Thursday, February 22, 2001

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The New England Journal of Medicine Genome-Wide Views of Cancer
"Nearly coincident with the publication of the article by Hedenfalk et al. (1) in this issue of the Journal are reports of the complete DNA sequence of the human genome. (2,3) This remarkable point in biomedical history marks the beginning of an era in which we expect to learn the molecular basis of all human diseases. How long this will take is uncertain, but the boundaries of the problem are now clear. The increasing understanding of molecular medicine will shift clinical practice from empirical treatment to therapy based on a molecular taxonomy of disease."

"The study by Hedenfalk et al. illustrates the potential of genome-wide views to influence the diagnosis of cancer. Complex patterns of gene expression can serve as proxies for abnormalities in entire molecular pathways, without the need to identify the particular gene that causes the disturbance. It is likely that in the future, the integrity of functionally important pathways in tumors will be evaluated by transcriptional profiling rather than by the sequencing of individual genes within the pathway, most of which are still unknown. The study by Hedenfalk et al. also illustrates the way in which the difficulty of sequencing large genes like BRCA1 can be partially overcome through the use of transcriptional profiling based on DNA microarrays."

redux [11.20.00]
GeneLetter Genome project leader says clinicians are unprepared for gene-based medicine
"A decade from now, predictive genetic tests will be available for some 10 to 12 conditions, and interventions will be available for several of these, yet the medical profession is far from ready to practice this kind of medicine, Dr. Francis S. Collins, director of the National Human Genome Research Institute, told healthcare leaders at a conference this morning."

"By 2010, many physicians will find themselves practicing genetic medicine, yet such individualized gene-based treatment is now a foreign concept in the examining room. "I think that most physicians are not really ready for this phase, through no fault of their own," he said.

redux [06.08.00]
GeneLetter Managed care needs to prepare for biotech revolution
"Unless they begin preparing now, health plan executives and medical directors could be blindsided by the revolution in medicine that will come with the mapping of the human genome, members of a managed care conference keynote panel warned on Monday."

"You think the genetic revolution is still 3-to-5 years off for your health plans," said Dr. Billings, who also serves as deputy director and chief medical officer of the Heart of Texas Veterans Health Care System. "I have to tell you, you better wake up. The tsunami is on the horizon," he warned.

For example, Schering-Plough's Dr. Haverty predicted that gene-based information could lead to the identification of many different types of asthma. As a result, health plans will need to develop many new codes and to upgrade their information systems, he said."

redux [03.30.00]
JAMIA Integration and Beyond: Panel Discussion
"I think one of the toughest things we all have to deal with is updating our dictionaries. In the simplest cases, the name of an organism is changed and we just have to do the maintenance. It is tougher, when, as with Citrobacter, they do genetic studies and say, "Oh, it's really six different organisms, not one." We have the human genome project coming very quickly. Even that is just the tip of the iceberg. We're not only going to see all the genes; we're then going to see clinical tests based on gene expression. Essentially, you'll be able to look at something on the order of 180,000 gene products and whether they're up or down regulated. How are we going to integrate such an incredible amount of data at a time when we're going to also be changing how we think about these processes? Classification and simple mapping are not going to work, because the lumpers and splitters are going to be arguing furiously on a daily basis."

redux [04.19.00]
Wired News Biotech Can Be Fun
"Scientists should quit fretting about how to classify organisms and start figuring out how to make biology a unifying influence for researchers, doctors and their patients, biology pioneer Dr. Leroy Hood said Tuesday."

""I think we can revolutionize and transform the teaching of biology if we look at it as an informational science," said Hood, who began his career at Caltech, where he developed some of the first DNA sequencing machines."

"He said the most important place for that shift to take place is in medical schools."