Tuesday, February 23, 2016

Tailored treatment just for you

Gene-sequencing company leads advances in precision medicine

By Jung Min-ho, Kim Eil-chul

During his State of the Union address in January, U.S. President Barack Obama called on his nation to conquer cancer.

During his speech, Obama mentioned the Precision Medicine Initiative, a research project he launched a year ago in order to revolutionize the modern healthcare system altogether.

The United States is not alone in striving for what he described as a medical "moonshot." As the world moves toward the new era of personalized genomic medicine, Macrogen, a Korean company that offers genome sequencing services, is drawing international attention for its huge potential to become a major player.

In September last year, U.S. National Institutes of Health Director Francis Collins visited the office of Macrogen Chairman Seo Jeong-sun in Seoul to discuss possible ways to collaborate on the Precision Medicine Initiative.

"Thanks to technological advances, treatments will be more tailored to maximize the effect for each patient," Seo, 63, said in an interview. "We are entering a new age of medicine that will bring fundamental changes."

Precision medicine refers to the customization of treatment according to a patient's characteristics of the patient's genetic information and other factors that make the patient unique.

DNA sequencing is an essential part of precision medicine because an individual's genetic information, such as whether he or she has any genetic mutation or defect, needs to be considered to find the best treatment for the person.

Chemotherapy, for example, is not effective for all cancer patients because their genetic makeup influences their response to the treatment. With precision medicine, doctors can, in theory, find out whether the treatment will work for each patient.

Macrogen is the world's first firm to sequence more than 30,000 whole human genomes, a laboratory process that determines the complete DNA sequence, Seo said.

"This shows the potential we have as a company that collects and manages biological data, which is required to make medical services personalized in the future," he said.

It is too early to tell the real value of such data as many companies, including Macrogen itself, are still trying to figure out how human health can benefit from the data. But Seo believes that goal will be achieved in the not-so-distant future.

"Revolutions occur when technological advances meet a massive market. Human-genome sequencing is more affordable today than ever before. In 2005, it cost an estimated $2.5 billion. The cost was reduced to just $1,000 in 2014," he said. "This set up a favorable environment for the revolutionary changes because many people can now afford it, just like what happened with computers in the 1980s."

With its advanced technologies, Korea could play a leading role in promoting the new approach for disease treatment and prevention, he noted.

"The country has, for instance, technologies to record a person's eating and exercise habits. Such information can be collected as data and be used, along with genetic data, for an overall health analysis. This way, an individual can know his or her health risks and can take steps to remain healthy," he said.

Moving from the current treatment-focused medicine to a prevention-focused one will be necessary for many developed countries facing increasing healthcare costs for their aging populations, he noted.

In fact, according to the state-run Health Insurance Policy Research Institute, medical costs for Koreans 65 and older are expected to reach as much as 337.1 trillion won ($278.8 billion) in 2060, approaching the entire government's budget in 2016.

"Concerns about the costs, which are increasingly becoming unbearable for many countries including the United States, are pushing them to shift their focus to prevention," Seo said.

He said Macrogen has already collected about 13 petabytes of genome information. "I think Macrogen will eventually evolve from being a sequencing service provider to something more like a global data powerhouse, and in its course, the company may end up competing with Google," he added.

Asian Genome Project

Sequencing a genome is one thing, but understanding it and using it is quite another. Macrogen's next step is taking its technologies out into the real world by helping to improve the health of the 4.5 billion Asians in the world.

In cooperation with researchers in each Asian nation, the company plans to build databases for the genes of the nation's population. By doing so, Macrogen can try to develop a comprehensive gene analysis to find the diseases the people in each country are particularly vulnerable to.

Given that those who are living in the same country share genetic and environmental backgrounds, such as ethnicity, climate and food, Seo believes gene databases will be useful resources for understanding many things about their health.

"Through the project, Korea can realize its founding value ― humanitarianism. This will be the meaningful beginning of precision medicine," Seo said.

In cooperation with Kyoto University, the company already started a Japanese gene analysis project. After completing the project, they want to develop the targeted gene therapy and medications for the health problems that many Japanese have.

Macrogen is also in collaboration with various universities and institutes in other countries, including China and Mongolia, Seo said.

"Our short-term goal is to sequence 10,000 whole human genomes in Asia and we will continue to go further," he said.

"Too many people suffer from diseases and live with inconveniences and fears. Ultimately, I want everyone to have a long healthy life and make the best use of it. That would make our work very meaningful."

Korea's first public biotechnology company

From the moment he got into Seoul National University College of Medicine in 1970, Seo never doubted his future as a physician-scientist.

"I was born into a family of physicians and other health workers, so having such a dream was natural to me. My initial plan was to become a cancer researcher," he said. "I thought I did not have an ‘entrepreneur gene.'"

But his curiosity about the field of genetics led him to an unexpected path. After graduating from medical school, Seo began his own gene study with mice. In 1984, along with other researchers, he set up a private biotechnology company, NUDON, in the United States.

The company closed four years later, but he continued the research, which caught the attention of some major Korean firms that were looking for new growth engines as well as that of the government. They recognized the potential value of what he was doing and offered to fund his research.

In 1997, Seo established Macrogen, which was listed on the KOSDAQ market to become the nation's first public biotechnology company in 2000.

Since then, Macrogen has grown steadily: its sales and profits last year reached 79.3 billion won ($6.5 million) and 4.9 billion won, respectively. He believes these figures will exceed 100 billion won and 12 billion won, respectively, by 2017.

"One of the most valuable things about Macrogen is that it creates its own market," he said.

"I think the company has not seen its best days yet."

His dream of publishing papers in the world's renowned scientific journals also came true in a surprising way, thanks to Macrogen. In the course of the Asian Genome Project, Seo made breakthroughs on various genomics challenges, such as the sequencing of the first Korean genome in 2009 and the discovery of the Asian copy number variations in 2010. The findings were published in Nature and Nature Genetics, respectively.

"Choosing Macrogen over my initial dream of becoming a physician-scientist was tough," he said. "But later, the company gave me what I gave up in a way that I had never expected. Life is so unpredictable, isn't it?"

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