Dr Graeme Black of Manchester is chief of the new “Genomic Centre Network” in NHS England. It relies on the fact that we have sequenced the whole of the Human Genome and at some point in the future (certainly not for you or me) this information might well be helpful in both risk assessment and prevention/treatment. News coverage indicates Wales will be included. What about Scotland and N Ireland? Will all the Regions afford to be involved?
Tens of thousands of patients have been promised faster diagnosis and more personalised treatment as part of a project that aims to make DNA analysis a routine part of NHS care.
Eleven hospitals across England will start recruiting patients in the new year as part of the “100,000 genomes project”, which aims to make the genetic revolution in medicine an everyday reality in the health service.
Ministers want to transform how the NHS treats cancer and many other diseases, with sequencing of patients’ entire genetic code becoming a normal first step in deciding on treatment.
“This is the day when genetic medicine starts to deliver real benefits and mean something for patients,” George Freeman, the life sciences minister, said. “Genomics goes from being something done in specialised laboratories to something that is beginning to be relevant to patients in the NHS, across the country.”
Professor Sir Bruce Keogh, medical director of NHS England, said that the three-year, £300 million plan “positions Britain to unlock longstanding mysteries of disease on behalf of humankind. Embracing genomics will position us at the forefront of science and make the NHS the most scientifically advanced healthcare system in the world.”
Reading a person’s entire genetic code cost more than £1 billion when the Human Genome Project was completed a decade ago, but the cost has now fallen below £1,000. Cancers are caused by DNA mutations and doctors believe that looking at patients’ genes will give them crucial information about the disease and how to tailor treatment, as well as allow analysis of rarer genetic conditions. In the longer term, they hope that genetic testing will reveal patterns that allow smarter drugs to be developed quickly and cheaply.
Hospitals in London, Manchester, Liverpool, Birmingham, Newcastle, Southampton, Oxford, Cambridge and Exeter have been chosen to recruit about 40,000 patients with cancers of breast, prostate, bowel, ovaries and lungs, and 110 rare diseases. The first patients will have to agree to have their DNA placed in a “reference library” for pharmaceutical companies to use when developing targeted drugs. Relatives will also have their DNA analysed, as will the tumours, making a total of 100,000 genomes.
“We hope that by doing whole genome sequencing we will identify the underlying genetic cause for some rare diseases as well as potentially highlighting new treatments for cancer patients through a better under- standing of the cause of their disease,” said Lyn Chitty, who will study children with inherited diseases at Great Ormond Street Hospital, London.
“In the longer term this is a project that stands to transform the NHS. Ultimately, if we can make it affordable and efficient, whole genome sequencing could be used as one of the first lines of investigation to help clinicians to diagnose diseases more quickly.”
The volunteers will have their anonymised data made available to researchers looking to develop drugs and also to discover whether compounds shelved by companies might work on patients with a particular genetic profile. Mark Caulfield, chief scientist at Genomics England, which oversees the project, promised that companies using the “reading library” would not be able to take data away.
Mr Freeman said that without genetic data doctors were practising “blind medicine”. He has also promised to rip up the NHS drug payment system. “We can move from practising one-size-fits-all medicine to beginning to do targeted, stratified, and ultimately precision and potentially preventative medicine,” he said.