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.”

 

Bringing Together Core Technologies Unlocks Genomic Data to Improve Healthcare

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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.

Genetics-Based Advances in Rare Diseases: Ideas into Action

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NextCODE Health-Claritas Genomics

Claritas Genomics and NextCODE have established a collaboration to support rare disease clinical care.  Combining robust sequencing with integrated diagnostic capabilities, the partnership aims to accelerate and augment the services provided to leading pediatric care organizations.

Today we have a tremendous opportunity to use the data being generated from genome sequencing to address the mysteries of rare genetic diseases affecting children. Though these diseases individually are rare, according to Global Genes, an estimated 7,000 different types of rare diseases affect more than 30 million people in the U.S., roughly half of whom are children.

To conduct diagnostic testing for pediatric genetic disorders, leading children’s hospitals are collaborating with specialized laboratories, including Claritas Genomics, a recognized leader in specialized pediatric genetic testing affiliated with Boston Children’s Hospital, part of the Harvard Medical School system.

The real opportunity lies in the analysis of raw genomic sequence data to identify patterns or markers of a rare disease. While it has been theoretically possible to use genomic sequencing to diagnose most rare diseases, a major hurdle has been in integrating dynamic informatics tools that can quickly interpret the data into accurate diagnostic insights and, ultimately, treatment options.

This is why Claritas Genomics and NextCODE have today established a collaboration, enhancing their collective capabilities to support rare disease clinical care. Combining robust sequencing with integrated diagnostic capabilities, the partnership will aim to accelerate and augment the services provided to leading pediatric care organizations.  Claritas has established a wide range of tests for genes known to be associated with pediatric disorders, which NextCODE is integrating into its clinical interface, resulting in accurate, reliable clinical reports. Learn more about NextCODE’s pioneering activities here.

Enabling this rapid, integrated approach to genomics-based care for rare diseases holds great promise for the community and for the many families who are anxiously seeking answers to these mysterious diseases.

Advancing Autism Research By Sharing Genomic Data Online: The Simons Simplex Collection

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THE NEXTCODE Exchange is hosting the Simons Simplex Collection (SSC), a global resource for research on autism spectrum disorders comprising genomic data from nearly 2,800 families.

THE NEXTCODE Exchange is hosting the Simons Simplex Collection (SSC), a global resource for research on autism spectrum disorders comprising genomic data from nearly 2,800 families.

Autism research is underway around the world to better understand the genetic basis for the disease, which is difficult to diagnose and has limited treatment options. With vast amounts of data being generated, the answers to this challenging disease may lie in the consolidation of this global data.

The newly launched NextCODE Exchange (read the release here) may be a critical solution in changing how autism is diagnosed and treated. The Exchange is hosting the Simons Simplex Collection (SSC), a global resource for research on autism spectrum disorders comprising genomic data from nearly 2,800 families.

With the Exchange, the SSC will be accessible to the world’s autism researchers to harmonize the growing body of relevant genomic data. By enabling the rapid analysis of massive amounts of sequencing data followed by instant collaboration and validation of findings, the availability of the SSC and other hosted data will accelerate the pace of discovery in this field.

This simple concept is likely to help usher in a new era of genomic medicine, offering global access to data that can answer questions to some of today’s most challenging diseases.

Learn more about the NextCODE Exchange and the Simons Simplex Collection here.

Maintaining Momentum Post-ASHG: Maximizing the Value of Large Genomic Databases

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The newly launched NextCODE Exchange provides a browser-based hub for multi-center sharing and collaboration on collective data from massive whole-genome databases like the Haplotype Reference Consortium (HRC).

The newly launched NextCODE Exchange provides a browser-based hub for multi-center sharing and collaboration on collective data from massive whole-genome databases like the Haplotype Reference Consortium (HRC).

The American Society of Human Genetics (ASHG) meeting convened this week in San Diego, bringing together genetics experts from around the world to discuss programs with great potential to advance genomic-based medicine in the years to come.

To maintain the momentum generated this week, we need to find ways to integrate these important ideas, insights and programs, and to maximize the use of the massive databases that have been launched to support research on cancer, rare diseases and other pressing health topics.

