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Intermountain and Stanford Medicine: Taking Precision Medicine from the Bench to the Bedside

May 16, 2016
by Heather Landi
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Lincoln Nadauld, M.D., Ph.D., executive director of precision medicine and precision genomics at Intermountain Healthcare, and Hanlee Ji, M.D., the senior associate director of Stanford Genome Technology Center discuss their clinical genomics partnership.
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Last month, Intermountain Healthcare and the Stanford Genome Technology Center (SGTC) announced a new collaborative research program with the aim of providing scientific advances in precision health and medicine.

The joint research team consists of members of Intermountain’s Precision Genomics Core Laboratory, based in St. George, Utah, and SGTC, based in Palo Alto, California. The team of researchers and clinicians are working to identify novel biomarkers using an advanced array of technologies developed at SGTC. The focus of the research will be on solving clinical issues for patients using cutting-edge technologies that enable delivery of precision health, or, essentially, taking genomics from the “bench to the bedside.”

Intermountain Health is a 22-hospital integrated health system based in Salt Lake City. And, Intermountain Precision Genomics is a service of Intermountain Healthcare, which offers genetic sequencing of solid tumors. This in-depth sequencing identifies individual mutations within a person’s cancer cells to identify specific DNA targets for personalized drugs. SGTC is a research center at the Stanford University School of Medicine that integrates personnel and expertise from the Stanford departments of Medicine, Genetics, Biochemistry and Electrical Engineering. SGTC’s mission is to develop innovative biomedical technologies that reduce the costs of health care.

Healthcare Informatics Assistant Editor Heather Landi recently caught up with Lincoln Nadauld, M.D., Ph.D., executive director of precision medicine and precision genomics at Intermountain Healthcare, and Hanlee Ji, M.D., the senior associate director of SGTC and an associate professor at the Stanford School of Medicine in the Division of Oncology, to discuss the clinical genomics partnership and how the research teams are moving beyond just talking about the promise of precision medicine to actual clinical application of precision medicine principles.

Can you tell me more about the work that you’re doing with the Intermountain Precision Genomics program?

Nadauld: About three years ago, we launched Intermountain Precision Genomics with the thought that we would take some of the emerging technologies and apply to cancer patients with advanced disease who were running out of options and see if we couldn’t make better determinations about which treatments might benefit them. So we wanted to apply a precision medicine approach where we identify molecular changes in their tumor and then give them the appropriate targeted therapy.

Lincoln Nadauld, M.D., Ph.D.

And that’s what we’ve done. We’ve been monitoring outcomes, and we’re pleased with what we’re seeing. We think patients benefit from this. It doesn’t mean we’re suddenly curing a bunch of incurable cancer cases, but we have seen patients live longer and feel better and have a higher quality of life with this approach. And so, as that has progressed and been beneficial for our patients, we recognize that one of the real opportunities here is to continue this effort around translational medicine, where we take emerging technologies, evaluate them for clinical application and then do what we do really well at Intermountain Healthcare,  which is provide excellent care to patients.

So we wanted to partner with entities and institutions that have world-class, cutting-edge research and help bridge that gap from the bench to the bedside. And that’s what this partnership with Stanford is really trying to get at.

What will this collaborative initiative enable you do accomplish that perhaps you could not accomplish separately?

Nadauld: It will allow us to evaluate new, cutting-edge, world-class technologies and apply them clinically. So, previously, we haven’t had access to cutting edge technologies. Our own institution, while innovative, is not fundamentally a technology company or a research institution that develops its own findings. We are an institution focused on care delivery and iterative improvements in that care delivery process, and that’s what we’ve exceled at for 40 years. We think to make real progress that sometimes requires a clinical implementation of novel technologies and we think marrying our really good clinical delivery with really excellent technology is a way to make changes and dramatic improvements in patient care.

Ji: A central part of this project is that we have a variety of methods, technologies and other approaches, including computational ones, that have a lot of potential to be informative in biomedical research and in studies of populations with specific diseases like cancer. Stanford generally is able to capture a swath of the population but it’s only one medical center. And, at some point, it becomes important to verify and validate what you discover and what you can develop on much larger clinical populations. And that’s where our project with Intermountain is so critical, and that’s the big advantage, is we now have access towards identifying common goals that both institutions and both research groups want to achieve and use all these advances that we have available at Stanford, particularly at Stanford Genome Technology Center, and apply that to address this question.

Hanlee Ji, M.D.

Can you give me an example of what you think you can accomplish?