / Prevention and Chinese Centre for Disease Control and Prevention. Genome BC also contributed to the joint China/Canada project. The MOU solidifies the relationship between China and the BC-CfE, which began in 2011 when China announced its implementation of the BC-CfE pioneered Treatment as Prevention strategy.

The mission was not only productive from a partnerships perspective, allowing us to meet with LNG interested groups on environmental/production issues and participate in the MOU signing, but also provided us the opportunity to visit China’s significant genomic facilities.

Whether it is personalized medicine or the LNG environment and production, we look forward to long and productive partnerships.

Alan E. WinterPresident & CEO, Genome British Columbia

A premier cardiologist, genetic researcher and technologist, Dr. Eric Topol likes what he sees in the future of health care. In September of 2013 in front of a sold-out crowd, he delivered an eloquent presentation on the fascinating developments in wireless technology allowing physicians to monitor and respond to their patients vital signs from anywhere in the world — all in real time.

As a leader in the movement to modernize medical treatment through the latest technology, Dr. Topol is creating new, more effective ways to treat patients — ways that could enable dramatic cost savings in health care. “When you can digitize and share data of a human being and the medical essence in each of us, that leads to the unique ability to prevent conditions or better manage ones that already exist,” he explains.

In BC we can see early applications of this technology in the management of HIV/AIDS where real-time monitoring of infected populations and viral load helps to lower health costs through timely and responsive treatments. Imagine if people could text vital signs to their physician and get almost instant feedback; or use

an app to manage their insulin levels. This could soon be reality.

In Dr. Topol’s recent book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, he describes how social networking, smartphones and connectivity are revolutionizing the medical field. He believes we are at the beginning of a major shift in healthcare but suspects it could take the medical system up to 15 years to adapt. This revolution will be spurred more quickly by users who are increasingly tech-savvy, vocal and powerful. Once consumers begin to understand more and more about their own DNA they will have the unprecedented capacity to take control of their own individual information and revolutionize medicine.

Dr. Topol is also a leading medical researcher in the area of genomics, where his work has led to the discovery of the genes that increase a person’s risk of heart attack. He has pioneered new drugs and new advances in the treatment of heart disease. His excellent medical research has led him to being named “Doctor of the Decade” by the Institute for Scientific Information.

Dr. Topol is working to bring a new kind of medicine into widespread practice: specifically-designed treatments based on the individual’s unique genetic structure. This innovative approach, combined with the latest in medical technology, opens up a world of highly personalized treatment, better care, reduced need for hospital beds, and lower costs for everybody.

As director of the Scripps Translational Science Institute, Dr. Topol is dedicated to training new generations of physicians and scientists for research based careers — bringing together the latest scientific findings and clinical work for more effective medical research.

PROFILE:DR. ERIC TOPOL

DIGITIZING HEALTHCARE ONE PERSON AT A TIME

Up until the mid-1990s, an HIV diagnosis was tantamount to a death sentence. The story of how we have changed the course of HIV and AIDS—transforming it into a chronic, manageable disease—is a lesson in innovation and collaboration.

Despite best efforts, the single-drug therapies in the early years of the epidemic had proven inadequate in stemming the progress of the disease. In 1994, working with a group of international collaborators, my colleagues and I at the BC Centre for Excellence in HIV/AIDS began to study a novel triple combination therapy regimen. The results were nothing short of remarkable. We found triple drug therapy was able to drive the levels of HIV in blood down to undetectable levels—key to stopping the progression of the disease.

We found triple drug therapy was able to drive the levels of HIV in blood down to undetectable levels.

ADVANCING HIV TREATMENT AS PREVENTION

PARTNERSHIPS IN ACTION: BC CENTRE FOR EXCELLENCE IN HIV/AIDS

MISSED THE WINTER SYMPOSIUM?

Checkout videos on our YouTube channel:

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We introduced this highly active antiretroviral therapy (HAART) at the 1996 International AIDS Conference in Vancouver and, later that year, the Ministry of Health announced B.C. would be the first province in Canada to adopt triple drug therapy, along with viral load testing, for all eligible patients.

It wasn’t long after we noticed an unanticipated and significant decrease in the number of new HIV diagnoses. It appeared HAART was making it less likely that a person living with HIV would transmit the virus. The concept of Treatment as Prevention, which calls for widespread HIV testing and immediate provision of HAART to those living with HIV, was born from this discovery.

We introduced this highly active antiretroviral therapy (HAART) at the 1996 International AIDS Conference in Vancouver... It wasn’t long after we noticed an unanticipated and significant decrease in the number of new HIV diagnoses.

As a result, B.C. has seen HIV-related morbidity and mortality decline by over 90 per cent since 1995.

