interrelated problems of personalized medicine and diagnostic biomarkers with creativity, originality and an amazing ability to catalyze significant strategic partnerships.”
Hartwell’s journey in personalized medicine, and rallying partners with complementary skills, started to take form about a decade ago, in his third or fourth year as president of the Hutch. As a basic scientist, he didn’t really know much about the practice of medicine. When he started digging into it, and figuring out how to connect the dots between science and medicine, he saw some huge gaps that need to be filled. By about 2015, U.S. healthcare spending is projected to reach $4 trillion a year, or about one-fifth of the nation’s gross domestic product. About 80 percent of that is spent on late-stage treatments of people who are severely ill, with only a tiny fraction devoted toward predictive or preventive medicine.
“One of the conclusions I came to about three years into the job, what was limiting in medicine was the evidence,” Hartwell says. “It’s the ability to know in detail what risks people have for disease, what disease they have, especially at an early stage, and how to respond. The ability to predict our actions in medicine is very, very poor. The system is all oriented toward late-stage intervention with therapeutics.”
The Human Genome Project, completed in 2003, was billed as a way of helping usher in the era of predictive, personalized medicine. It hasn’t yet materialized, and Hartwell says he’s not exactly a fan of most genomics companies. While the genomic code can be useful for how individual cancers differ, and should be treated differently, he’s more optimistic about scientists’ ability to glean information from a systematic review of the proteins in our blood, the complex 3-D molecules made from the information encoded in DNA. Many of the efforts to date have focused on finding a single protein “biomarker” that’s correlated with disease. That approach is “too narrow,” Hartwell says, and doesn’t fully account for the complex symphony of proteins that lead to disease. Scientists and clinicians will be better off investing years of effort on a systemic analysis of biomarkers that could lead to truly predictive early diagnostic tests, he says.
“What are the important questions they need to answer that would improve outcomes and reduce the cost of medicine? There’s enormous potential for controlling medical costs,” Hartwell says.
This effort is seeded with a $35 million contribution from the Virginia G. Piper Charitable Trust. That was one of the main elements that
