Revolutionary Therapies: It Takes a System

Geoff Lomax, CIRM’s Senior Officer for Medical & Ethical Standards, is blogging from this week’s Advancing Ethical Research Conference 2013. 

Two outstanding speakers, Dr. Atul Gawande and Dr. George Demetri, kicked off the meeting, both discussing themes of systems science to advance new therapies and treatments for patients. Dr. Gawande, who is a surgeon and popular medical writer, used the example of a small hospital in Switzerland that revolutionized trauma care by implementing a comprehensive and coordinated system for treating individuals. Specifically, the hospital was historically unable to revive patients involved in winter accidents involving drowning or avalanches. Typically, patients entered the hospital with limited or no life signs and suffering from extreme exposure. In an effort to improve survival, the hospital developed an action plan, involving everyone from phone receptionists to surgeons, to ensure a coordinated approach to treatment. Critical to this plan was getting the right people with the right technology in right place at the right time. Subsequently, the hospital has revived a number of trauma victims, some who entered the hospital with no vital signs, and saved lives.

Dr. Demetri, who is a physician at Harvard Medical School, discussed how molecular diagnostics are revolutionizing treatment of cancer patients. He described how “precision medicine” is enabling doctors to better evaluate treatment options. He used the example of the development of Gleevec as a treatment for cancer patients. (The New York Times did a nice piece a few years ago.) In this case, clinical trials using Gleevec treatment alone were sufficient to demonstrate the drug could be effective for the treatment of certain cancer types.

Dr. Demetri went on to suggest that in this era of expanding technologies doctors are working with their patients to identify the best treatment options. One concern he raised is that there are cases where new approaches to treatment are being attempted, but we are “loosing data,” particularly when new treatment options are ineffective.

These two talks made me reflect on CIRM’s recently announced Alpha Stem Cell Clinics program. The Alpha Clinics program is designed to apply a systems approach to the development of cell therapies. A major objective of the program is to get the right people with the right technology in right place at the right time. The program will provide funding for the coordinated delivery of advanced cell therapies in specialized medical facilities. The Alpha Clinics program also has a major emphasis on capturing information. One goal of the clinics established through this initiative is to set up a network to gather as much information a possible about cell therapies. This coordinated approach will avoid loosing data and provide doctors, patients and the public with the best information possible about what approaches tested were or were not effected. In short, the Alpha Stem Cell Clinics program is about taking a comprehensive systems approach to the development of new therapies.

Based on this mornings talks, it feels like we are on the right track.

Geoff Lomax