JCMS 2017: Chula-RAMA-SI survey through the biomedical knowledge (1)
14 September 2017
Morning session
Precision genomics - (Dr.Vorasak)
Biology always diverse;
How much diversity we have -- using the statistic to answer this question.
Trade-off to coexist; that means there must be the good dimension that can share to the society; if not it will be obsoleted
The advancement of scientific knowledge relies on these three steps, accordingly;
New tech
New discovery
New idea
The emergence of precision medicine is because of the emergence of new technology. In the old day, it might cure ppl 90% but 10% is left to be unsuccessfully treated, this bc of the host factor issue - meaning there is the diversity in the host which effects to the treatment.
Examples;
Precision management - clinical trial never 100%, to divide, it should be divided by the driver genes which can help the treatment, most of the time diverse gene has shared some features among the cancers, mimic the biological nature that it remains the good feature for itself to survive (finding the needle in the haystack)
He mentioned the investment of infrastructure is really important since the cost of precision medicine is very expensive.
Chula precision medicine center;
-Hardware; sequence and high-performance computing system (comp + storage)
-Software plus database
-Require the data scientist and molecular geneticist to work together
-11 targets, the center would like to reach the benefit of precision medicine
Rare disease - 8% of population from the country doing good statistic
Exome; 30,000 baht or research
HLA-B*1502;
Check the genetic before taking the drug, esp, Steven-Johnson disease ppl who has this hla type - the patients develops the adverse allergy. There is the publication reports the effectiveness of checking this gene prior receiving the drug. Check genetic type before giving the drug helps the patients to get effective treatment
The challenge this day not bc of technology but bc of logistic, the delayed of the result.
Microbiology -
is in the transition period, before that we used biochem and culture test, just sequencing the microbe then we know everything like genotype and phenotype even the strain that resists to the drug treatment
Precision oncology;
In my point of view, this kind of treatment in Thailand, we have to wait the technology to be cheaper. Right now, the technology goes beyond to sequence the single cell.
Dr.Somponnart
Bc thailand is going to enter the aging society and cancer is related to the aging disease. Together with, the cancer is the leading cause of dead.
Better way to solve cancer;
Umbrella trial
Focus on one organ and treatment based on the mutation
Basket trial
Focus on one mutation but diverse organs
Then compare which one give the most benefit out of it.
Actually, his team is working with colorectal cancer organoid
Dr.Nattinee
She mentioned using all kinds of technology with the patients, get the data and analyzing it, but in Thailand is very hard to do since the cost is very expensive, but in US is fine
Tissue biopsy is kind of old technique now, she mentioned in the liquid biopsy - she mentioned that it could reflect the heterogeneity of cancer but the poor advantage is that it gives high false positive rate.
There are steps of biomarkers;
Predispose biomarker - screening
Diagnostic - to detect the subtype so the physician can plan the treatment
Prognostic - to predict the successive of the treatment
Predictive biomarkers - to predict further and the physician can plan the treatment
Stroke management;
Dr. Bernard Yan,
He mentioned that the stoke is raising up ahead from the cancer and heart failure.
In the old day, they use tPA, thrombolysis drug, however, the effectiveness is not good enough, it depends on the burden of the clot. Later using the endovascular therapy. Then, there was the report in the trial showed the effective was the same between endovascular therapy and tPA (standard therapy). Then, the stent has come to help. He also mentioned the up to date management on stroke. It is not perfective but getting better and better - there is the ongoing
NCD Challenge
Dr.Renu Madanlal
NCD take 70% of leading cause of dead worldwide
NCD burden is increasing, why?
Aging population is increasing, however, there are other factors involves like sugar, tobacco and also alcohol drink - plus the massive marketing and globalization to sell this kind of things, they are all considered to be the root causes, moreover the lifestyles like the transportation is very convenient less physical activities or even the screen times that determined as the root causes for NCD (diabetes, chronic respiratory disease, heart disease, cancer) - more these kinds of diseases are the tip of the iceberg whereas the root causes are left behind.
What can we do?
Be the role model;
Start with yourself first.
Exercise 30 mins everyday
Take good food
Less alcohol consumption
Give up the tobacco
Be an advocate;
Prescribe the patients by advice
Go for the policy maker
Communication through the media
Good planning on urbanization that facilitating physical activity
Be the champion;
Make it as the lifestyle in each root cause
Thai;
Sugar consumption
Salt consumption
Tobacco use - the first priority that Thailand should address the most
Morning session
Precision genomics - (Dr.Vorasak)
Biology always diverse;
How much diversity we have -- using the statistic to answer this question.
