Category Archives: genome sequencing

Genomics Offers Game-Changing Solution to Rare Disease Diagnosis, Costs

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Hannes Smarason Wuxi NextCODE

As genomics is used more and supported by ever-more robust analysis and interpretation, its potential to offer a solution to diagnosing rare diseases is truly game-changing.

I believe strongly and have previously blogged on the potential for genomics to shift the care paradigm for rare diseases, and here I’d like to detail in particular the huge potential value genomics can add to rare disease diagnosis. According to the National Institutes of Health (NIH), there are over 7,000 rare diseases affecting between 25 and 30 million Americans, which is nearly 1 in 10 people, making the overall prevalence of rare diseases significant. Rare diseases can be chronic, progressive, debilitating, disabling, severe, and life-threatening.

When a patient presents with a spectrum of unusual symptoms, a costly scramble naturally begins to diagnose the patient’s disease. Some people refer to this diagnosis process for rare diseases as a “diagnostic odyssey,” as patients and their families are subjected to test after test while being handed from one doctor to another, oftentimes to medical centers far from their home. Too often, this odyssey yields no concrete diagnosis or—worse—misdiagnosis. The direct medical costs can be significant, and the indirect costs—the frustration and disillusion felt by the patients and the family—can be extraordinary.

Since NIH believes that approximately 80 percent of rare diseases have genetic origins, the potential for genomic sequencing, interpretation, and analysis to offer a solution here is truly game-changing. A recent article in Bloomberg BusinessWeek highlighted medical histories of two patients who recently received a diagnosis informed by genomics. In both these examples, genomic analyses provided an end to the burden, cost, and stress of their multidecade-long diagnostic odyssey:

  • Jackie Smith, 35, spent the 32 years from age 3 unable to receive a correct diagnosis that could account for her weak limbs and turned-in ankles, despite seeing many doctors on numerous occasions. Indeed, Jackie’s parents were told to “take the 3-year-old girl home and enjoy her while they could”…”[her disease] would probably kill her before she was old enough to drive.”  This past February, using genomic interpretation and analyses from Wuxi NextCODE, Claritas Genomics definitively identified her condition as centronuclear myopathy in less than three weeks.
  • Dustin Bennett, 24, would tremble and violently jerk for hours or days at a time and had been developmentally delayed since childhood. After dozens of doctor visits and incorrect diagnoses—seizures, muscle disorders, mental health problems—a Mayo Clinic genomic-based analysis showed he has episodic ataxia type I, a neurological disease characterized by hours-long attacks with no clear trigger. Dustin, a 24-year-old who functions at a first-grade level, is now on the second round of a medication doctors say should help reduce the frequency and severity of his episodes.

As genomics is used more and supported by ever-more robust analysis and interpretation, I expect these types of clear successes to become even more commonplace. And the value to the healthcare system and the patient is clear, expressed powerfully in the Bloomberg BusinessWeek piece:

While there isn’t yet a cure, Smith is participating in research that may one day lead to treatments or more supportive care. “Just being connected feels good. I felt alone for a long time,” she says. “And I want to do it for the bigger picture, too. Not just for myself, but so I can be counted.”

 

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Bringing Together Core Technologies Unlocks Genomic Data to Improve Healthcare

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genome analysis technologies

Within the “3-legged stool” of genomics-enabling technologies, lower-cost genome sequencing has reached a point of strong commercial viability, and the remaining two legs—genomic analysis tools database storage—are rapidly evolving to support the use of genomic information in medical care.

The adoption of genome sequencing technology is rapidly expanding as medical centers around the world embrace its utility in informing healthcare decisions—an emerging reality of personalized medicine.

There are three important areas of technology that are driving the use of genomic data in healthcare:  genome sequencing, genomic analysis tools, and database storage.

The first of these—genome sequencing—has advanced to the point that it is more widely accessible, with the cost of sequencing at nearly $1,000 or less. This lower cost of genome sequencing has reached a critical milestone to enable the use of sequencing as a mass-market product for medical care.

