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Implementing Genomics and Precision Medicine in Canada
Dr. Catalina Lopez-Correa
CSO & VP Sector Development at Genome British Columbia
6th Munich Biomarker Conference
November 30th, 2016
Why Genomics?
“What physics was to the 20th century, biology will be to the 21st” The Economist, Jun. 2007
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Canada’s Genomics Enterprise
• 6 regional Genome Centres
• 10 Genomic Innovation
Network Nodes
• 210+ large-scale research
projects/initiatives funded
across all life science sectors
• 45 HQP on average,
per project
• 58+ companies created
or enhanced
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Genome BC - History
• Co-founded by the late Dr. Michael Smith, Nobel Laureate, Genome British Columbia was formed in July 2000
• Vision: Genome Sciences will revolutionize many aspects of our lives and provide solutions to humankind’s challenges.
• Four strategic plans to date:
• Plan 1 (2001-2005); $107M - complete (Provincial contribution - $27.5M)
• Plan 2 (2005-2010); $316M - complete (Provincial contribution - $75M)
• Plan 3 (2010-2015); $340M - on track (Provincial contribution - $85M)
• Plan 4 (2015-2020); $306M - launched (Provincial contribution requested - $85M)
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7
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Genome BC – Investment portfolio
• Cumulative portfolio of $710 million in genomics research projects and science and technology platforms:
• Current Platforms: Genome Sciences Center (GSC) Proteomics
Metabolomics
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ACADEMIA
INDUSTRY GOVERNMENT
Sustainable Investment for
Economic Cluster Development
Genome BC - Catalyst role
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SOCIETY
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Genome BC - Investment Sources
Provincial 25%
Federal 45%
Provincial Funding Objectives • Match BC’s key economic
priorities.
• Attract co-investment, including from users to help realize the benefits from commercialization.
• Partner with a broad cross-section of provincial universities and colleges.
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International, Industry &
Institutional 30%
Genome BC - Funding Continuum
Discovery Research Applied Translational
Genome BC invests in critical space along the research funding continuum to bring genomics discoveries from
the bench into real world applications
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Commercialization
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Many Partner Co-Investors Worldwide (300+), e.g.:
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2000-2005 Plan
Building the
Foundation
2005-2010 Plan
International
Recognition for
Excellence
2010-2015 Plan
Strategic
Investment for
Applications
2015-2020: Meeting User Needs Through a Sustainable Pipeline
Discovery 90%
Applied 10%
Discovery 63%
Applied 30%
Translation 7%
Discovery 41%
Applied 37%
Translation 22%
Translation 35%
Applied 35%
Discovery 30%
2015-2020 Plan
Sector-driven
User Co-investment
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Building a Future: Genome BC 2015-2020
• Invest $340M into Discovery, Applied and Translational research key
to Life Sciences jobs plan
• With $85M from the Province, attract $255M from partner co-investors for genomics R&D
• Focus on sector-driven research to deliver economic and social benefit of BC
• Continue to enhance BC’s national/international competitiveness for scientific excellence in genomics
• Drive opportunities for BC through 2020 and beyond
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Genome BC’s 2015-2020 Plan – Key Themes
Maintaining a world-class genomics region
• Enhance BC’s capacity for world-class genomics research • Balance a portfolio of discovery and user driven applied and translational research • Support BC’s research universities, research institutes and teaching hospitals • Attract and support the best talent
Building BC’s bioeconomy and engaging with sectors
• Attract federal and other co-investment, including private and foreign funds • Increase interaction with industry, users, and investors in key sectors • Engage with industry through Public/Private Partnerships, such as
sector innovation centres • Target investment through sector specific programs
Education
• Continue to enhance the education of the next generation of genomics scientists
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Companies Advanced by Genome BC (38) 38 Companies Advanced by Genome BC:
Connecting User with
Researcher
Genome BC Programs: GeneSolve
User
Sector Challenge
Academic Solutions
Finalize the Project
Academic Scientist
•Panel Review • Funding
• Deliverables
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Examples of communities throughout the province where Geneskool Workshops have been presented.
Abbotsford
Burns Lake
Campbell
Castlegar
Chetwynd
Coquitlam
Dawson
Fort Nelson
Fort St.
