Cultivating and Administering Next-Generation Diagnostics and Treatments
Cancer ranks as the second leading cause of death in the United States, killing nearly as many people as heart disease. To combat this crisis, in July Mount Sinai launched the Center for Personalized Cancer Therapeutics (CPCT), within The Tisch Cancer Institute, where we are receiving the support necessary to elevate cancer therapy to a highly personalized level. Here is a brief overview of how our two labs are working to help cancer patients live longer while enjoying an improved quality of life.
The Mount Sinai Medical Center is continuing its tradition of fostering breakthrough biomedical discoveries by nurturing a new breed of scientists. These scientists, both faculty and students, are exceptional men and women who have committed themselves to furthering medical science through innovation and are driving translational medicine using new tools, models, and approaches.
I am delighted to be part of this vision, which, combined with Mount Sinai’s history of world-class biomedical research, is now drawing students and faculty from quantitative sciences such as engineering and computer science, as well as other non-traditional backgrounds, to join in the process of creating new technologies for the prevention and treatment of human disease. For example, our recent academic affiliation with Rensselaer Polytechnic Institute, pools our expertise in biomedical research and patient care with Rensselaer’s talent in engineering and computational science. This unique partnership offers tremendous possibilities as it will enhance the infrastructure needed for translationally-focused faculty and students to develop novel biomedical technologies.
The Mount Sinai Medical Center is about to embark on a new chapter, one that calls for growth and expansion through a planned combination with Continuum Health Partners, and continued success within a challenging health care environment.
That message was conveyed by leaders of The Mount Sinai Medical Center at three Town Hall meetings held on Tuesday, July 9, and Wednesday, July 10, in Stern Auditorium.
“Our combination with Continuum is about preserving Mount Sinai for decades to come as a great institution,” said Kenneth L. Davis, MD, President and Chief Executive Officer of The Mount Sinai Medical Center, before a standing-room-only crowd of faculty, staff, and students on Wednesday morning. “It is time that we move to the next step in health care and that is an integrated health care delivery system.”
A year ago, the Icahn School of Medicine at Mount Sinai (ISMMS) took a giant step toward tackling some of the most difficult questions in science and launched a new era in scientific computing by building and operating “Minerva,” an on-site supercomputer for genomics and other basic sciences. In that short time, Minerva has helped ISMMS scientists analyze major diseases such as cancer, diabetes and Alzheimer’s with more precision, and it has also brought the medical world closer to developing more effective drugs and obtaining more accurate pathology results.
Driving Personalized Cancer Therapy
Eric Schadt, PhD, Professor and Chair for Genetics and Genomic Sciences and Director of the Icahn Institute for Genomics and Multiscale Biology, and his team rank as Minerva’s biggest users. With their research studies offering novel insights into the evolution and signaling of different cancers, they have discovered a vast diversity in most tumors, a diversity that may continue to increase as the tumors mutate to evade treatment. This information has led them to understand that, although analyzing genetic data is vital to delivering the right treatment for a patient’s cancer, it is not the only piece of the puzzle.
Cancer biology and immunotherapy, the future of psychiatry, the direction of medical education, and the importance of advance directives were among the topics Kenneth L. Davis, MD, President and Chief Executive Officer of The Mount Sinai Medical Center, discussed at an Aspen Ideas Festival preview event held recently at The Studio Museum in Harlem.
The talk, titled “The Future of Medicine,” was a prelude to a larger discussion in which he will participate at the Aspen Ideas Festival in June. Corby Kummer, Senior Editor of The Atlantic magazine interviewed Dr. Davis for 20 minutes before inviting questions from the audience of about 75 invited guests. The event also featured Thelma Golden, Director and Chief Curator of The Studio Museum, who was interviewed by the actor and writer Anna Deveare Smith.
Integrating a Patient’s Clinical and Molecular Information for Improved Diagnosis and Treatment
We often hear about the “potential” that biomedical science and technology have to offer “the future of medicine.” At The Mount Sinai Medical Center, some 25,000 patients are living that future and receiving more precise, personalized care—in real time—based on their own DNA.
Each has enrolled in BioMe (TM), our robust biobank which is among the largest such repositories in the United States. It is also unique in that each patient has broadly consented to DNA sequencing, contact from researchers, and longitudinal studies stemming from the electronic medical record (EMR). Mount Sinai has implemented the Epic EMR system throughout its inpatient and outpatient services, the emergency department, pharmacy, and in many affiliate offices across the city.
Abraham Flexner published his landmark report on undergraduate and medical school preparation of physicians in 1910. Within a few decades and continuing throughout the remainder of the 20th century, there have been admonitions to enhance, overhaul, or abolish the “traditional” pre-med requirements that he established.