The second and third core genomic technologies—genomic analysis tools and database storage—are in the midst of evolution. Their progress and integration are critical for the next stage of adoption of genomic data into health care.

The rapidly evolving legs of the “3-legged stool” of genomics technology are genomic analysis tools and database storage.

  • Genomic Analysis Tools: Since the human genome was first sequenced more than a decade ago, an increasingly robust body of research has showcased the links between mutations identified in the genome and disease risk. Informatics tools have been developed by medical centers and genomics companies to apply to whole-genome samples. Increasingly, these genome analysis tools will need to adapt to the steady pace of new genomic linkages to disease and to operate at a level approaching “big data.”
  • Database Storage for Human Genomes: There are a growing number of robust databases of human genomes, including data for healthy people or those with certain diseases. When properly analyzed, these databases offer the potential to provide the medical community with a reference library against which to compare genetic data. Large-scale, high-quality databases are an essential element to cross-reference a patient genome to guide more informed medical decisions.

Recently, two leading genomics companies—WuXi and NextCODE Health—have combined their technology capabilities in these two areas. WuXi has industry-leading capabilities to analyze, store, and manage the vast amounts of genomic data. NextCODE Health brings a leading-edge system for sequence-based clinical diagnostic applications and genome analysis.

The combination of WuXi’s foundational genomic database storage and management and NextCODE’s sophisticated genome analysis tools will integrated the key components that are most rapidly evolving to apply genomics to medical care.

Initiatives like these advance the state-of-the-art in genomic analysis and database storage, bringing us to the heart of helping the world to fully harness personalized medicine and providing tools directly to doctors to provide better diagnostics and treatments to patients.

The progress to date has been amazing. Yet the opportunities ahead are even more extraordinary to improve the speed, accuracy, and accessibility of genomic information to improve human health.

A New Era, New Vision for WuXi and NextCODE Health

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WuXi-NextCODE

WuXi PharmaTech has acquired NextCODE Health to create WuXi NextCODE Genomics, a global leader in genomic medicine. Pairing WuXi’s technology and existing reach with NextCODE’s leading analytics and database promises to advance the pace of genomics research today.

In the fast-paced genomics community, we continually look for new opportunities and strategies to enhance the value of genomics and use the increasingly robust body of genomic data for the advancement of clinical medicine.

We’re excited to announce a new, ambitious vision to do just that, with WuXi’s acquisition of NextCODE Health. NextCODE will be merged with WuXi’s existing Genome Center in wholly-owned subsidiary called WuXi NextCODE Genomics, with unique, comprehensive and global capabilities for using genomic data to deliver better medicine and improve healthcare.

WuXi, a Shanghai-based genomic laboratory service partner for companies in the pharma and biotech community, has already been collaborating with NextCODE to provide analysis services to customers of the WuXi Genome Center. Now, with the in-house capability to analyze, store, and manage the vast amount of genomic data, NextCODE’s industry-leading genome sequence analysis platform will expand WuXi’s core next-generation sequencing benefits and services.

Pairing WuXi’s technology and existing reach with NextCODE’s leading analytics and database promises to advance the pace of genomics research today. More importantly, however, this new era for NextCODE brings exciting opportunities to maximize the most advanced tools available today and contribute to major advances in genomic medicine.

Global Projects Move Genomic Medicine to the Next Level

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NextCODE takes top marks in Genomics England analysis and interpretation “bake-off:” NextCODE’s proven population-scale platform delivered the best results in rare disease and cancer clinical interpretation, as well as secondary analysis and variant refinement.

New genomics-based technologies and tools are making their way into a range of exciting research programs and clinical studies around the world. Leading-edge organizations are quickly adopting hardware for sequencing and systems for collecting genomic data. Now, the focus has turned to analysis and interpretation – the critical component necessary to gain the insights from the sequence data that will transform medicine.

