Dr. Lukas Wartman is ground zero in the genetic battle against cancer. The assistant director of cancer genomics at Washington University in St. Louis developed acute lymphoblastic leukemia himself.
When treatment options ran out, his colleagues looked to his DNA and RNA (the messenger chemical that helps turn DNA into proteins) to try to get him a second chance. It was an arduous process that took months and required the dedicated brainpower of several researchers – but it worked.
Now Wartman is participating in an effort that could make DNA sequencing accessible to many more cancer patients. The Genome Institute at Wash. U. is one of 14 big-name cancer centers partnering with
“I’m not aware of another platform that allows as much power right now nor have I seen one in development,” Wartman says.
The 14-university effort is part of a grand court press to push Watson into healthcare. A month ago it announced collaborations with
Whereas NantHealth, the business being built by billionaire Patrick Soon-Shiong, has proposed building a product that sequences patients DNA and proteins as well as analyzes the data and interacts with patient medical records, IBM will be more focused, only providing analysis for institutions that are already sequencing cancer patients’ genes. Already, Harvey says, many of these institutions are paying subscription revenue, although the structure of each deal depends on when they were signed up.
The participating centers: Ann & Robert H Lurie Children’s Hospital of Chicago; BC Cancer Agency; City of Hope; Cleveland Clinic; Duke Cancer Institute; Fred & Pamela Buffett Cancer Center in Omaha, Nebraska; McDonnell Genome Institute at Washington University in St. Louis; New York Genome Center; Sanford Health; University of Kansas Cancer Center; University of North Carolina Lineberger Cancer Center; University of Southern CaliforniaCenter for Applied Molecular Medicine ; University of Washington Medical Center; and Yale Cancer Center.
The hope is that Watson will be able to replace the way decisions about which drugs to give based on genetic information are made: with a committee of doctors called a “tumor board” who look at the mutations and try to make a call.
“The way the molecular tumor board report results is neither scalable nor perfect,” says Norman Sharpless, the director of the Linberger Cancer Center at the University of North Carolina. “It’s error prone and it won’t work as we do more. It’s going to require Watson or something like Watson.”
Sharpless, a skeptic who initially told a Watson-using colleague “that’s the Jeopardy-playing computer -- it’s not going to solve cancer,” still wants to see more proof. The first step, he says, will be to look at the patients who are being analyzed at UNC (all of whom have consented to be in a clinical trial) and see how often tumor boards and Watson agree. Of course, that won’t tell anyone who’s right – Watson could be better than people at picking drugs based on genes. Or worse.
Harvey, the IBM VP, says that the other groups are already demanding the creation of such a study, and that the data will be anonymized based on the consent forms signed by the various institutions. At the end of the day, he says, the data belong to the patients they come from.
But it’s still a big question how much DNA sequencing to pick drugs helps patients. There are certainly dramatic stories of patients who were saved, but they are often few and far between. And Watson still needs to be proven, too. The risk is that this technology will be adopted without being properly studied. It's impressive that IBM has announced a deal with so many institutions, and Wartman's opinion matters, but Watson remains an unproven technology in health care.
Wartman himself is evidence that even when treatment works, it is not a perfect solution. He underwent a second bone marrow transplant, and developed graft-versus-host disease, in which his new bone marrow and his body attacked each other. “Most of those problems now are manageable,” he says. “I’m working full time, but I’m definitely not 100%.”