With funding from Genome BC and others, we’re now developing an improved HIV drug-resistance test, real-time drug resistance surveillance, and improved methods for personalizing treatment of HIV based on each patient’s unique DNA. This cutting-edge test will detect drug-resistant HIV strains that existing tests can’t, and we’ll be able to monitor the emergence of drug resistance in real time and identify patients with newly acquired drug-resistant strains faster.

These advances will allow us to intervene proactively and preemptively so resistance doesn’t become widespread, further improving the quality of life for patients and reducing the likelihood of transmission of drug-resistant HIV.

Thanks to innovation and collaboration, we now stand at the precipice of eliminating this disease. It is only together we can stop HIV and AIDS.

Dr. Julio Montaner is the Director of the BC Centre for Excellence in HIV/AIDS.

PARTNERSHIPS IN ACTION:ADVANCING HIV TREATMENT AS PREVENTION Cont’d from previous

We expanded testing and treatment across the province and, led by Dr. Richard Harrigan, our Laboratory Program performed viral load and resistance testing. This has made the identification of appropriate patient therapy more effective in reducing the amount of HIV in the blood and improving the individual’s health. As a result, B.C. has seen HIV-related morbidity and mortality decline by over 90 per cent since 1995. Over the same time period, the number of new HIV diagnoses has fallen from more than 800 per year in 1995 to 238 in 2012.

The success of Treatment as Prevention is a testament to what we can achieve when we work together.

Dr. Richard Harrigan

Dr. Julio Montaner

NEWS & ANNOUNCEMENTS

GENESKOOL CLASSROOM VISITS

Volunteers from Genome BC’s Geneskool program visited three new communities this past October. Students in Cranbrook, Jaffray and Fernie had a great time learning about genomics and DNA. The demand continued into early 2014 when volunteers also visited almost 400 students in Boston Bar, Hope and Agassiz.

INTERNATIONAL SCIENTIST VISITS VANCOUVER

Genome BC introduced Sir Gregory Winter (2nd from the left) as the keynote speaker at the LifeSciences BC Breakfast on October 21st, 2013. A scientist and entrepreneur, he has been at the forefront of protein engineering, and his inventions can be found in commonly used drugs including Herceptin and the first human monoclonal antibody, Humira.

GENOME BC BOARD MEMBER RECOGNIZED

Congrats to Dr. Victor Ling (Genome BC Board Member) who received the award for Exceptional Leadership in Cancer Research at the Cancer Research Conference Awards on November 5th, 2013. He was recognized for his outstanding contributions to the leadership of cancer research and his contribution to the development of a Canadian strategy for cancer control which ultimately led to the formation of the Canadian Partnership Against Cancer.

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Genome British ColumbiaSuite 400575 West 8th AvenueVancouver, BC V5Z 0C4Tel: 604 738 8072

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Alan PelmanChair

lan de la RocheVice Chair

Alan WinterGenome BC

Neena L. ChappellUniversity of Victoria

Ken GalbraithVentures West Capital Ltd.

Ida GoodreauUniversity of British Columbia

Janet HalliwellJ.E. Halliwell Associates Inc.

Victor LingTerry Fox Research Institute

Peter O’CallaghanBlake, Cassels & Graydon LLP

Edward SafarikOcean Fisheries Ltd.

John ShepherdUniversity of British Columbia

John F.H. ThompsonPetraScience Consultants Inc.

BOARD MEMBERS

We welcome your comments and input.Please send comments to: [email protected]

Genome BC is supported by the Province of British Columbia, the Government of Canada through Genome Canada and Western Economic Diversification Canada and more than 300 international public and private co-funding partners.

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TOP 40 UNDER 40

BC’s Top 40 Under 40 Awards were handed out on January 30th. Winners from life sciences sectors include James Taylor (CEO & co-founder, Precision NanoSystems), Paul Schaffer (Head of Nuclear Medicine, TRIUMF) and Andrew Knowles (VP Operations, Stemcell Technologies).

WINTER SYMPOSIUM

Genome BC hosted its annual Winter Symposium at the SFU Segal Building on January 21st. This dynamic forum for the life sciences included talk from scientists and end-users in human health, forestry, and fisheries and aquaculture. Talks from this session have been posted to our YouTube channel: www.youtube.com/user/genomicseducation

BRINGING GENOMICS HOME TO PRINCE GEORGE

Genome BC partnered with the University of Northern British Columbia to host an open dialogue on genetically modified organisms (GMOs) on January 28th, 2014. The event featured four panelists (Serena Black, Yvonna Breed, Shawn Mansfield and Jillian Merrick) moderated by Don Bassermann and included an active Q&A session with the audience. Stayed tuned as the event will be uploaded to our YouTube channel soon.