Individualized medicine is a healthcare procedure that separates patients into various groups—with healthcare judgements, practices, treatments and/or products being tailored to the personal patient based on their expected response or risk of disease

1. TRANSFORMING PATHOLOGY

2. Personalized Medicine &
Pathology
Medicorx Sp
102nd Avenue
Dawson Creek
BC V1G

3. Personalized Medicine
- Friend or Foe?
 What is it?
 Why now?
 When will it be real?
 Call to Action for Pathologists

4. Successful When it Leads to
Innovation and Improves
Standard of Care.
Fails When We Settle for
“Trial and Error” Medicine
AS the Standard of Care.
Old Paradigm: Trial and Error Medicine
Personalized Medicine

5. Personalized Medicine
New Paradigm: Personalized Medicine
Linking Tests to Action and Therapy
Observation Test Action
Predictable
Response
Breaking The Cycle of Trial and Error Medicine

6. Diagnosis Save Lives
Diagnosis Save Money
Personalized Medicine
Why is it Important?

7. Drug Selection
Breast Cancer Herceptin® HER2
Drug Dosage
Colorectal Cancer Camptosar® UGT1A1
Drug Efficacy
Chronic Myelogenous Leukemia Gleevec® Quant BCR-ABL
Disease Status
Chronic Lymphocytic Leukemia Campath® Minimal Residual Disease
Recurrence Risk
Breast Cancer Oncotype DX® Multivariate Analysis
Predisposition
Breast Cancer BRACAnalysis® Gene sequencing, risk analysis
Personalized Medicine Test Categories

8. Personalized Medicine Saves Lives
80
Years Ago
Leukemia or Lymphoma60
Years Ago
Chronic Leukemia
Acute Leukemia
Preleukemia
Indolent Lymphoma
Aggressive Lymphoma
100
Years Ago
“Disease of the Blood”
Today
38 Leukemia types identified:
Acute myeloid leukemia (12 types)
Acute lymphoblastic leukemia (2 types)
Acute promyelocytic leukemia (2 types)
Acute monocytic leukemia (2 types)
Acute erythroid leukemia (2 types)
Acute megakaryoblastic leukemia
Acute myelomonocytic leukemia (2 types)
Chronic myeloid leukemia
Chronic myeloproliferative disorders (5 types)
Myelodysplastic syndromes (6 types)
Mixed myeloproliferative/myelodysplastic syndromes (3 types)
51 Lymphomas identified:
Mature B-cell lymphomas (14 types)
Mature T-cell lymphomas (15 types)
Plasma cell neoplasm (3 types)
Immature (precursor) lymphomas (2 types)
Hodgkin’s lymphoma (5 types)
Immunodeficiency associated lymphomas (5 types)
Other hematolymphoid neoplasms (7 types)
5 Year
Survival
~ 0%
70%

9. Molecular Characterization
Standard Practice In Hematologic Oncology
Morphology Evaluation
+
Fluorescence-Activated Cell Sorting
+
Cytogenetic Analysis
+
Molecular Analysis
Expanded Characterization
and Response Prediction

10. Personalized Medicine Reduces
Ineffective Treatment in Colon Cancer






kras Testing


Do Not Treat
Treat with Erbitux



Treat with Erbitux


Treatment
Success


11. Personalized Medicine is Cost Effective
in Treatment of Colon Cancer
 60% reduction in cost
per success
 40% of patients spared
side effects from
ineffective treatment
 Overall success rate is
unchanged at 25%
Erbitux Treatment Cost Comparisons with and without
kras Testing to Direct Personalized Treatment
$22,800
$97,022
$38,000
$156,554
$0
$50,000
$100,000
$150,000
$200,000
Average Treatment Cost (per
person)
Average Treatment Cost (per
success)
With kras Testing Without kras Testing

12. Personalized Medicine is Beneficial in
Treatment of Pancreatic Cancer
Suspected
Pancreatic
Cancer
Watch And
Wait
Pancreatectomy
Increased
Risk
Insulin
Insufficiency
Suspected
Pancreatic
Cancer
PathFinderTG
Diagnostic
Benign Condition
Do Nothing
Pancreatic Cancer
Treat Aggressively
Two
Bad
Choices
Informed
Choices
70%
30%

13. Disease
1 Year
Survival
Lung cancer 42%
Colorectal cancer 76%
Chronic myeloid leukemia (CML) 63%
Heart failure 74%
End stage renal disease 78%
Patients Don’t Have Time for Trial & Error
93%

14. THANK YOU