group leader at Oslo University and lead principal
investigator for the consortium. He notes
that Norway’s government-run health system
should prove a boon to the project. “Virtually
all cancer treatment is through the public health
service,” he says, “and we have a national cancer
registry that has a very good track record for
following the entire population.”
Still more ambitious is IT-Future of
Medicine (ITFOM), a massive multinational
project now under consideration for funding
under the European Union’s Future and
Emerging Technologies (FET) Flagship program.
Lehrach and Alacris are coordinating
the project, but ITFOM brings together
scientists from leading research centers
across Europe as well as top technology and
sequencing companies around the world. “We
have proposed going beyond sequencing as a
main way to generate biological information
to incorporate many data sources—genomics,
metagenomics, epigenomics, transcriptomics,
proteomics and metabolomics—to basically
derive predictive models for all individuals in
the healthcare system,” says Lehrach. Most of
the data and IT infrastructure would need to
be generated from scratch, and the scope of the
project is such that preliminary data would be
years away, but Lehrach believes that he has
already seen promising proof of concept from
his work at Alacris. “By taking the current state
of the art, we can probably get predictions that
are much better in oncology than the 25% success
rate you would get with normal first-line
treatment,” he says. He further notes that as
health costs soar both in Europe and the US,
smarter treatment guidance will likely become
a necessity.
Indeed, one of the strongest arguments being
marshaled in favor of cancer genomic medicine
is economic—how we approach treatment
now is both inefficient and, in the long run,
financially unsustainable. “The government’s
own numbers said that in 2007, they spent
$52 billion on oncology therapeutics, and there
are great data to show that about $15 billion
had no impact on patients,” says Andrews. “My
argument is that if you spent $2 billion in testing,
you might end up $13 billion to the good
while giving all the patients in that group better
treatment.”