Solutions for Organ Failure

Transcription

1 Solutions for Organ Failure It Takes an Analytics Collaborative IO Informatics and PROOF Centre Bob Stanley, Bruce McManus Innovator Presentation

2 Do data analytics matter? Meteorological Tools The Cave in Obama s Chicago HQ Presidential Election 2012 Your Car

3 The Burden of Heart, Lung and Kidney Failure in North America All Other NCDs 24% Cancer 28% All other NCDs 26% Cancer 29% All other NCDs $6.2 Cancer $1.7 Lung 12% Lung 8% Heart $5.4 Kidney 3% Heart 33% Kidney 3% Heart 34% Lung $1.5 Mortality DALYs Economics US $Trillions, North America & EU Sources: Global Health Data Exchange/ Institute for Health Metrics and Evaluation Global Burden of Disease Study 2010 Results by Cause ; Bloom et al The Global Economic Burden of Non-communicable Disease. World Economic Forum

4 The Burden of Heart Failure 1 in 5 people will develop heart failure 70% of all direct costs for heart failure are related to hospitalization $ BILLIONS: $$$ $$$$$ $$$$$$$$$$ Annual costs of heart failure will double in North America in the next 20 years DIRECT COSTS: HOSPITALIZATIONS SOURCES: Go et al., Circulation 127:e6-e245; Braunschweig et al., Europace 13, ii13-ii17

5 The Burden of COPD HEALTHCARE COSTS, US >300M WORLDWIDE 15.4M NORTH AMERICA 30M INDIA LEADING CAUSE OF MORBIDITY & MORTALITY IN US DIRECT COSTS: ACUTE EXACERBATIONS China Vietnam India Pakistan Bangladesh Indonesia Myanmar Ethiopia Nigeria Congo Thailand Brazil Turkey Egypt USA Mexico Philippines Iran UK Russian Italy Germany France Japan COPD IS THE 4 th LEADING CAUSE OF DEATH WORLDWIDE Aged-adjusted deaths/100,000 SOURCE: US BURDEN OF DISEASE COLLABORATORS JAMA 2013

6 3 Patients, 3 Precious Lives JOHN VIVIANNE TYLER Heart failure, age 45 Dx: BNP, NTproBNP Rx: Diuretics, ACE inhibitors, lifestyle changes Social: No more square dancing, chronic family stress COPD lung attacks, age 50 Dx: FEV1 Rx: Bronchodilators, inhaled corticosteroids Social: Cannot walk with friends, cannot sleep laying down at night Heart transplant, age 19 Dx: Invasive heart biopsies to monitor for immune rejection Rx: Immunosuppressive therapies Social: Travels all day for routine tests

7 Our Patients Have Urgent Needs More accurate, less-invasive, closer-to-home diagnostic & monitoring tools Reduced patient visits to urgent care for heart and lung attacks and acute organ failure More effective, timely therapeutics

8 Our Emerging Solution New high quality laboratory tests Reduce urgent care visits Reduce healthcare costs Improve precision of care Bio-signatures Identify patients with rapid organ decline Expedite successful drug development

9 Cohorts, Biospecimens Systems Science M 4 EDAL HTG Agilent Bruker Life Tech Zeiss CARTa GENE Alberta HEART GSK ECLIPSE Can PREDDICT BiT TNFa Can COLD Macro Rapid Transition LEUKO CORE ICV Health Tech Transfer PROOF IP Committee US, Cdn Legal Counsel Bus Dev Heart Lung Kidney Blood Pathways Interactions UVic Proteomics Centre Scripps IO Informatics RNA Metabo-Proteomics lomics Epigenetics Clinical mirna Tissues Cell types Networks Mining Ensembles Blood Clinical Expertise IP, Regulatory Patients as Partners Data Analytics Laboratory Medicine Health Economics, Outcomes PROOF Centre Biomarker Development Heart COPD Kidney Asthma Brain Spinal Cord Skeletal Muscle Pancreas Bowel CHEOS IO Informatics Biomarker Consort C2E2

10 What do we mean when we speak of data analytics? PATIENT COHORT DATA PREPARATION PRE-FILTERING CLINICAL DATA PHENOTYPIC DATA BLOOD OMICS DATA mrna, mirna expression (Affy, NanoString, qnpa) Plasma proteomics (mass spectrometry) RNA-sequencing (Illumina) Metabolomics (NMR, mass spectrometry) DNA methylation (Illumina BeadChip) SYSTEMS SCIENCE BIOSIGNATURE LISTS BIOMARKER ALGORITHMS COMBINATORIAL ALGORITHMS BLOOD TEST CONTENT

