Raju Kucherlapati

Raju Kucherlapati

President Obama has proposed the Precision Medicine Initiative, a $215 million effort to help uncover the genetic variations that drive health and disease. The ultimate goal is to translate these findings into better health care based on an individual’s unique genetic profile.

First mentioned in his 2015 State of the Union address on Jan. 20 and outlined in more detail in a press conference on Jan. 30, the proposal includes $130 million earmarked for the National Institutes of Health to kick-start the genomic sequencing of 1 million volunteers; $70 million for the NIH’s National Cancer Institute to identify additional genomic drivers of cancer and to develop more targeted cancer treatments; $10 million for the U.S. Food and Drug Administration to support the regulation of advances in personalized medicine; and $5 million for the Office of the National Coordinator for Health Information Technology to safeguard data privacy.

Harvard Medicine News recently talked with BWH’s personalized medicine specialist and bioethicist Raju Kucherlapati about the proposed initiative and about recent advances and future hopes in the field. Excerpts from that interview appear below – read the full story on the Harvard Medical News website here.

Q: What is your reaction to the president’s announcement?

Kucherlapati: We’ve been working to bring genetics to the clinic for many, many years. I think it’s very exciting that the president recognizes the importance of precision medicine, or personalized medicine.

Q: What could we learn from a million genomes that we can’t learn from the estimated 10,000 to 20,000 we have now?

Kucherlapati: People initially thought so-called association studies could be done with small cohorts, like 1,000 patients and 1,000 controls. Most studies were too small to provide meaningful results. So recently, people have thought about doing meta-analyses and trying to bring many studies together and assemble the data. When you get very large cohorts like that, 200,000 or 300,000 patients and comparable numbers of controls, then new discoveries are made.

Another difficulty is these studies are from different investigators, and everybody does them differently. Having a uniform cohort would be fantastic.

Q: What makes this particular moment ripe for an initiative like this to be proposed?

Kucherlapati: The last couple of years have seen some dramatic examples of how things are changing in terms of applications of personalized medicine. To name just a few, we now have noninvasive prenatal diagnosis, treatments for melanoma where before there was nothing people could do, and immune therapies for cancer that just a few years ago were a dream. There is an opportunity to develop targeted therapies for many, many disorders because of the genetic knowledge we’re gaining about them.

The question is, how do you catalyze this? The president commenting about this is galvanizing at the national level.

Adapted from Harvard Medical News.