Earlier this year, Genomics England announced investments for broad sequencing and analysis of 100,000 human genomes. At the time, Genomics England had selected Illumina as its sequencing partner and was coordinating resources and centers to support the effort, including resourcing for analysis and interpretation. [See blog post here]. Other initiatives, such as the Qatar genomics program and the initiatives by Longevity and Regeneron also represent the accelerated progress in seeking medical advancements from genomic data insights. [See blog post here.]

This week, Genomics England announced a select group of companies with advanced capabilities to move to the next stage of evaluation to provide clinical interpretation for the 100K Genomes Project. At the tip top was NextCODE, which received top marks by Genomics England for its analytical capabilities across all the categories evaluated: rare disease interpretation, secondary pipeline analysis and cancer interpretation. [See press release here.] The company’s advanced Genomically-Ordered Relational database, or GOR, combined with its clinical and discovery interfaces offer the most advanced and reliable capabilities to support the ambitious tasks undertaken by Genomics England, and are already proven at population scale. [Read more on the GOR database here.]

The coming months will be a very exciting time for genomic medicine, with interpretation taking the spotlight as we take leaps toward the next stage of personalized medicine.

Population-Scale Research Efforts Enabled by Progress in Sequencing

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population-scale genomics

Significant insights gained from population-scale genomic studies, based on the knowledge of genetic variation and disease causation, will help to enable a new reality of personalized medicine and treatment.

The ability to sequence whole genomes quickly and economically is driving interest in population-scale sequencing efforts that can reveal meaningful insights on a much more systematic basis than previous approaches. A range of large initiatives announced recently are prime examples of the trend in population sequencing, including industry programs by Regeneron and Human Longevity, and the 100,000 Genomes Project by Genomics England. Perhaps better than any other effort since the founding of deCODE in Iceland, the establishment of a high-throughput Genomics Center at Sidra Medical and Research Center in Qatar embodies the movement toward these types of population studies. The eventual goal of the project is to sequence the entire Qatari population of some 300,000 people. But from the beginning, the Sidra facility will help advance genetic mapping projects, including the creation of Arab consensus genome to obtain a better understanding of genetic variants that influence health across Arab populations and, indeed, beyond. In addition to these efforts, the center will focus on uncovering the causes of rare genetic diseases. The significant insights that can be gained from population-scale studies, based on the knowledge of genetic variation and disease causation, will help to enable a new reality of personalized medicine and treatment. And this is where efficient, powerful and industrial-scale analysis will become critical. NextCODE’s analytics and interpretation systems have already been tested at such scale, as they are based on the world’s first and largest population genomics effort—that of deCODE. [see blog post] Our systems will be useful tools to efficiently deliver insights based on the vast amount of data that will be generated by these major population-based efforts to improve the state of global healthcare.

Genomics and Rare Diseases: Hope for Solving Unanswered Questions

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genomics and rare diseases

Leading institutions around the world are leveraging the power of advanced sequencing technology to solve some of the greatest unanswered questions in medicine.

As we learn more about disease biology and uncover new insights thanks to the availability of genomic technologies, we are making meaningful progress in identifying means to address many rare diseases for which there is little medical hope today.

With these new genomic tools and insights, a wide range of opportunities has emerged to improve diagnosis and treatment of rare diseases. Over the past few years, DNA sequencing has begun to uncover the causes of rare diseases and, at the heart of each case solved is a patient and a family that has gained new understanding about their condition. With time, these success stories in diagnosis will lead to more successes in treatment.

Now more than ever, there is more hope that identifying the key mutations will lead to better understanding of the biology of disease and then to novel therapies. Better and faster technologies are being promoted by leaders in the field of genomics that are enabling much more rapid analysis and interpretation of a patient’s genome to find answers. The critical first step is to obtain sufficient data to analyze, compare it against a robust database of reference data, and gain an accurate understanding of potential mutations associated with these rare conditions.

