On Jan. 30, the Obama administration revealed what the president meant when he announced the Precision Medicine Initiative during his 2015 State of the Union address. The new initiative represents a $215 million investment in the 2016 budget to fuel research for clinicians to develop new tools, knowledge and therapies that are tailored to patients’ genes, cellular biologies and lifestyles.
The initiative will fund public and private collaborations that drive a budding field of research forward, and will also use the health data of more than 1 million Americans to improve medical outcomes on a national scale. The goal of the initiative is to find new and better treatments for cancer, while establishing new institutional infrastructure that will make further research in the field possible.
Specific investments include $130 million in funding for the National Institutes of Health (NIH) to develop a national research cohort of at least 1 million volunteers whose medical data that will create a foundation of precision medicine research.
The National Cancer Institute and NIH will receive $70 million to research genomic drivers of cancer and apply any findings to new treatments.
The Food and Drug Administration (FDA) will receive $10 million to develop curated databases to support a precision medicine regulatory structure.
The Office of the National Coordinator for Health Information Technology (ONC) will receive $5 million to develop interoperability standards and requirements for data privacy and security.
No one knows what the eventual outcomes of this initiative will be, but it’s an exciting investment that brings the U.S. on par with what other nations are already researching, said Dr. Deepak Voora, assistant professor of medicine at the Duke Center for Genomic and Computational Biology.
“I think in the cancer applications, we’re going to see some of those short-term goals and more tangible goals,” Voora said. “I would view the larger investment in the NIH as more as a long-term investment that will reap its benefits over time. Much like the human genome project was a large, long-term investment that has continued to reap benefits slowly over time, I suspect this million-patient initiative will be a longer-term investment that we may not understand all the benefits right away.”
The NCI pioneered this field of research, so it’s fitting that they should receive a chunk of the funding, Voora said. “I think cancer is by far probably the exemplar case for precision medicine,” he said. “Cancer is a disease of altered genes and genomes and I think it’s really clear that our ability to understand what drives cancer at the genetic level has dramatically altered our ability to understand the prognoses of these patients and then also be able to match the right therapy to those cancers better.”
The larger general investment in NIH will help further research in other fields of medicine other than cancer, he added. Broadly defined, precision medicine is already widely used today. When medical practitioners ask patients questions about family history or anything else unique to that patient, it’s toward the goal of personalizing that patient’s diagnoses and treatments.
“In some ways, precision medicine is something we do all the time,” Voora said, “but as we look forward, we want to be able to incorporate types of data into those discussions with our patients so we can make even more precise decisions about what to do and to improve their health.”
The details of the specific research that will follow these investments is yet unclear. On Feb. 11-12, NIH will host and live-stream a workshop to discuss the opportunities and challenges around building a precision medicine research cohort.