UCSF

TRANSPERS Center sponsors genomic medicine talk by British expert

Dear Colleagues,

Our Center continues to build the evidence-base and make our findings relevant in the real world. We have recently examined the utilization of gene expression profiling and HER2/neu testing in breast cancer patients. This analysis fills a major gap in our knowledge about who gets tested and what tests are used in actual clinical practice. We have also been working with major U.S. health plans to address what evidence is needed for their policy decisions. Input from these key stakeholders will help us develop and recommend approaches for evaluation that will improve evidence-based policy decisions.

We are excited to have recently expanded TRANSPERS via new funding sources and collaborations. We are expanding our topics to include coronary heart disease and we have added disciplinary expertise to include medical oncology and anthropology. We are also now training new investigators to ask critical questions about personalized medicine.

Thank you for your continued interest in our Center.

Kathryn Phillips signature

Kathryn Phillips, PhD

TRANSPERS Center Director

In this issue

TRANSPERS Center sponsors genomic medicine talk by British expert

Patel

Lord Naren Patel

Lord Naren Patel, a member of the British House of Lords, discussed the barriers to the translation of genomic innovations into improvements in medical care in a seminar sponsored by the TRANSPERS Center on September 10.

Lord Patel is the chairman of the British House of Lords Science and Technology Committee, which published the report “Genomic Medicine” in July. The report provides recommendations for the Government and National Health Service (NHS) of Britain to realize genomic advances in medicine. Patel noted the broad applicability of their findings, many of which are at the heart of the TRANSPERS Center mission and research: investigating the evidence gap between the development and use of genomic medicine, collaborating with stakeholders in a variety of fields, and recognizing the necessity of translating research into practice and policy.

In her introduction, TRANSPERS Center Director Kathryn Phillips noted the importance of collaboration between industry and government in promoting advances in genomic medicine and preventing potential problems, advocating that this teamwork extend into the academic and non-profit sectors as well.

Lord Patel took questions from a standing-room only crowd. Participants included UCSF researchers from a variety of disciplines, including psychiatry, clinical pathology, health policy, and pharmacy. Local representatives from biotechnology companies, venture capitalists, health care consultants, and payers also took part in this seminar.

TRANSPERS Center grows with research projects and training initiatives

With little more than a year since its founding, the TRANSPERS Center has begun expanding to include additional research projects and training opportunities.

Additional fields of research

TRANSPERS Center members have begun to develop novel collaborations in the areas of coronary heart disease and colon cancer treatment.

Additional research funding

TRANSPERS Center members have been awarded funding to continue the mission of translating policy into practice:

  • Executive Committee member Deborah Marshall has received a grant from Cancer Care Ontario and the Ontario Institute for Cancer Research (CCO/OICR) to investigate adherence to Canadian HER2 testing and the impact of adherence on patient outcomes and use of cancer care services.
  • Director Kathryn Phillips, Senior Analyst Su-Ying Liang, and Post-doctoral Fellow Grace Wang will work with the Department of Veterans Affairs to continue building the evidence base for personalized medicine.

Training initiatives

The TRANSPERS Center has started several training opportunities:

  • Writing Seminar Series: Led by Director of Training Mary Beattie, participants review and critique proposals and drafts of manuscripts and grants.
  • Case Study Workshop: Led by Executive Director Stephanie Van Bebber, participants in the Case Study Workshop work together to develop research on specific cases of personalized medicine in breast or colorectal cancer.
  • Pilot Research Awards: Funding has recently been awarded to Dr. Galen Joseph and Dr. Katie Kelley for their research proposals. Greater detail of their projects will be provided in the TRANSPERS Winter Newsletter.

If you are a junior investigator interested in opportunities with the TRANSPERS Center, please contact Program Manager Christina Hosenfeld at [email protected].

TRANSPERS Center in the spotlight

TRANSPERS Center members have recently been recognized for their contributions to the fields of genomics and personalized medicine:

  • TRANSPERS Center Collaborator Elena Elkin and Director Kathryn Phillips were recently interviewed by Bloomberg News and UCSF Today for their contributions to “Clinical Practice Patterns and Cost-Effectiveness of HER2 Testing Strategies in Breast Cancer Patients,” a recent study published in the journal Cancer.
  • The UCSF Decision Services program was recently selected as a National Model of Care by the Mayo Clinic Center for Innovation. Headed by Jeff Belkora, a TRANSPERS Center Advisor, this service helps breast cancer patients navigate treatment decisions.
  • Joan Scott, a TRANSPERS Center Board Member, was named Director of the Johns Hopkins Genetics and Public Policy Center (GPPC). She replaces Kathy Hudson, who was tapped as Chief of Staff to the Director for the National Institutes of Health.
  • TRANSPERS Center Director Kathryn Phillips recently provided an expert interview to Medscape about how to address the challenges of personalized medicine.

TRANSPERS Center research

A key question for personalized medicine is whether and why technologies are adopted. An examination of Oncotype DX, a diagnostic tool for breast cancer, suggests a range of factors probably influenced adoption including not only clinical evidence but also market factors. Presented at The Age of Personalized Medicine conference, Alberta, Canada, September 16-18, 2009.

Despite being established as a standard of care in clinical practice, little is known about the actual utilization of HER2 testing in the U.S. Analyses of HER2 testing in actual clinical practice suggested that a majority of women were receiving testing but that there were differences in tumor classification based on what test was used (IHC or FISH). Further work should clarify whether the lack of trastuzumab for HER2- positive women is clinically appropriate. J Clin Oncol 2009, 27 (suppl; abstr e17518); published for the 2009 American Society of Clinical Oncology annual meeting.

Although clinical guidelines recommend screening for hereditary non-polyposis colon cancer (HNPCC) among those diagnosed with colon and related cancers, an examination of VA records demonstrates that screening for HNPCC is rarely documented. Presented at the Genomics Applications in Practice and Prevention Network (GAPPNet) Inaugural Meeting.

Personalized medicine in the news

Report watch

The report Initial National Priorities for Comparative Effectiveness Research was released by the Institute of Medicine on June 30. Many of the national priorities recommended fit with the TRANSPERS Center objectives and research projects, including the comparative effectiveness of genetic testing in prevention and treatment of breast and colorectal cancer, and the dissemination and translation of these results by patients, clinicians, payers and others.

On the same day, the Federal Coordinating Council released its Report to the President and Congress on Comparative Effectiveness Research (PDF), which provides strategies regarding CER. Like the TRANSPERS Center, the Council has identified the need to create and build the data infrastructure as a key priority towards improving the quality and value of health care.

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