As researchers focus on specific areas, new partnerships are extending access to data and accelerating progress with rare diseases around the world. Recently, genomic analysis collaborations were initiated by ACoRD at University College Dublin to implement NextCODE’s proprietary database and analytical tools to mine whole genome data for variants linked to autism spectrum disorders. [See blog post here]. Another genomic analysis program with ANZAC in Australia applies advanced sequencing analysis technology to better understand X-linked Charcot-Marie-Tooth Syndrome, a rare and progressively debilitating neurodegenerative disorder. [See blog post here] More collaborations are in the works and we’ll be talking about them as soon as we can.

We look forward to the results of these and other collaborations as leading institutions around the world make efforts to leverage the power of advanced sequencing technology to solve some of the greatest unanswered questions in medicine.

A Standard Database Architecture Will Build a Stronger Foundation for Genome Discoveries

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big data genome sequencing hannes smarason

The general adoption of the Genomically-Ordered Relational database (GOR) as a data standard for storing genomic data may greatly accelerate the spread of sequencing and its effectiveness as a tool for advancing medicine.

It is widely accepted that the ability to share the analysis and insights from DNA sequencing will be a key driver of discovery and innovation. But one current limitation to extending this knowledge is that sequencing and analysis platforms, as well as samples, are often proprietary to and stored at different institutions. Perhaps more important, the structures and formats in which genomic data has customarily been stored—the relational databases developed by the likes of IBM and Oracle—make it unwieldy to analyze as the amount of data grows, and very difficult to share. The upshot is that institutions cannot easily share and consolidate information to generate more robust analyses and clinically relevant insights. This presents a serious hurdle to discovery both in rare disorders, where samples need to be gathered in order to generated adequate analytical power, and in complex ones, where truly massive studies can tease apart different facets of disease and reveal their causes.

Over the past decade, a novel and comprehensive database model has been developed to solve this bottleneck, offering a flexible and fast means to overcome these problems. It is called the Genomically-Ordered Relational database, or GOR, and was designed to manage and query the detailed genomic data amassed by deCODE genetics in Iceland – the world’s first and still by far largest and most comprehensive population-based genomic database.

The thinking behind the GOR is as simple as it is revolutionary. Genomic data is a sort of big data but one with an important difference: It is divided up in distinct packets—the chromosomes—and then arranged within each chromosome in linear fashion. The GOR makes use of this by storing and querying sequence data according to its unique position in the genome, rather than as huge files as long as the sequence. This radically reduces the data burden of querying even large numbers of whole genomes, at the same time making it possible to store and visualize instantly the raw sequence underlying an analysis.

In practice, the GOR thereby enables researchers to home in on specific variants without having first to call up entire patient genomes, and separates raw data from annotations to focus in on only the most relevant search components. It’s these types of functions and features that can be consistently applied across data storing systems to allow for more multi-institutional, collaborative research and consistency in outcomes worldwide.

Leaders in the genomic research community are now beginning to create coalitions and working groups to underpin and coordinate the adoption of standards for sharing genomic data. As these groups create flexible and efficient policy frameworks, the GOR is tested and ready to support the fundamental data requirements of global data sharing and the acceleration of discoveries in genome-based medicine. The general adoption of the GOR as a data standard for storing genomic data may greatly accelerate the spread of sequencing and its effectiveness as a tool for advancing medicine around the world.

Genomics-Based Medicine Coming Into View

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NextCODE Health

NextCODE Health has quickly gained recognition for its unique capabilities to address unmet needs in the genomics space through a massive genomics database that interprets DNA samples to identify relevant disease markers.

The practice and adoption of genomic medicine is accelerating as technologies improve, costs fall and new insights drive better patient care. While many companies are supporting this emerging field, a select few are providing the unique perspectives and capabilities to advance progress even faster.

