The Dahlem Centre for Genome Research and Medical Systems Biology
A novel approach to diagnosing and treating human diseases
We are all different. We have different genomes, live in different environments, have different behaviour patterns, different disease histories and, if we look closely enough, often have superficially similar, but molecularly different diseases.
This has many consequences.
We respond very differently to diseases, including COVID-19, a pandemic which is now responsible for hundreds of thousands of deaths and trillions in economic losses. While most people exhibit mild or moderate symptoms, with the potential to spread the disease without being aware, approximately 15% progress to severe disease requiring hospitalization, and 5% will require intensive care unit treatment. This has necessitated strict global distancing strategies to avoid hundreds of millions of potential deaths (~1 % of a world population of ~8 billion).
A second consequence of these biological differences is the fact that we often react very differently to therapies or preventive measures. While some patients respond to a specific therapy, others might not or even show serious (and sometimes lethal) side effects, part of the reason for almost 200,000 deaths in Europe every year, and contributing to the enormous (and still increasing) healthcare costs in Europe (4.5 billion euros per day).
Fortunately, we have now, just in time, new, powerful tools to address these enormous challenges, based on technologies developed as a result of the Human Genome Project. Of major importance is the great leaps forward in our ability to generate vast amounts of molecular information on individuals, using next generation sequencing technologies. We now have access to powerful technologies that have shifted the cost of sequencing a human genome from billions to a projected $100 by the end of this year. This technology potentially gives us the capability to carry out population-wide testing in regions, nations and supranational organisations such as the Schengen space, or even on a worldwide basis.
This is a major new area of our technology development goals for the near future (see our FAZ article and COVID-19 page), which we plan to carry out in collaboration with Alacris Theranostics and George Church (Harvard Medical School, USA), one of the founders of this company.
We are all different. So are our diseases.
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Digital Twins for better treatment
We will, however, using available funding, also continue the essential work on our second focus area, the selection of optimal therapies or preventive measures for individuals based on detailed molecular analyses of the individual and their disease. A goal ultimately based on the concept of Digital Twins, to ensure truly personalised therapy choice, first in oncology, but also in many other disease areas (including infectious diseases).
Currently, our major focus (in collaboration with Alacris Theranostics and the Max Planck Institute for Molecular Genetics) is the use of virtual tumour models to improve the success of cancer patient treatment. We use the detailed molecular imprint of an individual tumour as the basis for mathematical modelling that can predict individual outcomes following virtual treatment.
DCGMS uses this virtual 'patient' technology to direct more tailored therapies, with the potential to improve disease prognosis, diminish side effects, improve patient quality of life and, ultimately, help to save lives.
In tandem, application of the virtual 'patient' model also has the prospect of accelerating the drug approval process, further helping patients to find the right therapy. At present more than 90% of drugs tested fail during development. The virtual 'patient' model could represent a robust and reliable drug testing framework, expediting the drug approval pipeline in an affordable and timely manner.
Patient stratification based on a more complete description of the tumour will facilitate the selection of accurately tailored therapies, i.e. matching the ‘right’ patient to the ‘right’ drug. Ultimately, this will improve the likelihood of a positive prognosis, reduce healthcare costs and, most importantly, help to save lives.