Personalised Medicine

9:00-9:15 Alain van Gool, Radboudumc, TNO

9:15-9:35 Diederik Bruins, Fortified Food Coatings

9:35-9:55 Leon Terstappen, Utwente

9:55-10:15 Andrea van Elsas, Aduro Botech

10:15-10:25 Closure Alain van Gool

Personalized Medicine: moving towards Personalized Health(care)

Professor of Personalized Healthcare Head Radboud Center for Proteomics, Glycomics and Metabolomics Coordinator Radboud Technology Centers

Senior Scientist Integrator Biomarkers

Prof Alain van Gool

Health Valley Event 2016 17 March 2016

Scientific lead DTL-Technologies Head Biomarker Platform

Source: Chakma, Journal of Young Investigators, 16, 2009

Principle of Personalized Medicine

4

• The right drug for right patient at right dose at right time • Molecular biomarkers as key drivers of patient selection • = Precision medicine or Targeted medicine

4 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Companion diagnostics

Good examples personalized medicine in Oncology and Neurosciences:

• Cyp450, Her2/neu, BRCA, BRAF, EGFR, EML4/ALK, etc

Emerging companion diagnostics, also linked to non-drug therapies:

• Volker: Intestinal surgery → XIAP → Cord blood

• Beery twins: Cerebral palsy → SPR → Diet 5HTP

• Wartman: Leukemia → FLT3 → Sunitinib

• Gilbert: Healthy → BRCA → Mas/Ovarectomy

• Snyder: T2Diabetes → GCKR, KCNJ11 → Diet, exercise

• Lauerman: Scotoma, leg → JAK2 → Aspirin

• Bradfield: Healthy → CDH1 → Gastrectomy

Coming up: metabolic biomarkers, imaging biomarkers

5 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Moving towards Personalized Health(care)

“The term "personalized medicine" is often described as providing "the

right patient with the right drug at the right dose at the right time."

More broadly, "personalized

medicine" may be thought of as the tailoring of medical treatment to the individual characteristics, needs, and

preferences of a patient during all stages of care, including prevention,

diagnosis, treatment, and follow-up.”

(FDA, October 2013)

6

6 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Personal need in efficient personalized health(care)

It’s personal !

‘I want to stay healthy.’ ‘If not, how do I get healthy?’

7 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

3 key aspects of personalized health(care)

‘I want to stay healthy. If not, how do I get healthy?’

1. What to measure?

2. How much can it change?

3. What should be the follow-up for me?

8 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Exponential technological developments • Next generation sequencing

• DNA, RNA • Risk analysis and therapy selection

• Mass spectrometry • Proteins, metabolites • Monitoring of disease and treatment effects

• Imaging • Non invasive images, real time

• Spatial view of intact organs and organisms

500

1000

1500

2000

m/z

5 10 15 20 25 30 35 40 Time [min]

9 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

… but not all data is useful data !

Translation is key in personalized health(care)

Personal profile data

Knowledge

Understanding

Decision

Action

Shared decision making

11 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Translation is key in Personalized Healthcare !

“I’m afraid you’re

suffering from an

increased IL-1β and

an aberrant miR843

expression”

Adapted from:

?

12 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Personalized health(care) model

Personalized Intervention

of patients-like-me Personal thresholds of persons-like-me

Big Biomarker Data

Molecular Non-molecular Environment …

Time

Disease

Health

Selfmonitoring

Adapted from Jan van der Greef, TNO

Personal profile

Personalized health

Personalized medicine

13 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Personalized health(care) monitoring as part of our lives

• Monitor on background

• Alert when you are at risk

• Advice what to do

Examples from car dashboard:

• Empty gas tank

• Traffic jam ahead

14 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

15 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

15

New data (generators, owners)

Not all innovations are useful

17 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

Patient Adherence Current

Disease progression

Disease stable

€ Effect

NEW innovative platform (app to improve adherence to therapy)

Added value ?

Health Technology Assessment

Hemofilia NO CML YES

Richard van der Broek Sabine Mulders

18 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

What’s next?

Simulating YOUR health

Heleen Wortelboer Herman van Wietmarschen Jan van der Greef Esther Zondervan Wim van Hartingsveldt

19 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

What’s next?

Simulating YOUR health + Personalized advice + Feedback

Acknowledgements

Ron Wevers

Jolein Gloerich

Hans Wessels

Dirk Lefeber

Monique Scherpenzeel

Leo Kluijtmans

Lucien Engelen

Nathalie Bovy

Paul Smits

Maroeska Rovers

Bas Bloem

the Technology Centers

and many others

www.radboudumc.nl/personalizedhealthcare

www.radboudresearchfacilities.nl

www.radboudumc.nl/research/technologycenters

alain.vangool@tno.nl

alain.vangool@radboudumc.nl

www.linkedIn.com

www.slideshare.net/alainvangool

Many collaborators and funders

Jan van der Greef

Ben van Ommen

Bas Kremer

Cyrille Krul

Ivana Bobeldijk

Lars Verschuren

Marjan van Erk

Peter van Dijken

Peter Wielinga

Ronald Mooij

Suzan Wopereis

and many others

CarTarDis

20 Alain van Gool, Maasziekenhuis Pantein, Boxmeer, 17 Mar 2016

9:00-9:15 Alain van Gool, Radboudumc, TNO

9:15-9:35 Diederik Bruins, Fortified Food Coatings

9:35-9:55 Leon Terstappen, Utwente

9:55-10:15 Andrea van Elsas, Aduro Botech

10:15-10:25 Closure Alain van Gool

Personalized Medicine: Conclusions and follow-up

Professor of Personalized Healthcare Head Radboud Center for Proteomics, Glycomics and Metabolomics Coordinator Radboud Technology Centers

Senior Scientist Integrator Biomarkers

Prof Alain van Gool

Health Valley Event 2016 17 March 2016

Scientific lead DTL-Technologies Head Biomarker Platform

Nationale ongoing & planned events

Nationale wetenschaps agenda

24

Nationale wetenschaps agenda

25

16

routes

26

Workshops April/May Advice to government

Health RI

27

Downloadable at www.dtls.nl

Health RI

28

Health RI

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26th May – ‘Our Future health’ virtual conference

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http://ourfuturehealth.org/news/can-we-change-the-way-we-conference/

Special Interest Groups

Oprichting Special Interest Groups (S.I.G.)

- Krachtenbundeling in de regio - Per thema één S.I.G. - Kartrekkers gezocht (per S.I.G. 3 á 4 personen) - Deelnemers actief via netwerkapp community - S.I.G. brainstormt over content, sprekers, thema’s - Health Valley zorgt voor sessies en events - Meld je bij de sessievoorzitter, Marc Kalf of Victor Haze (Meeting Point Health Valley of via de Netwerk app)

9:00-9:15 Alain van Gool, Radboudumc, TNO

9:15-9:35 Diederik Bruins, Fortified Food Coatings

9:35-9:55 Leon Terstappen, Utwente

9:55-10:15 Andrea van Elsas, Aduro Botech

10:15-10:25 Closure Alain van Gool