How to innovate precision technology in precision medicine

The world of precision medicine, for the general public, is still a strange existence, but it has entered our lives faster than expected In January 2015, President Barack Obama announced the precision medical plan; in September, the National Institutes of health released a white paper of more than 100 pages, "precision Medical Project Cluster - establishing the 21st century medical research foundation" Precision medicine has quickly become the focus of medical attention The role of precision medicine is to find the cause and target of the disease from the micro level How to carry out personalized treatment for the disease and specific patients, improve the benefit of disease diagnosis and prevention, and what information technology support is needed in this process? What are the real needs of doctors? A series of questions came up In the event of "data analysis and precision medicine" hosted by Intel, Yu Yi, general manager of Asia Pacific region of Intel's medical and life sciences business unit, Li Yingrui, chief scientist of Huada gene, Mao Yu Yu, senior vice president of transformation science and diagnosis Department of Wuxi Pharmaceutical Co., Ltd., and Yu Ying, CEO of meizhongyi and comprehensive outpatient center, respectively from the aspects of computing technology innovation, gene sequencing technology development and treatment means Development, clinical needs and other aspects of precision medicine We shared the development status of precision medicine in China and the value of innovative technologies such as data analysis in accelerating the development of precision medicine Information sharing is the prerequisite for precision medical treatment Yu Ying, who was once a physician, emergency physician of Beijing Union Medical College Hospital and now the CEO of meizhongyi and comprehensive outpatient center, not only has rich clinical work experience, but also witnessed the benefits of precision medical treatment and medical information technology to patients Since its establishment, Meizhong Yihe comprehensive outpatient center has cooperated with Mayo to establish data channels, introduce advanced accurate diagnosis technology and clinical decision support system of Mayo, etc "In the early days of our clinic's real opening, what we found out about our real success was to let our patients know that we could have a referral with mayo." Yu Ying said "Doctor, I have a benign tumor, but the treatment is very difficult." When hearing this sentence, most doctors will be shocked In everyone's cognition, benign tumors have great hope for treatment Yu Ying met such a patient, because the tumor grows in a special position, such as the fourth lateral ventricle, although benign, it is often unable to cure because of the special position When referring patients to Mayo, Yu Ying encountered greater difficulties "Our patients will not have films in medical institutions in the United States It is a film with format, convenient for network transmission and subsequent medical institutions to get data for storage, analysis and even three-dimensional reconstruction In China, it is a photographic negative." Yu Ying said The data transmission of patients is not smooth, which brings great inconvenience to the treatment "As an emergency doctor, I am very upset and helpless every night when I see the patients with these tumors and their strange treatment plans Why can't our treatment plan be unified for such cancer patients? " Yu Ying began to think about using precision medicine to bring better treatment for patients Through gene sequencing technology, we can judge the disease well As a doctor, how to judge the reliability of these data, and whether these data are connected with the PACS system of the hospital? This is a problem in front of us "As a private medical institution, we will cooperate with many gene companies and intelligent medical hardware companies What is the premise of this cooperation? It's information sharing " Yu Ying explained In the future, technology will become the primary support of precision medicine High performance computing helps gene sequencing technology to develop precision medicine not only needs rich clinical experience, but also needs more powerful gene sequencing technology support Li Yingrui, chief scientist of BGI, interpreted precision medicine from different stages of disease prevention and treatment, "if a disease can be monitored from prevention, effectively managed in the follow-up work of the disease, and the data at different time points can be linked, then precision medicine will be developed." Compared with the past, due to the progress of technology, there are some ways to quantify life If we put together the molecular biological data, medical image data or electronic medical record data of genetic genes, environmental data that can be explored, social data and other data in the process of life development, we can relatively quantitatively describe everyone "We now have the opportunity, the technology, the ability to start quantifying everyone's life One of the important points is the analysis of genes Li Yingrui said With the knowledge of this information, we can master life more in our own hands "It's a precision medical process that can be built by comparing everyone's comprehensive data with others." Taking tumors as an example, the new technology can be very sensitive to capture tumors, DNA molecules or their cells in the blood, and can see the signal of early mutation of tumors On this basis, it is possible to diagnose cancer in the early stage when no tumor is found in medicine or imaging, or when the place is not confirmed to be a tumor How to innovate precision technology in precision medicine? What should we do when we have cancer? "We can use the