One of the databases unveiled during the meeting was the Haplotype Reference Consortium, which aims to become the world’s most comprehensive database of genetic variations. Large databases like the HRC, along with several others already underway, can be tremendously helpful to researchers finding answers to some of the most challenging diseases. But there remains a significant bottleneck: these large, cumbersome databases cannot easily be shared and manipulated, limiting their utility for broad, multi-center genomic research.

The solution lies in the newly launched NextCODE Exchange (see release here). This browser-based hub allows for the sharing and harmonizing of massive whole-genome databases like the HRC to accelerate research. The integrated architecture allows users to visually confirm and validate findings in raw sequences, collaborating and sharing with others around the world who may have complementary research underway.

The momentum generated during ASHG will be multiplied by sharing and learning from the world’s collective genomic data on the NextCODE Exchange. Learn more here.

Imagine the Potential: The World’s First Online Hub for Global Genomic Data Access

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The NextCODE Exchange, a new browser-based hub, allows for real-time sharing of whole genome collections in a simple, consistent format.

The NextCODE Exchange, a new browser-based hub, allows for real-time sharing of whole genome collections in a simple, consistent format.

The field of genomic medicine is rapidly advancing as the research community becomes more comfortable manipulating genomic data with the goal of discovering insights about disease causes and risks. Yet each database is hosted within separate organizations, organized in unique ways and vastly too cumbersome to easily share with others who may be working on similar research.

This weekend a new tool launched to enable just that. The NextCODE Exchange (see release here), a new browser-based hub, allows for real-time sharing of whole genome collections in a simple, consistent format.

The availability of this Exchange is a critical advance in extending the utility of genomic data by allowing organizations around the world to access and harmonize large complementary datasets, potentially multiplying their study data sets to gain more reliable insights than ever before.

Already, numerous organizations are participating in the NextCODE Exchange to add and share their genomic data, including clinicians and researchers affiliated with Boston Children’s Hospital, University College Dublin, Queensland Institute of Medical Research (Australia), and Saitama Medical University (Japan).

As new institutions look to the Exchange to share genomic data, this hub holds significant potential to help advance progress in genomic-based medicine.

Learn more about the NextCODE Exchange here.

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.

Genome Data Interpretation: How to Ease the Bottleneck

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Bloomberg NextCODE Hannes Smarason

Bloomberg BNA Business’ “Diagnostic Testing & Emerging Technologies,” highlights how NextCODE is providing a qualitatively different way to store and analyze genomic information to meet growing opportunities in personalized medicine.

With advances in sequencing technology and reduced costs, more and more data are generated every day on the genetic basis of disease. The challenge has become how to derive meaningful information from these mountains of data.

While various systems have been established in recent years to store the large amounts of genomic data from patients’ DNA, a remaining obstacle is to “break the bottleneck” so that researchers can process the vast data in multiple human genomes in order to identify and isolate a small, useful piece of information about disease. Conventional databases and algorithms have not been able to efficiently and reliably identify subset information among the millions of genetic markers in order to inform clinical decisions. This has become a major data management roadblock.

The key is to find new approaches for databases and algorithms that accommodate the unique ways that genomic information is analyzed and interpreted. As discussed in Bloomberg BNA, Diagnostic Testing & Emerging Technologies, NextCODE is already easing this bottleneck by providing a qualitatively different way to store and analyze genomic information and apply it to meet the growing opportunities for personalized medicine.

NextCODE’s Genomically Ordered Relational (or GOR) database infrastructure is a truly different way of storing this huge amount of data. The principle is very simple: rather than store sequence and reference data in vast unwieldy files, it ties data directly to its specific genomic position. As a result, the algorithms are vastly more efficient compared to a traditional relational database because they can isolate by location in the genome. That makes analysis faster, more powerful, and radically more efficient, both in terms of clinicians’ and researchers’ time, as well as computer infrastructure, I/O, and CPU usage.

This holistic approach applies broadly to the priorities of genome scientists around the world, helping them eliminate the data management bottleneck to identify more culprits to many inherited diseases, more quickly and cost effectively.

Read more about NextCODE’s work here.