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August 5, 2008 • Volume 5 / Number 16 E-Mail This Document  |  Download PDF  |  Bulletin Archive/Search  |  Subscribe

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Director's UpdateDirector's Update

Guest Update by Ken Buetow

Personalized Medicine - BIG Health

Dr. Ken BuetowExcitement has been building around the concept of personalized medicine for several years. The promise is a new era in which medicine is personalized, preemptive, predictive, and focused on patient participation.

Certainly, the science that is enabling a highly individualized approach has shown explosive growth. For example, just since January of this year, dozens of genes have been correlated with cancer and other diseases, any number of which may eventually be clinically validated as "biomarkers" to identify which patients will benefit from certain therapies. These novel genetic abnormalities may also serve as targets for new drugs. More and more genetically based diagnostic products or new targeted therapeutics are in development or being marketed.

In addition, an increasing number of academic medical centers and health care providers are initiating system-wide activities meant to make clinical care better tailored to individual patients. The Baylor College of Medicine, for example, is building a new hospital from the ground up with a specific focus on personalized, genetic-based medicine.

Although much progress is being made, the groups that will be essential to the success of personalized medicine too often are still operating as silos. There has been no systematic, national endeavor to connect all the requisite constituencies and capabilities together into a seamless, networked process to demonstrate the feasibility and value of this new model for health care.

With the BIG Health Consortium, I'm pleased to announce that such an endeavor is now getting started. The BIG (Biomedical Informatics Grid) Health Consortium will be a public-private partnership comprised of all the key stakeholders in health care: patient advocates, health care providers, payers, product innovators, investors, and information technologists. Conceived at NCI, its mission is to show - in real settings, in real time - how and why personalized medicine works. Through a series of demonstration projects, the BIG Health Consortium will model a new approach in which clinical care, clinical research, and scientific discovery are linked. The key enabler for this linkage is the informatics infrastructure that NCI has already developed, the cancer Biomedical Informatics Grid (caBIG).

caBIG is connecting the world of cancer research and care through the "glue" of its interoperable tools and technology. NCI's designated Cancer Centers and Community Cancer Centers - which collectively treat millions of patients - are already adopting or adapting caBIG infrastructure in order to achieve connectivity within their walls, between each other, and with the larger biomedical enterprise. That same set of tools and technology can operate inside the BIG Health Consortium to connect all the participating organizations.

A BIG Health Consortium roundtable, scheduled for next month, will be the first time that interested parties gather to discuss the goals of this new initiative and how they can be made operational. The roundtable will serve as a way to gather those who see the essential unity of research and care, and who wish to define specific projects that can have an impact in the near-term. Among those that have already expressed a desire to participate - NCI Cancer Centers, Community Cancer Centers, personal genomics and pharmaceutical companies, molecular diagnostic firms, health care providers, pharmaceutical companies, and advocacy organizations - there is already a new "mega-community" starting to emerge that can share information. The BIG Health infrastructure will ultimately link with electronic health records and personal health records, enabling us to achieve what some have called the "rapid learning system." Such systems draw on networks of biomedical information to acquire knowledge and process it into practice much more quickly than is currently possible.

NCI leadership is very excited about this new initiative, BIG Health, and our hope is to have the broadest participation possible. NCI is inviting academic, advocacy, government, and commercial organizations to participate in the BIG Health Consortium. For more information, please contact me at

Dr. Ken Buetow
NCI Associate Director for Bioinformatics and Information Technology