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Genomic-Based Prospective Medicine Collaboration Announced by Duke University Medical Center and The Center for the Advancement of Genomics

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Duke Health News 919-660-1306

Groups will work together to create the first
genomic-based, prospective medicine practice utilizing
correlations between comprehensive genomic and medical data
relevant to prediction, early detection and prevention of
disease

ROCKVILLE, Md. and DURHAM, N.C. -- The Center for the
Advancement of Genomics (TCAG) and Duke University Medical
Center (DUMC) today announced a formal collaboration to create
the first fully integrated, comprehensive practice of
genomic-based prospective medicine. Through this new
collaboration, Duke and TCAG plan to generate predictive and
prognostic data on specific diseases that can aid both doctors
and patients in the earlier detection and better treatment of
these illnesses.

The groups signed a Memorandum of Understanding which
outlines the details of the Duke/TCAG genomic-based prospective
medicine collaboration. Detailed planning between Duke and TCAG
medical, scientific, technology and bioethics teams is under
way to determine specifically how genomic technology can best
be applied clinically to improve health. This includes focused
research in genomic predictors of cardiovascular, hematologic
and infectious diseases; the design of future clinical practice
models including personalized health planning; and strategies
to tackle ethical and legal issues that will arise as a result
of advances in genomics. Initially funded internally by both
organizations, TCAG and Duke will seek outside funding through
government grants, foundations and philanthropic donations.

"One of my reasons for wanting to sequence the human genome
more rapidly was to get to this point in history where genomics
could begin to be used to better understand and potentially
treat or prevent human disease," said J. Craig Venter, Ph.D.,
president and chairman of TCAG. "We are delighted to
collaborate with Duke in this endeavor, given its preeminence
in the fields of clinical medicine and research. The
collaboration between TCAG and Duke is the first extensive step
toward my long-term goal of enabling everyone to participate in
the genomics revolution, which has the power to transform our
lives. This is a basic research collaboration that may take
several years to see results, but it is a necessary first step
toward a time when all of us can use our genomic information to
better understand our future health outcomes."

According to Ralph Snyderman, M.D., chancellor for health
affairs and president and CEO of Duke University Health System,
"Duke, in its commitment to utilize the best tools available to
create better models of health care, is proud to partner with
TCAG and its president, J. Craig Venter, to lay the groundwork
for using genomics to provide a new kind of personalized health
planning to promote health and prevent disease. We call this
prospective health care. Genomics can revolutionize our ability
to predict an individual's health risks and response to
therapy. With TCAG's state-of-the-art genomic sequencing and
informatics research facility and genomic research and policy
capabilities and Duke's world renowned medical practice,
clinical research capabilities and know-how, along with its
university-wide Institute for Genomic Sciences and Policy led
by Dr. Huntington F. Willard, we feel confident this
collaboration will lead to important advances toward improving
health care for all."

Dr. Venter also outlined how this collaboration will spur
innovation and lower costs of DNA sequencing technologies.
"TCAG scientists continue to work toward the goal of a $1,000
genome in our new Venter Science Foundation Joint Technology
Center (JTC) -- a 60,000 square foot, high-throughput DNA
sequencing center. Through this collaboration we will be able
to refine the current state of the art of sequencing while
continuing to work with developers of rapid new DNA sequencing
technology so that we can realize this goal. Only by lowering
the cost of sequencing can we make genomics a viable tool in
large-scale clinical research and medical care."

"The current American health care system is driven more by
tradition than by scientific principles and is inherently
wasteful," said R. Sanders Williams, M.D., dean of the Duke
University School of Medicine. "By incorporating scientific
advances, such as genomics, into new models of prospective
health care delivery, we can improve outcomes while controlling
costs."

According to Willard, director of Duke's Institute for
Genome Sciences and Policy, "TCAG's genomic scientific
expertise coupled with their state-of-the-art genome sequencing
and informatics capacity perfectly complements our Institute,
which studies both genome discoveries and their applications to
society, including health policy."

The Duke/TCAG genomic-based medicine collaboration has
several initial goals:

  • To integrate high-throughput DNA sequencing technologies
    and state-of-the-art analysis with distinctive medical
    expertise by re-sequencing and genotyping the relevant
    genetic material (genes and regulatory regions) of selected
    patients from Duke's clinical population. These are patients
    who have been well characterized through detailed
    retrospective medical records. By sequencing the DNA of this
    patient population and associating these profiles with
    phenotype and disease outcomes, TCAG and Duke researchers
    plan to correlate genetic variations to disease states to be
    able to initiate preventive steps or earlier treatment of
    disease.
  • To focus initially on major disease areas, including
    cardiovascular, hematologic and infectious diseases, as well
    as cancer.
  • To create a futuristic personalized health plan and
    medical record including genomic information to predict
    health risks and outcomes from therapy.
  • To leverage the unique high-end computing center that
    TCAG is currently building as part of its next generation,
    high-throughput DNA sequencing center (the JTC) that is
    slated to open in June 2003 with 100 ABI 3730XL automated DNA
    sequencers, which will allow for an initial ability to
    sequence 45 billion base pairs of DNA per year. TCAG and Duke
    along with several technology partners will create unique
    computing, storage, database and software solutions to manage
    and mine the massive datasets that will be generated through
    the genomic medicine collaboration.

Duke and TCAG see this collaboration as an opportunity to
make preventive or prospective medicine a reality. Medical care
is currently focused on treating chronic disease after it
occurs. According to the National Center for Health Statistics,
there are currently more than 40 million Americans under the
age of 65 with no health insurance. Thus, a large portion of
individuals in the U.S. fails to receive even an early-stage
diagnosis for many diseases. Overall, health care inflation
continues to rise precipitously. In 2000, total health care
expenditures in the United States were $1.3 trillion —- more
than any other industrialized nation in the world. Hospital
care, physician services and prescription drugs accounted for
most of this total spending. The health care system in the U.S.
is in need of a new paradigm to change this inflation rate. In
contrast, genomics potentially provides an invigorating
solution to accelerating the advent of preventative or
prospective medicine and thus lowering the cost of health
care.

"The vision for this collaboration includes creating a
partnership in translational genomics that generates meaningful
information to help patients and physicians make better and
earlier decisions in diagnosis and treatment of disease. The
partnership will be unique through its ability to integrate
high throughput genomics technology and analysis with
distinctive medical expertise and a commitment to an
economically viable and socially responsible system of health
care delivery," the partners said.

# # #

The Center for the Advancement of Genomics (TCAG) is a
not-for-profit genomics policy and research center dedicated to
advancing science and medicine through education and
enlightenment of the general public, elected officials and
students. TCAG will seek to better understand evolutionary
issues, broad social and ethical issues such as race as a
social concept rather than a scientific one, and combating
genetic discrimination. TCAG will also focus on the public
issues associated with biology/genomics in mitigating
greenhouse gas concentrations and biological energy production.
TCAG is a 501 (c) (3) organization.

Duke University Medical Center is dedicated to providing
patient care, professional education and biomedical research.
It includes: Duke University Hospital; Duke University School
of Medicine; Duke University School of Nursing; the Private
Diagnostic Clinic, PLLC; and one of the largest biomedical
research enterprises in the country.

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