Precision Medicine Outside of Oncology

Mana Chandhok:
Hi everyone. Welcome to this podcast from Cambridge Healthtech Institute for the next generation diagnostic summit, which runs August 15th to the 18th in Washington D.C. I'm Mana Chandhok, an associate producer. We have with us today one of our speakers from the Companion Diagnostics strategy and partnerships track, Dr. Jonathan Pan, vice president and head of biomarkers strategy and development at Aevi Genomic Medicine. Dr. Pan, thank you for joining us.

Jonathan Pan:
Thank you very much for inviting me.

Mana Chandhok:
We have discussed personalized and precision medicine for over a decade, but the only therapeutic area we have seen visible progress in is oncology. Your company Aevi Genomic Medicine is working on breaking this paradigm. Can you share why and how you are doing this?

Jonathan Pan:
That's a very interesting question. I think precision medicine has actually been around us for quite some time, outside of oncology actually. We think about drugs like Sovaldi, Colidica, Selzentry, all of them require a precision medicine approach, but as one can see, oncology has definitely taken the limelight over the past few years and is pretty synonymous with precision medicine.

I think when we get outside of oncology, it gets a little bit interesting in terms of the ideology of the disease and how diseases are diagnosed and then treated. I think if we look at the example of a product like Plavix where we look at pharmecogenomic markers to look at the metabolism of the drug, that in and of itself is a precision medicine looking at the pharmecogenomic markers that determine response to the medicine. From that perspective it's been around for quite a while.

I think what's interesting about what we're doing at Aevi Genomics compared to predicate precision medicines is really related on the fact that we've taken a very unique genomic approach to understanding disease. Through that, we've looked at where exactly do we get the best understanding of how genomics plays a part in disease and where we actually find that is in the pediatric population.

Looking at the pediatric population, it allows us to really look at what I like to call almost a clean genetic landscape. One that isn't fettered with mutations and other types of things that may potentially cause disease such as cancer, as an example. When we look at that, looking at this clean genetic background and those pediatric patients that do develop disease, we get a very good sense in terms of what potentially is causing those diseases.

What's interesting about our unique circumstances, our strategic relationship with Children's Hospital Philadelphia, the reason why that matters and probably why diseases, precision medicine and the assessment of diseases outside of oncology have been extremely difficult is because the signatures and biomarkers associated with diagnosing disease are extremely complicated once you walk out of oncology.

Think activating mutations and, [inaudible 00:02:57] for potentially proteins that cloak the cell to check-point inhibitors. I think when we look in a reasonably pure pediatric population that has disease, which biomarker are you really looking for? And what's unique about the relationship, as I eluded to with Children's Hospital is that, we were able to look the genetic information of pediatric patients, their associated electronic medical records, as well as other different types of data that allows us to really correlate and collate that information into one place.

Of the 400,000 plus samples at Children's Hospital, as well as the electronic medical records that associate with them, and the genotyping that occurs; allows us to quickly understand exactly what's causing disease. Once you understand what's causing disease, then you have a really great shot as to understand what type of medicines may potentially treat that disease.

And so I think from that perspective, it's been a very, very interesting position that we have within the field to really break through that precision medicine bill, which is really around how you better that diagnose a patient. And once you have a better diagnosis, then you'll have the ability to develop the appropriate medicine for that particular patient.

And so I think given the biomarker signatures, which leads to diagnostic tests, which then leads into segmented populations, and from there we can look for unique medicines that will treat those segmented populations.

Mana Chandhok:
That sounds very interesting and promising. When do you think it will be implemented in routine care?

Jonathan Pan:
That's a great question and I wish I could tell you a date, hour or minute that that would actually happen. And I think ... We hope in the next five to ten years, this will become the norm especially in the pediatric population. We are developing unique signatures and understanding different actors in various pathways that can define disease.

And, once we understand all of that, I think that the really tough challenge for us would be how do we get the unique biomarkers into the marketplace to begin segmenting disease. I eluded to Hepatitis C which [inaudible 00:05:00] previously and to understand, one needs to understand the genotype first and then, the associated medicines that will treat that disease.

So, I really do hope that we can push forward first with diagnostic testing, and identify that population. So hopefully, that would be on the lower end of the estimate, and then the associated medicine shortly thereafter.

Mana Chandhok:
We are looking forward to the summit and hope it to be productive for each and every participant. What do you expect to gain from the meeting as a speaker and an attendee?

Jonathan Pan:
So as we talked about earlier, we're hyper-focused on Oncology. If you go to one of these conferences, everything's about Cancer and everything's about Oncology. And rightly so, it is a very devastating disease with high degrees of unmet need. But I also think that we need to understand and to communicate that outside of Oncology, much larger populations, much larger slots of people that require precision medicine.

Ideas, theories, and concepts to really drive to better treat patients all around. For example, we're looking at Attention Deficit and Hyperactivity Disorder, and there's a huge amount of unmet need. There's six million kids in the United States that are diagnosed with ADHD, with about 300 thousand diagnosed annually. Those out-number any Oncology indication almost four to one in any given year.

And so from that perspective, it's very, very important for us to better diagnose those diseases, and also for us to develop treatments that are much safer and much more targeted for those specific patients that could benefit from treatment. I think also that this should be something that will align the incentives both from a diagnostic company, as well as from a pharmaceutical company.

Traditionally, when I've come and spoken at these conferences, we often talk about the gaps between diagnostic companies and pharma companies. 30,000 patients, 20,000 patients, as we all know in the diagnostic realm it's a very, very volume based versus value based type of proposition.

Whereas, I think now, when we look at much larger populations, millions of patients, tens of millions of patients looking to be tested and then segmented for the appropriate precision medicine. I think that should better align the incentives for both pharma partners, as well as diagnostic partners and I look forward to having the tough conversations and to explain the overall concepts that exist.

Mana Chandhok:
Dr. Pan, thank you for your time and insights today.

Jonathan Pan:
Thank you.

Mana Chandhok:
That was Dr. Jonathan Pan; Vice President and head of Biomarker Strategy and Development at Aevi Genomic Medicine. He'll be speaking at the Companion Diagnostics Strategy and Partnerships track at the upcoming Next Generation Diagnostic Summit, which runs August 15th to the 18th in Washington D.C. I'm Mana Chandhok, thank you for listening.