NextCODE Health made headlines less than a year ago with the announcement of its launch and funding by major investors in healthcare and biotechnology. The company quickly gained recognition for its unique capabilities to address unmet needs in the genomics space through a massive genomics database that interprets DNA samples to identify relevant disease markers. (See the features in Xconomy, Bio-IT World and PLOS Blog.) The company was later mentioned in Nature Biotechnology News for its potential contributions to genome studies by leveraging key reference data from deCODE’s Icelandic work in Iceland.

Its rapid trajectory since launch and the utility of its genomic analysis technology was featured in BioCentury in May, featuring testimonials from clinicians using NextCODE capabilities to diagnose patients at Boston Children’s Hospital, the Baylor College of Medicine, and the Sanford School of Medicine. In June, it was featured in a major interview with Bio-IT World and the company continues to expand. Since then, NextCODE has announced several programs through which global pioneers in clinical genomics research are applying its interpretation and analysis technology to support research and diagnosis in rare diseases, including:

As more organizations employ genomics in major research initiatives, NextCODE’s interpretation technology will be an increasingly important asset in delivering meaningful insights from the wealth of genomic data being produced. Visit NextCode for the latest on how the future of genomics-based medicine continues to evolve.

Seeking Genomic Answers to Autism and Rare, Idiopathic Diseases

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rare-diseases-hannes-smarasonAs more is learned about autism spectrum disorders, more questions seem to arise. Yet with DNA sequencing, researchers are able to investigate the genetic roots of this and other diseases that are not yet well understood. It’s another instance in which genomics can shed light upon the workings of that most important organ system—the brain—which is so difficult to analyze.

Institutions around the world have sought to fill in pieces of the autism puzzle with links to other disorders and diagnostic insights, and these efforts have in recent years uncovered a number of possible genetic triggers and pathways. Yet the causes and manifestation of these diseases remain largely elusive.

University College Dublin’s Academic Centre on Rare Diseases (ACoRD) in Ireland, which is world renowned for its discoveries in rare genetics, is using NextCODE’s genome analysis technology to power large-scale, sequencing-based diagnostics programs and genome discovery efforts to study autism and rare pediatric disorders.

Recognizing the enormous potential of large-scale sequencing to mine whole genomes and accelerate discoveries in rare genetic diseases, ACoRD will focus on some of the most challenging areas to inform and provide new directions for research that may help lead to diagnosis, treatment, and even prevention for these disorders. In using NextCODE technology both for analyzing as well as storing large-scale genomic data, ACoRD is well positioned to become a focal point for multinational research and clinical diagnosis in conditions that require the gathering and collective analysis of genomes from many participants in many countries.

Rare Disease Research Focuses Charcot-Marie-Tooth Syndrome, Guided by DNA Sequencing

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rare diseases nextCODE hannes smarasonGenome sequencing is a relatively young technology and has been in active use in the research space for just over a decade. Yet already it has found very meaningful applications in clinical care, supporting the world’s leading researchers in discovering answers to some of the most rare and confounding diseases. The interface between the research and clinical realms is seeing some of the most exciting and fruitful applications of the power of sequencing. The ANZAC Research Institute in Sydney, Australia sits right at this nexus and is using the latest DNA sequencing and interpretation technology from NextCODE to mine genomes in search of genetic mutations that are associated with X-linked Charcot-Marie-Tooth syndrome (CMTX). CMTX is a rare, progressively debilitating neurodegenerative disorder that can be caused by mutations in many different places in the genome, including the X chromosome. At present there is no cure or drug treatment available. The team at the ANZAC Research Institute, recognized for their expertise in familial genetics, sought out the unique capabilities of the NextCODE analysis platform to investigate spaces outside the normal coding areas of genes. The aim is as pioneering as the technology: to identify not just just single SNPs but also structural variants that conventional approaches have not been able to search for systematically and link to CMTX. With dedicated research minds and the latest technology, the program aims to better understand this disease and potentially find novel targets for the development of therapies. This is one great example of the many opportunities to improve lives that are being generated by insights gained through the rapidly evolving field of genome sequencing.