11 Connecting the ( Big Data ) Dots to Harvest Meaning Global frameworks for integrated analytics enable global knowledge creation and sharing Linked patients, tissues, assessments (e.g., omics ), endpoints and references facilitates efficient, comprehensive discovery and promotion of classifiers Connecting blood-based signatures to integrated search and reporting systems improves access and interpretation and reduces response time

12 Addressing the Challenge of Acute Cardiac Transplant Rejection 1 ST YEAR POST TRANSPLANT >2000 TRANSPLANTS PER YEAR IN NORTH AMERICA CURRENT MOLECULAR Dx 10-20% TREATABLE ACUTE REJECTION BIOPSIES PER PATIENT 20-30% PATIENTS OVER TREATED NOT USEFUL IN FIRST 2 MONTHS POST-TX LONG TURN AROUND TIME $ 2,950 $ 48,000 75,000 BIOPSIES $ 16,000 20,000 Rx

13 Better Tools for Clinic Care Draw blood anywhere TRANSPLANT RECIPIENTS M 4 EDAL: Molecular Markers for Modern Medicine: Emergent Diagnostics and Analytics Laboratory ASK: Applied Semantic Knowledgebase NO REJECTION NO BIOPSY M 4 EDAL ASK LIKELY REJECTION BIOPSY Implement new test mrna-based Exclusion of acute rejection Minimal sample input Fast turnaround time Effective during first 2 months post-transplant

14 ASK for Faster Cures Applied Semantic Knowledgebase ( ASK ) Precision Medicine Screening Interrogate Multiple Data Streams, Multiple Signatures Visualize, Test, Refine Pre- Submission Hypotheses Score-based Decision Support

15 Expert Clinical Care Teams Patients as Partners and Biospecimens High Technology Platforms Data Analytics Crowd Laboratory Relevant Resources Utility Outcomes Assessment Richly Diverse Cohorts Adjudicated Phenotypes Expert Clinicians and Imagers Scripps UVic Proteomics Human Metabolomics Project Valaista IO Informatics PROOF Centre G. Cohen-Freue S. Baranzini M. Wilkinson HTG Molecular NanoString Vela Diagnostics Workflow Automation Medical Biochemistry M 4 EDAL ICV Health / K. Humphries CORE / L. Lynd UNMET HEALTHCARE NEEDS DEFINED BIOMARKER DISCOVERY BIOMARKER REPLICATION ANALYTICAL DEVELOPMENT CLINICAL VALIDATION CLINICAL UTILITY AND USE Health Economics Modeling Wealth Creation Strategy Commercialization Strategy Regulatory Approvals

16 Expert Clinical Care Teams UNMET HEALTHCARE NEEDS DEFINED Patients as Partners and Biospecimens Richly diverse cohorts Adjudicated phenotypes Expert clinicians and imagers BIOMARKER DISCOVERY High Technology Platforms Scripps UVic Proteomics Human Metabolomics Project Valaista BIOMARKER REPLICATION Data Analytics Crowd IO Informatics PROOF Centre G. Cohen-Freue S. Baranzini M. Wilkinson ANALYTICAL DEVELOPMENT INTERNAL DRUG DEVELOPMENT AND TARGET VALIDATION Laboratory Relevant Resources HTG Molecular NanoString Vela Diagnostics Workflow automation Medical Biochemistry M 4 EDAL CLINICAL VALIDATION Utility Outcomes Assessment ICV Health / K. Humphries CORE / L. Lynd CLINICAL UTILITY AND USE COMPANION DIAGNOSTICS Improved Diagnostics and Drugs FASTER CURES M 4 EDAL CDRD Adiga AstraZeneca GSK vida

17 Help for Other Failing Systems Troponin of Stroke Dr. A. Penn/UVic Genome Canada/BC Spinal Cord Injury Dr. B. Kwon/UBC Brain Canada Muscular Dystrophy Dr. R. Ng/UBC Jain Foundation/MRM Proteomics Asthma Dr. S. Tebbutt/UBC Adiga Life Sciences/Circassia Chronic Kidney Disease Dr. A. Levin/UBC AstraZeneca Lung Function Decline in COPD Dr. D. Sin/UBC FNIH Diabetes Drug Response Dr. T. Elliott/UBC Personal Biomarkers

18 Conquering Complexity SUFFERING: Clarify pressing unmet needs SOPHISTICATION: Magnetize the best people, harness the best tools, generate and interrogate the best data SOLUTIONS: Push forward openly, fairly, relentlessly, allowing no barriers to goals

19 Thank You

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