Fraser Lake
Haida Gwaii
Invermere
Kamloops
Kelowna
Mackenzie
Nanaimo
Nelson
North Delta
North
Parksville
Prince George
Quesnel
Richmond
Surrey
Terrace
Vancouver
Williams Lake
Clinton
Port Moody Burnaby
Chilli
wack
Comox
Fraser Lake
Langley Mill Bay
Richmond
Surrey
Cortes Island
Chemainus
Chilliwack Parksville
Fraser Lake
Richmond Surrey
Coquitla
m
Chetwynd Mackenzi
e
Fort St. James
Invermere
Haida Gwaii
Fraser
Valley
North Delta
Education
Inspiring the next generation of scientists
Geneskool Workshops for students across BC
2000
Educating Leaders in BC
2015
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|
GENOME BRITISH COLUMBIA
PRECISION MEDICINE PROJECTS
Cumulative investment in 145 projects • 53 Active
Total $352.5M: GBC $69.3M with Co-investment $283.2M
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Prevention Prognosis Treatment
Diagnosis
Genomics
First Nations
Biobank
RapidOMICS Genomics for
pharmacists Biomarkers for COPD
Management
Prenatal
Screening
Non-invasive prenatal testing (NIPT) Researchers: Francois Rousseau, Sylvie Langlois
Safer prenatal screening solution (each year 10,000 amniocentesis cause the loss of 70 healthy fetuses). NIPT is revolutionizing prenatal care.
New genomic technologies allow the detection fetal genetic abnormalities in maternal blood. Equip decision makers, pregnant women and their partner to make informed choices pertaining to prenatal genetic screening and diagnosis. High demand from the public for test coverage of NIPT – health care decision-makers will use project results to decide on coverage policies.
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From years to days: RapidOmics Researchers: Jan Christilaw, Jan Friedman, Alison Elliot and Horacio Osiovich
Genetic disorders are a leading cause of infant mortality and make up a large percentage of the patients in BC NICU’s
An accurate and rapid diagnosis can guide treatment decisions but this is currently a significant challenge RapidOmics: pilot study exome sequencing 25 trios (baby + parents) provide results in 5-7 days This proof-of-concept could replace hundreds of different tests, improving outcomes and saving the system money
BC pharmacists leading precision medicine Researcher: Corey Nislow
Approximately 50% of all emergency department visits each year are due to adverse reactions to medications in adults aged 50 and over
Across BC, 33 community pharmacies have taken part in North America’s first project to implement pharmacogenomics
Extract DNA from Saliva, sequence DNA and prescribe
the right drug to the right patient at the right time
and right dose
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Combatting “lung attacks”
• Blood test that will identify patients at high risk for Chronic Obstructive Pulmonary Disease (COPD).
• Marker panel is in development; refining selected markers.
• Test will improve treatment, lead to patients with fewer attacks and reduced hospitalization and emergency visits.
The project is led by Dr. Don Sin, St. Paul’s Hospital, University of British Columbia
Leading the world in HIV/AIDS research Researchers: Julio Montaner and Richard Harrigan
In Canada over 70,000 people are infected with HIV and nearly $1 billion is spent on HIV drug cocktail therapies each year
The BC Centre for Excellence is HIV/AIDS is leading the world to reduce HIV/AIDS global burden
by 90 % in 2030
Genome BC is supporting the BCCfE in developing an HIV drug-resistance test, real-time drug resistance surveillance and better methods for personalizing treatment of HIV based on each patient’s unique DNA
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The Personalized Onco-Genomics (POG) Program Researchers: Janessa Laskin and Marco Marra
This BC Cancer Agency project looks at the specific mutations that cause cancer.
350 patients have received personalized treatment, based on their DNA
representing 50 different cancer types.
The next phase: More patients, more cancers
Doctors can then customize treatment
options to target those mutations,
increase efficacy and reduce overall cost
Path to the clinic
Centre for
Clinical Genomics
“Test” e.g.
