Precision medicine for blood cancers through knowledge banks
The David Grimwade Award, established in 2017 to honor outstanding basic and translational researchers in hematology, was granted to Dr Peter Campbell (The Wellcome Trust Sanger Institute, Hinxton, UK). In the honorary lecture he discussed the need for knowledge banks in order to achieve evidence-based precision medicine. “Evidence-based medicine and precision medicine are not immediately easy to reconcile. If you are going to personalize treatment for a specific individual patient, then how can you base that decision on any kind of evidence, because each patient is unique?”
The approach Campbell and colleagues are using is to build large knowledge banks by collecting information on treatment and outcome of big cohorts of patients, and characterize them using molecular profiling. This information can then be used to guide treatment decisions. Campbell: “The knowledge bank becomes the evidence base, and we can still use the features of the individual patient sitting in front of us to personalize the therapeutic choice.”
In collaboration with other groups from Europe knowledge banks were built for acute myeloid leukemia (AML) and myeloproliferative neoplasms (MPN). One challenge is to identify driver mutations in the large amounts of sequencing data, to this end, an automated algorithm is being developed. Patterns of driver mutations in AML can identify different subsets of patients. Some genomic subtypes were found to be present in different myeloid diseases, transcending traditional disease classes. Based on the information from knowledge banks, models can be built to predict outcome for an individual patient.