The reasons for this dissatisfaction are self-evident:
- The pace of scientific discovery and its clinical application has far outstripped the current century-old requirements.
- The age of information technology has made memorizing vast amounts of content unnecessary.
- The current requirements lack clinical, scientific, and social relevance.
- The traditional requirements are used to ‘cull the herd’ of talented aspiring physicians.
- The requirements disproportionately disadvantage minority and female students who are desperately needed to maintain diversity in our healthcare workforce.
- The requirements consume so much time and effort that few students end up being grounded in bioethics, social justice, and health policy.
- A rigid and highly structured pre-medical curriculum, followed by a rigid and highly structured medical school curriculum, deprives students of the ability to develop the critically important skill of lifelong self-directed learning.
Perhaps most important, the current model has perpetuated “pre-med syndrome,” an undergraduate culture of aggressive competition for grades that runs counter to what we value most in medicine: academic and intellectual rigor, creative thinking, teamwork and collaboration, and social conscience.
February is American Heart Month, the time of year when the nation turns its attention to cardiovascular disease and other matters of the heart. While many public service efforts this month focus on educating people about the warning signs and symptoms of heart attack and stroke, as members of the medical community we have a real opportunity to change the course of this disease by encouraging heart-healthy lifestyles well before risk factors develop.
Cardiovascular disease kills 7.3 million people across the globe each year, making it the world’s leading cause of death. In the United States alone, one in every three deaths is from heart disease and stroke, equal to 2,200 deaths per day. At Mount Sinai, our renowned Director of Mount Sinai Heart and Professor of Cardiology, Valentin Fuster, MD, PhD, believes these sobering statistics mandate a new approach to preventing cardiovascular disease that identifies people much earlier in order to promote a healthy heart.
A new Muppet with a heart for health
So what do Muppets, push-ups and pears have to do with it? Many children between the ages of three and six who live in Spain already know. Born in Barcelona, Dr. Fuster is the inspiration for Spain’s newest Muppet, Dr. Valentin Ruster, who has a passion for heart health and appears in the Spanish version of Sesame Street. The only physician in the Muppet cast, Dr. Ruster’s character teaches kids how to make healthy decisions, like choosing fruits and vegetables, and having fun with exercise.
How do we continue to make giant leaps in medicine? What new treatment or approach will allow us to make the greatest gains for patients, in the most effective and efficient ways possible? Where will the next breakthrough come from? These are questions that academics, clinicians, hospital CEOs and medical school deans are constantly asking as we seek to meet the challenges of modern healthcare.
People and technology have a clear role in the answer, but there is another critical factor that is often overlooked: space, and the spontaneity and ideas generated when scientists and clinicians have the ability to work side-by-side.
A great example of this came up during a recent panel discussion at our SINAInnovations conference. Eric M. Genden, MD, and Chief of the Division of Head and Neck Oncology, discussed his experience on a recent case in which a patient had distant metastatic disease that he and his team could not get to surgically. While working on the case, he happened to bump into Ross Cagan, PhD and Associate Dean of the Graduate School of Biomedical Sciences. Through their conversation, Dr. Cagan suggested getting a biopsy of the tumor, sequencing it, dropping it into fruit flies, and crossing it with 150 different types of chemotherapeutic agents to see what kills the tumor. Over their chance meeting and a cup of coffee, they mapped out a targeted solution to treat the patient.
The entrepreneurial spirit that brought us personal computing, mobile technology and social networks has fundamentally changed the ways in which we shop, do business, communicate with others and generally connect with our world. Yet it has left medicine largely untouched. Electronic medical records are in their infancy, mobile applications for health are disconnected, and we’re just beginning to scratch the surface when it comes to applying the power of Big Data to medicine.
At our SINAInnovations Conference held November 12-14, Jeffrey Hammerbacher, who led the original data team at Facebook, and is currently Assistant Professor at the Icahn School of Medicine at Mount Sinai and Founder and Chief Scientist of Cloudera, was asked why health care and biomedicine are so far behind when it comes to entrepreneurship and the data revolution. His answer: “Failure hurts a lot more here.”
He could not be more right. Hammerbacher’s experience in data science comes from a place where new applications are built to be broken so that better solutions can emerge. Success is measured in clicks. Failure is a pit stop on the way to the next breakthrough. In health care and medicine, lives hang in the balance of all we do. Success is measured in lives saved. It is our moral obligation to proceed with caution when introducing new surgical techniques, therapies or different ways of doing business.