Outlining current and future developments in personalized healthcare for a group of enthousiastic citizens.

1. Personalized Health(care):
more than ‘just’ targeted medicines
Rotary Cuijk-Maaskant
9 Nov 2017
Prof Alain van Gool

2. Alain’s path 1989-now
• Basis in molecular biology
• Academia, pharma, medical center,
applied research institutes
• Biomarkers / Omics / technologies
• Mechanisms of disease
• Translational medicine
• Personalized healthcare
Senior Scientist Integrator Biomarkers
Scientific lead DTL-Technologies
Head EATRIS Biomarker Platform
Professor of Personalized Healthcare
Head Radboud Center for Proteomics, Glycomics & Metabolomics
Coordinator Radboud Technology Centers
2 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

3. Alain van Gool, Rotary Boxmeer, 9 Nov 20173
Alain’s path 1989-now
• Basis in molecular biology
• Academia, pharma, medical center,
applied research institutes
• Biomarkers / Omics / technologies
• Mechanisms of disease
• Translational medicine
• Personalized healthcare
Senior Scientist Integrator Biomarkers
Scientific lead DTL-Technologies
Head EATRIS Biomarker Platform
Professor of Personalized Healthcare
Head Radboud Center for Proteomics, Glycomics & Metabolomics
Coordinator Radboud Technology Centers

4. Consider individual differences in life science research
4 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

5. Source: Chakma, Journal of Young Investigators, 16, 2009
Principle of Personalized Medicine
• The right drug for right patient at right dose at right time
• = Precision medicine or Targeted medicine
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6. Crash course in molecular biology
6
DNA, protein, cell, tissue, system biology
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7. Personalized medicine in melanoma
B-RAFV600E mutation Strong growth of cell Growth of tumor
• B-RAFV600E cells always grow and become cancer cells
• RAF inhibitors will block pathway, block cell growth
and inhibit cancers that have a B-RAFV600E mutation
• 60% of melanoma patients have B-RAFV600E mutation
• Basis for a personalized medicine !
*
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8. Personalized medicine in melanoma
Treat patients with
B-RAFV600E mutation Inhibit growth of cell
Patients live longerTumors disappearCells stop growing
B-RAFinhibitor
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9. Exponential technology developments in laboratories
• Next generation sequencing
• DNA, RNA
• Risk analysis and therapy selection
• Mass spectrometry
• Proteins, metabolites
• Monitoring of disease and treatment effects
• Imaging
• Non invasive images, real time
• Spatial view of intact organs and organisms
500
1000
1500
2000
m/z
5 10 15 20 25 30 35 40 Time [min]
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10. Example: advances in molecular biomarker analysis
• Mass spectrometry analysis of glycoproteins in human plasma
• 1/20 microliter analysis: detection of 1.000.000 signals in one scan (1,4 Gb)
• ~40.000 peptides of which >80% contain sugar modification
• Potential to screen patients and identify new biomarkers?
500
1000
1500
2000
m/z
5 10 15 20 25 30 35 40 Time [min]
Proof of principle study:
Biomarkers !?
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11. Emerging Personalized / Precision / Targeted Medicine
2010:
5%of drugs in pipeline had companion diagnostic biomarker test
2017:
80%
50%
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12. Optimal Personalized / Precision / Targeted Medicine

13. Moving to personalized health(care)
{Source: Barabási 2007 NEJM 357; 4}
• People are more than linear pathways
• Different systems and networks
• Different risk factors
• Different preferences
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14. 14
“It’s far more important to
know what person the
disease has
than what disease the
person has.”
Hippocrates, 400 B.C
Alain van Gool, Rotary Boxmeer, 9 Nov 2017

15. Personalized health(care) in a systems view
15
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16. Personalized health(care) monitoring as part of our lives
• Monitor biomarkers on
background
• Alert when you are at risk
• Advice what to do
16
Alain van Gool, Rotary Boxmeer, 9 Nov 2017

17. A changing world: Getting digital
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18. 18
New data !
18

19. 19 Alain van Gool, IHE jaarcongres, Bussum. 11 Nov 2016

20. 20 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

21. 21 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

23. Ongoing: translate laboratory to society
• Point-of-care analysis of
few biomarkers
• 1.000.000 signals per
proteomics analysis
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24. And many more …
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25. What does my DNA tell me?
23% chance blond hair 3.1% Neanderthaler DNA
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26. Genetic risk lung cancer
→ don’t smoke !
What does my DNA tell me?
No expected adverse reaction
to Warfarin
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27. 27 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

28. 28 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

30. Demo room

32. 3 key aspects of personalized health(care)
‘I want to stay healthy. If not, how do I get healthy?’
1. What to measure?
2. How much can it change?
3. What should be the follow-up for me?
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33. Always focus on the end user: the patient / citizen
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Participatory health(care)

34. Translation is key in personalized health(care)
Personal profile data
Knowledge
Understanding
Decision
Action
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35. Translation is key in Personalized Healthcare !
“I’m afraid you’re
suffering from an
increased IL-1β and
an aberrant miR843
expression”
Adapted from:
?
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36. Need for optimal quality in health biomarker analyses
Test, interpret, advice
“Post-traumatic Test Syndrome” ?
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37. Patient participation is key
http://radboudreshapecenter.com/portfolio/uninvited-guests/
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38. Personalized health(care) monitoring as part of our lives
• Monitor biomarkers on
background
• Alert when you are at risk
• Advice what to do
38 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

39. View in the (very near) future
39 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

40. View in the (very near) future
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41. 41 Alain van Gool, Rotary Boxmeer, 9 Nov 2017

42. Acknowledgements
Hans Wessels Jolein Gloerich
Roel Tans Esther Willems
Maurice van Dael Jenneke Keizer
Dirk Lefeber Monique van
Scherpenzeel
Leo Kluijtmans Ron Wevers
Marcel Verbeek Lucien Engelen
Jan Kremer Bas Bloem
Nathalie Bovy Paul Smits
the Radboudumc Technology Centers
and many others
www.radboudumc.nl/personalizedhealthcare
www.radboudumc.nl/research/technologycenters
www.radboudresearchfacilities.nl
alain.vangool@tno.nl
alain.vangool@radboudumc.nl
www.linkedIn.com
www.slideshare.net/alainvangool
Many collaborators and funders
Jan van der Greef Ben van Ommen
Ivana Bobeldijk Hans Princen
Lars Verschuren Marjan van Erk
Suzan Wopereis Heleen Wortelboer
Wessel Kraaij Ronald Mooi
Peter van Dijken Cyrille Krul
and many others
CarTarDis
Ruben Kok Barend Mons
Jaap Heringa Merlijn van Rijswijk and
many others
Anton Ussi Florence Bietrix
Laura Bermejo Andreas Scherer
Sulev Koks Marian Hajduch
Giovanni Migliaccio
and many others
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