The era of “personalized medicine” arrives

Pathologists are tapping the power of DNA to tailor treatments

“Most Christmas presents don’t end up changing your life, but this one did,” says Greg Merhar of South Burlington. A few years ago, he and his wife, Debra Leonard, gave each other detailed reports of their genomes – the complete set of “instructions” in our DNA that makes each of us unique – to see what it revealed about their current, and possibly future, health.

GREG MERHAR
(Courtesy Kathleen Masterson/VPR)

Leonard’s interest is more than personal. She is a physician and nationally respected expert in genomic medicine who chairs the Department of Pathology and Laboratory Medicine at The University of Vermont Health Network and The Robert Larner, M.D. College of Medicine at the University of Vermont.

Her test did not turn up much of interest, but Merhar’s pinpointed a rare, painful inflammatory disorder that had significantly limited his activity level for decades. “I’m now on a very effective medication that allows me to do whatever I want to without pain.”

The experience confirmed Leonard’s belief that genetic information is a powerful tool in prevention, diagnosis and treatment. Eventually, she wants all patients in the UVM Health Network to have their genome screened for more than 1,000 diseases and conditions.

“It greatly improves our ability to make accurate and early diagnoses, and that means we have a better chance to really help people,” she says.

Leonard and her colleagues are moving with intention on two tracks: growing the UVM Medical Center’s use of disease-specific genomic testing and the personalized treatments it indicates will be effective; and preparing providers and the public for conversations about the impact of genomics on medical care.

The new Genomic Medicine Laboratory

Testing of solid cancers – such as lung, colon and prostate – started in February 2016 and is driving the use of tailored treatments that have already led to positive outcomes. A genomic medicine laboratory opened in January 2017, testing for blood cancers, inherited diseases and pharmacogenomics, which helps predict whether a medication will be effective for an individual.

A 2016 study at the UVM Medical Center revealed that people have a lot of questions about how genomic medicine will affect their privacy and insurance coverage, and just how much information they really want. Says Leonard, “We’re working hard to develop effective ways of talking about these and related issues.”

Visit our Genomics Medicine website to learn more.