big data system of life to understand the law of cancer development, optimize the whole diagnosis scheme and system, and make patients live healthier and longer." "Everyone's tumor has a different mutation spectrum, which is why the same treatment sometimes works and sometimes doesn't," Li said Why do we talk about precision medicine today? It's because everyone is different We must have a way to analyze the specific situation of each patient " The diversity of patients' condition urges the development of precision medicine Everyone's DNA is a very long sequence composed of 30 base pairs What's the concept of 30 base pairs? It's 3G data In fact, in data analysis, generally speaking, each person's data is above TB level If the data at different time points are linked, the global data, frequent sampling and real-time calculation developed by this super Moore's law put forward higher requirements for computing, storage and network infrastructure "Computer system is the development of Moore's law When there is a data development like life science super Moore's law, it will inevitably become a new bottleneck This is both a challenge and an opportunity for the computer industry, which is why I think Intel will have a great potential contribution to precision medicine " Li Yingrui said so It is reported that Intel Xeon phi is a coprocessor for highly parallel high performance computing (HPC) applications, which can provide up to 61 cores, 244 threads and 1.2 trillion floating-point computing performance In addition, the rest of Intel Xeon processor architectures use the same programming language, parallel mode, technology and developer tools, with the advantages of easy migration and programming portability It can meet the needs of complex gene sequencing data processing and high performance computing In addition to gene sequencing technology, cell biology also provides a means of in vitro research for tumor Medical institutions can use tumor cells to screen new drugs, instead of testing on patients without cells, as before "The most fundamental cause of tumor is the mutation of tumor gene, oncogene or oncogene, and even these mutations will make the tumor develop further Therefore, the mutations of these oncogenes and oncogenes become the targets of drugs, and targeted therapy is born And targeted treatment of mutated tumor cells, that is, precision medicine " Mao Yu, senior vice president of transformation science and diagnostics at Wuxi apptec Although the name of tumor cells is the same, in fact, tumor cells of the same organ are different under the microscope For example, lung cancer cells, although they grow in the lung tissue, are also divided into small cell lung cancer, non-small cell lung cancer, non-small cell lung cancer and adenocarcinoma "Just because the cells are different, the process is different, and the effect of drug treatment is also different." Precision medicine requires higher effect of drugs "In a tumor tissue, there may be thousands of mutations in tumor cells Because of the instability of tumor genome, some mutations are only some accompanying phenomena But there must be some key mutations, such as the mutation of EGFR, which is the most fundamental target for targeted therapy " Mao Yu said In lung adenocarcinoma, according to the most important gene mutation, it can be classified Previously, it was classified by tissue type and pathological type Now after the emergence of targeted drugs, we can use molecular type With the maturity of targeted therapy, targeted drugs in clinical trials have also shown some good results "This part of the drug may also be approved in the next one to two years Most patients in lung adenocarcinoma need targeted treatment Some patients, like KARs mutation, don't have good drugs, and some patients, we still can't find the real gene mutation, which is the direction we need to work on in the future " In the future, precision treatment will become the main treatment of cancer In the face of thousands of different mutations, how to find the key driving gene mutations? "It's about biology, it's about computing to find mutations that drive genes With the analysis of the whole gene tissue and the judgment of the driving gene, we may choose a targeted drug for the driving mutation of this patient from the targeted drug, and finally have a good effect " "The future trend of tumor treatment must start with accurate calculation, then have a precise diagnosis, and finally bring us a precise treatment effect," Mao said The construction of computing capacity and information technology has become the "vanguard" of the development of precision medicine In the face of a steady stream of cancer patients and miscellaneous treatment programs, Intel has made its own efforts "We have been committed to promoting a number of innovations, including high-performance computing, big data analysis, cloud computing, to help the development of life science research and application, and to improve the level of medical care to ultimately benefit the public." "We expect that by 2020, the development of computing technology is expected to help doctors complete the main process of precision medicine within 24 hours, including gene sequence detection, result data analysis, analysis based disease diagnosis, and customized personalized treatment programs," said Yu Yi, general manager of Asia Pacific region of Intel's medical and Life Sciences Department Precision medicine not only changes the individualized medicine, but also brings a miracle to the reconstruction of the whole medical service and puts forward new requirements In addition, another embodiment of precision medicine is gradual decentralization With the development of technology, medical services that must have been implemented in the hospital as the center before can now be developed