Genomic medicine will change the way we see patients and what we need to know about them to treat them. We will have to know something about their genetics and if they have a tumour we will want to know something about the tumour's genetic profile. It is the changes that are within the tumour DNA that are meaningful and which will give us information about how responsive the tumour will be to cancer medicines and what the tumour will do in response to that medicine - will it die or will it further mutate to evade the effects of treatment?
The big issue is where and how will we receive this level of analysis about our disease? Currently our generalist hospitals are not equipped with the people, skills or equipment to make this happen.
I visited the Christie Hospital in Manchester - a dedicated cancer centre with a huge catchment area of new patients each year. Alongside the Christie Hospital, Cancer Research UK has a thriving cancer research institute, The Paterson Institute, which does research of the highest calibre and most impressively with the delivery of future medicines in mind. The University of Manchester is adjacent to the Christie/Paterson site and provides critical access to technologies from their faculties. Working together, those in the Christie Hospital, at the University and in the Paterson Institute (collectively forming the Manchester Cancer Research Centre, MCRC) are trying to identify rapid ways to assess the patient's status and that of their disease. The scientists and clinicians hope that from nothing more than a blood sample they will gain significant information to guide treatment. More drugs coming through company pipelines will be associated with diagnostic and prognostic tests to make treatment more effective and ultimately more affordable (as they will be used when they can be most effective to reduce the disease burden and not when they cannot work). A magnificant building of the Christie Hospital, jointly funded with CRUK, will provide a PhaseI/II unit to ensure UK cancer patients are given access to the newest drugs on trial.
Why does this set up in Manchester excite me? Because it is dedicated to one therapeutic area - Cancer. All the stakeholders can point to the goal of curing cancer and helping their patients. This common interest and integrated skill set between academia and the clinic and NHS has to be how we design the future of our healthcare systems - specialist centres with the ability to use molecular analytical techniques, whole body imaging technology and sophisticated medicines is where there is hope that today's drug R&D research will be sufficiently understood to be used to best effect for us all when we are patients. Well done to CRUK, University of Manchester, the Christie NHS hospital for supporting this integration and collaboration and to Nic Jones who as well as running the Paterson Institute, heads up the MCRC.