Indiana Institute For Personalized Medicine David A Flockhart MD, PhD Professor of Medicine, Genetics and Pharmacology Indiana University

Challenges for Personalized Medicine as a Health Care Solution n Genomics has not delivered n Proteomics has not delivered n Bioinformatics has not delivered n Small and Dry Pharmaceutical Pipelines n Effective Electronic Medical Records are Rare Events

. F S Collins Science 2011;331: It’s Been Ten Years

“the once-hypothetical medical benefits of individual genome sequencing are beginning to be realized in the clinic.” F S Collins Science 2011;331: ….in fact, it's one of the many reasons that NIH plans to create a National Center for Advancing Translational and Therapeutic Sciences

“If I could move the clock back to 2001 and change course, I would invest significantly more in developing large clinical resources with detailed, individual clinical histories, deep phenotyping, and longitudinal follow-up in order to better understand outcomes and treatment responses” Tom Hudson, Science 2011;331:547

The Genome Wide Association barrier : 282 Genome Wide Association Studies Published in Peer-Reviewed Journals since January 2007

Genome Wide Association as a tool for predictive medicine Fletcher R, Flockhart DA, 2010

Genome-wide association study identifies 6 novel breast cancer susceptibility loci Nature May 27 th, fold = the risk conferred by 1 glass of wine per day

Tools for Personalized Medicine in Indiana n A Robust Electronic Medical Record with Long Follow Up n A Biobank of Samples that Links to the EMR n Genomic and Pharmacogenomics Expertise n Imaging Expertise n Informatic Expertise u Center for Computational Biology n Modeling Expertise u CTSI Disease and Therapeutics Modeling Program n Trained Professionals n Strategic Partnerships with Implementers

Implementers of Personalized Medicine n Patients n Physicians n Pharmacists n Nurses n Diagnostic Companies n Pharma Companies n Biotech

Indiana Institute For Personalized Medicine n Founded January 1 st, 2011 n Schools of Medicine, Nursing and Informatics, IU Cancer Center and the Regenstrief Institute u Open to all IU Faculty u New Brater Fellowships in Personalized Medicine u New Pilot funding u New Faculty

Brater Scholar Program n A Mentored Program to Prepare Physician Scientists for Careers in Personalized Medicine n Emphasis on Peer Collaboration Among Fellows n Salary supplement n $ for supplies and travel

2011 Brater Scholars in Personalized Medicine n Troy Quigg MD, Pediatric Oncology n Vic Senadhi MD, Division of Gastroenterology n Jody Skiles, Department of Pediatrics

Indiana Biobank: Goals  To create a statewide, robust collection of biological samples  To be accessible to basic and clinical investigators as a research tool  To enroll and collect samples from 50,000 patients in 5 years

Established in July ,000 high quality samples in 5 years linked to the electronic medical record and to genomic and proteomic data. Available to basic and clinical researchers. Patients from Clarian Health, Wishard and other clinical venues throughout Indiana: a Key Research Arm of the IU Health system Indiana Biobank: Purpose Anne Nguyen CCRP

Academic Strategic Partnerships n Department of Medicine n Department of Pediatrics n PREGMED n Center for Pediatric Clinical Therapeutics n Department of OB/GYN n IU Cancer Center n Center for Computational Biology n Department of Radiology n Regenstrief Institute

Targeted Areas for Strategic Partnerships n Diagnostics Organizations n Therapeutics Organizations n International: u Kenya u China n NIH n FDA

Indiana Institue For Personalized Medicine Leadership Lang Li PhD Computational Biology Bryan Schneider MD IU Cancer Center Jamie Renbarger MD, MS Pediatrics Anne Nguyen CCRP Indiana Biobank