Hereditary cancer panel
Oncopanel
Myeloid Panel
Ethics
Privacy
Economic evaluation
Populations
(BC and beyond)
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Genome BC’s strategy for investment in health
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Invest in genomic health research across diseases based on merit and potential impact
Enable targeted application of genomics at the level of populations Genome BC
focus areas MIND THE GAP
External guidance Research Oversight Committee
Common requirements
Cancer Infectious diseases
Rare diseases Pharmaco-genomics
Oversight Committee
Funding / partners
Genome BC, Genome Canada, CIHR, Industry partners, other partners
Stakeholder Research
Establish Health Sector Task Force
Consultations
Draft Health Sector Strategy
Health Sector Strategy
Genome BC Health Strategy
Rare diseases
Pharmacogenomics
Infectious disease
Cancer
Exemplars
Genome BC Health strategy
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Total GBC investment in four priority areas
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Infections Diseases
Cancer
HIV (UPP), Bridges (PP)
POG (SI), BIX (PP)
Rare Diseases
CAUSES (SI), iTarget (SI)
Pharmaco- Genomics
DynaCare (GAPP), BCPharma (UPP)
$2,6 M
$0.4 M
$1,7 M
$0,6M
Total GBC investment ~ $5,4M
Implementation Barriers
1. Lack of coordination and centralization
2. Need to stablish an official mechanism of Genomic Data Sharing (GDS)
3. Bioinformatics focusing mostly on research instead of data interpretation and data integration into the clinic
4. Limited number of Genetic Counselors & Bioinformatics (interpretation)
5. Several EHR systems are being used (work in isolation and implementation varies greatly between regions)
6. Lack of unique/harmonized system to evaluate new technologies (NICE, FDA)
7. Education of health care providers
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Crosscutting Areas to Accelerate Implementation
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Cancer
Education of Heath Care Providers
Infectious Diseases
Rare Diseases
Pharmaco- Genomics
Big Data (Data integration, data sharing)
Infrastructure (Biobanking, Sequencing, etc)
Delivery/Access (policy, reimbursement, economics, etc)
Implementation
Requirements for success
1. Scientific understanding and technical capabilities
2. Alignment and prioritization
3. Health information technology tools and infrastructure
4. Clinical and laboratory infrastructure and capabilities
5. Regulatory guidelines
6. Harmonized ethical consent
7. Privacy / anti-discrimination policies and legislation
8. Reimbursement guidelines
9. Healthcare professional capacity, awareness, training and adoption
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Capabilities / Resources
Patient Adoption
Provider Adoption
Aggregating, Integrating and Sharing Data
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International Colaborations
Genome BC & Genomics England Collaboration
Finalize exemplar and business plan
1. Build expert working group 2. Generate candidate exemplars 3. Expand / assess top 2-3 ideas 4. Refine and prioritize exemplars 5. Identify exemplars for collaboration
1. Build oversight committee 2. Review proposed exemplars 3. Develop business plan** 4. Harmonize data sharing tools
and processes
1. Solidify partners and funding
2. Develop agreement amongst partners
3. Implementation of pilots
Disease
Indication
Phase 2: Implementing Pilots (Dec 2015-Dec 2016) 32
Phase 1: Implementing the MOU
(Sept-December 2015)
Develop projects Projects Identify mutual
interests
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Infectious
Pilots
Review Launch Concept Submission Resubmission
/ Review
Rare Review Launch Concept Submission Resubmission
/ Review
Cancer Review Launch Concept Submission Resubmission
/ Review
Bio-
informatic
s
Review Launch Concept Submission Resubmission
/ Review
Pilots Status
Steering Committee Meeting (Monthly)
MOU Advisory Council meeting (February, March, May, October)
Activities
A very long SAGA…
The CEO of an Icelandic
gene-hunting company says
he is able to identify everyone
from that country who has a
deadly cancer risk, but has
been unable to warn people of
the danger because of ethics
rules governing DNA research
MIT Technology Review, 2015
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The Global Alliance was formed to help
accelerate the potential of genomic
medicine to advance human health.
Brings together over 400 leading
institutions working in healthcare,
research, disease advocacy, life science,
and information technology.
Framework of harmonized approaches to enable the responsible, voluntary, and secure sharing of genomic and clinical data Data Overload – Informatics
Big Data
Questions?
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