Trade-off to coexist; that means there must be the good dimension that can share to the society; if not it will be obsoleted
The advancement of scientific knowledge relies on these three steps, accordingly;
New tech
New discovery
New idea
The emergence of precision medicine is because of the emergence of new technology. In the old day, it might cure ppl 90% but 10% is left to be unsuccessfully treated, this bc of the host factor issue - meaning there is the diversity in the host which effects to the treatment.
Examples;
Precision management - clinical trial never 100%, to divide, it should be divided by the driver genes which can help the treatment, most of the time diverse gene has shared some features among the cancers, mimic the biological nature that it remains the good feature for itself to survive (finding the needle in the haystack)
He mentioned the investment of infrastructure is really important since the cost of precision medicine is very expensive.
Chula precision medicine center;
-Hardware; sequence and high-performance computing system (comp + storage)
-Software plus database
-Require the data scientist and molecular geneticist to work together
-11 targets, the center would like to reach the benefit of precision medicine
Rare disease - 8% of population from the country doing good statistic
Exome; 30,000 baht or research
HLA-B*1502;
Check the genetic before taking the drug, esp, Steven-Johnson disease ppl who has this hla type - the patients develops the adverse allergy. There is the publication reports the effectiveness of checking this gene prior receiving the drug. Check genetic type before giving the drug helps the patients to get effective treatment
The challenge this day not bc of technology but bc of logistic, the delayed of the result.
Microbiology -
is in the transition period, before that we used biochem and culture test, just sequencing the microbe then we know everything like genotype and phenotype even the strain that resists to the drug treatment
Precision oncology;
In my point of view, this kind of treatment in Thailand, we have to wait the technology to be cheaper. Right now, the technology goes beyond to sequence the single cell.
Dr.Somponnart
Bc thailand is going to enter the aging society and cancer is related to the aging disease. Together with, the cancer is the leading cause of dead.
Better way to solve cancer;
Umbrella trial
Focus on one organ and treatment based on the mutation
Basket trial
Focus on one mutation but diverse organs
Then compare which one give the most benefit out of it.
Actually, his team is working with colorectal cancer organoid
Dr.Nattinee
She mentioned using all kinds of technology with the patients, get the data and analyzing it, but in Thailand is very hard to do since the cost is very expensive, but in US is fine
Tissue biopsy is kind of old technique now, she mentioned in the liquid biopsy - she mentioned that it could reflect the heterogeneity of cancer but the poor advantage is that it gives high false positive rate.
There are steps of biomarkers;
Predispose biomarker - screening
Diagnostic - to detect the subtype so the physician can plan the treatment
Prognostic - to predict the successive of the treatment
Predictive biomarkers - to predict further and the physician can plan the treatment
Stroke management;
Dr. Bernard Yan,
He mentioned that the stoke is raising up ahead from the cancer and heart failure.
In the old day, they use tPA, thrombolysis drug, however, the effectiveness is not good enough, it depends on the burden of the clot. Later using the endovascular therapy. Then, there was the report in the trial showed the effective was the same between endovascular therapy and tPA (standard therapy). Then, the stent has come to help. He also mentioned the up to date management on stroke. It is not perfective but getting better and better - there is the ongoing
NCD Challenge
Dr.Renu Madanlal
NCD take 70% of leading cause of dead worldwide
NCD burden is increasing, why?
Aging population is increasing, however, there are other factors involves like sugar, tobacco and also alcohol drink - plus the massive marketing and globalization to sell this kind of things, they are all considered to be the root causes, moreover the lifestyles like the transportation is very convenient less physical activities or even the screen times that determined as the root causes for NCD (diabetes, chronic respiratory disease, heart disease, cancer) - more these kinds of diseases are the tip of the iceberg whereas the root causes are left behind.
What can we do?
Be the role model;
Start with yourself first.
Exercise 30 mins everyday
Take good food
Less alcohol consumption
Give up the tobacco
Be an advocate;
Prescribe the patients by advice
Go for the policy maker
Communication through the media
Good planning on urbanization that facilitating physical activity
Be the champion;
Make it as the lifestyle in each root cause
Thai;
Sugar consumption
Salt consumption
Tobacco use - the first priority that Thailand should address the most
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