2017 03-07 World Economic Forum - Dutch topsector Life Science Health, The Hague, Alain van Gool

Netherlands approach to personalized medicine and health research

Prof Alain van Gool

Meeting World Economic Forum – Dutch Topsector LSHThe Hague, 7th March 2017

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

Principle of Precision Medicine

• The right drug for right patient at right dose at right time• = Personalized medicine or Targeted medicine

2 Alain van Gool, The Hague, 7 March 2017

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Optimal Personalized / Precision / Targeted Medicine

Personalized health(care) modelPersonalizedIntervention

of patients-like-mePersonal thresholdsof persons-like-me

Big BiomarkerData

MolecularNon-molecularEnvironment…

HomeostasisAllostasisDisease

Time

Disease

Health

Selfmonitoring

Adapted from Jan van der Greef, TNO

Personal profile

Personalized health

Personalized medicine


Internet of Personalized

Medicine&Health Data&Things

Biobanks, cohorts

Twitter data

Research

laboratory

MRI center

Wearables

Clinical records

Microscopy

facility

NL National Comprehensive Infrastructure for Personalized Medicine&Health Research

See Youtube – Health-RI


HRI_SD480P30-SMALL_ENG+ (1).mp4

Rich history of PPP in the Netherlands

(Centre for Translational Molecular Medicine) (Top Institute Pharma)

(BioMolecular Materials)

Public-private collaboration on diagnosis, drugs, devices (2006-2015)


implementation

innovation

research


Biomarker innovation gaps !

Discovery Clinical

validation/confirmation

Diagnostic

test

Number of

biomarkers

Gap 1

Gap 2

• Too much biomarker discovery• Too little development to application


Biomarker innovation gaps: some numbers

~ 5 biomarkers/working day

1 biomarker/1-3 years

1 biomarker/2-10 years

Eg Biomarkers in time: Prostate cancerMay 2011: 2,231 biomarkersNov 2012: 6,562 biomarkersOct 2013: 8,358 biomarkersNov 2014: 10,350 biomarkersOct 2015: 11,856 biomarkers 14 Nov 2016: 14,481 biomarkers

Discovery Clinical

validation/confirmation

Diagnostic

test

Number of

biomarkers

Gap 1

Gap 2


Choice for biomarker scientists: discover or confirm?


European infrastructures


PARTNERSHIP FOR DATA, TECHNOLOGIES & LEARNING

Ruben KokBarend MonsAlain van GoolJaap Heringa

OVER 100 EXPERT GROUPS ALREADY INVOLVED

• Nijmegen, The Netherlands

• Mission: “To have a significant impact on healthcare”

• Strategic focus on Personalized Healthcare through“the patient as partner”

• Core activities:

• Patient care

• Research

• Education

• 11.000 colleagues

• 52 departments

• 3.300 students

• 1.000 beds

Radboud university medical center

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Radboud campus:- Radboudumc- Radboud University- Hogeschool Arnhem Nijmegen- Max Planck Institute- Multiple companies

www.radboudumc.nl/research/technologycenters

Genomics

Bioinformatics

Animalstudies

Stemcells

Translationalneuroscience

Image-guided treatment

Imaging

Microscopy

Biobank

Healtheconomics

Mass Spectrometry

RadboudumcTechnology

Centers

Investigationalproducts

Clinicalstudies

EHR dataanalysis

Statistics

Humanperformance

Datastewardship

Molecule

Flowcytometry

3D lab

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Advances in mass spectrometry• Mass spectrometry analysis of glycoproteins in human plasma

• 1/20 microliter analysis: detection of 1.000.000 signals in one scan (1,4 Gb)

• ~40.000 peptides of which >80% contain sugar modification

• Potential to screen patients and identify new biomarkers?

500

1000

1500

2000

m/z

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

Proof of principle study:

Biomarkers !?


Serum N-glycopeptide profiling as biomarker discovery

Comprehensive QC analytics

New diagnostic glycoprotein biomarker

• Glycoprofile of intact transferrin protein (80 kDa)

• Identified through combination glycoproteomics and exome sequencing

• Is linked to specific glycosylation disorders (rare metabolic diseases)

• Implemented now in clinical care as diagnostic mass spec test



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New data ! (generators, owners)

Exciting next steps: translate laboratory to society

• Point-of-care analysis of few biomarkers

• 1.000.000 signals per proteomics analysis


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?


Translation is key in Personalized Healthcare !

“I’m afraid you’re

suffering from an

increased IL-1β and

an aberrant miR843

expression”

Adapted from:

?


Critical component in personalized healthcare: Data

• Data capture

• Data stewardship

• Data interpretation

• Data literacy


Further joining forces in NetherlandsTo drive personalized medicine & health research


Health-RI Congress

1 December 2016De Flint in AmersfoortRegister: www.nlhealthresearch.nl

Acknowledgements

Hans Wessels Jolein Gloerich

Roel Tans Esther Willems

Maurice van Dael Jenneke Keizer

Dirk Lefeber Monique van

Scherpenzeel

Leo Kluijtmans Ron Wevers

Marcel Verbeek Lucien Engelen

Jan Kremer Bas Bloem

Nathalie Bovy Paul Smits

the Radboudumc Technology Centers

and many others

www.radboudumc.nl/personalizedhealthcare

www.radboudumc.nl/research/technologycenters

www.radboudresearchfacilities.nl

[email protected]

[email protected]

www.linkedIn.com

www.slideshare.net/alainvangool

Many collaborators and funders

Jan van der Greef Ben van Ommen

Ivana Bobeldijk Hans Princen

Lars Verschuren Marjan van Erk

Suzan Wopereis Heleen Wortelboer

Wessel Kraaij Ronald Mooi

Peter van Dijken Cyrille Krul

and many others

CarTarDis

Ruben Kok Barend Mons

Jaap Heringa Merlijn van Rijswijk

and many others

Anton Ussi Florence Bietrix

Laura Bermejo Andreas Scherer

Sulev Koks Marian Hajduch

Giovanni Migliaccio

and many others


http://www.erasmusmc.nl/index.htm

2017 03-07 World Economic Forum - Dutch topsector Life Science Health, The Hague, Alain van Gool

Health & Medicine

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