Thank you for the honour of speaking with you today. As Marco indicated, I work very closely with Marco and I, like many of you, wear several hats.
I run our ovarian cancer research team and we've managed to make huge progress in British Columbia in the understanding of this disease by having access to the infrastructure, which Marco and his colleagues have built. We've managed to find the mutations that drive and underpin several types of ovarian cancer, which has immediately led to new diagnostic strategies, and we're working on new treatments.
I also run the Centre for Translational and Applied Genomics, which takes our genomics discoveries and sort of beats them into clinically usable diagnostics, which we hope then to be able to translate and transfer to the laboratory communities not just in Canada, but internationally.
The last thing I'm involved in is the British Columbia personalized medicine initiative, which I'll come back to at the end. The personalization or individualization of disease control is something that is of great interest, because it's the only way we can move things forward at this point. Genomics is really the harbinger of high-content medicine. Our goal is basically to improve decisions. The vast majority of medical decisions are very much like putting on a blindfold and throwing a dart at a dart board. The people making the decisions don't have the information they need to make a refined choice for their patients.
As we move forward into more personalized medicine, we may wonder why genomics and also why cancer and microbiology? The reason that genomics is coming first is that DNA, as many criminals have discovered, is very difficult to destroy and nucleic acids are easy to study, and we can use digital technologies such as the amazing sequencing tools that Marco and his team have led in their implementation to decode cancers.
Everything we learn about how to use genomics could be applied to proteomics, metabolomics, and any other way of looking at biology in a deep and broad fashion.
Cancer and microbiology will always come first and this is why I think Dr. Plummer is here with us, because these are the two diseases where you can remove diseased tissue and you can actually look at the genome of the entity that is causing a problem—cancer or some micro-organism—and study it as being separate from the host. We're learning things in cancer that we hope will be applicable across medicine.
The discoveries we're making and the things that are coming into the clinic should improve both cancer control in terms of cancer susceptibility and also, as Marco suggested, treatment, a trial of on-the-fly whole genome sequencing to help patients, one patient at a time. But this is a very special project and it's strange. Even though this is something that we're all invested in and we're trying to figure out how to use the information, it's hard to argue that our genome sequence, as in our full genomes, won't be some kind of base part of our health care records in 20 years' time or so. How are we going to get there? If health care in Canada is going to keep up with the rest of the world, we'll have to find a way.
We don't have to do this just in tertiary care settings. If we're really going to make a difference, we have to make a difference where most decisions are made, that is, even though we may start in cancer clinics and other academic enterprises, we have to move this process into primary care. And this is where the BCPMI comes in, where we realized in British Columbia that although we look for successes in the diseases we study as individuals, the challenges we face are shared across the whole of medicine, such as some of the ethical, legal, and social challenges of changing the way health care is done.
Genomics isn't the only underpinning; bioinformatics is the other. And if we're going to use information to improve clinical decisions, we have to improve the informatics not just in research centres, but also in decision tools in primary care as well. This is going to take a culture shift, but also a major change in the way we educate all types of health care practitioners.
At this point I would also like to echo my gratitude to the Canada Foundation for Innovation, in particular, because if not for their initial investments into the Genome Sciences Centre, none of the fantastic work that has happened in British Columbia over the past few years would have been able to occur.
Also, I suggest that we have to not just fund the infrastructure but also fund the projects—which have to be peer reviewed— that are going to use these infrastructures, such as the continued support of CIHR. If we are going to improve our health and also have a healthy economy, these are key things that we are going to have to accomplish.
Lastly, I would like to echo Marco's last comment. If we are going to personalize cancer care and personalize the care of other decisions, we have to rethink the way that evidence is perceived in making the decisions to approve drugs. The large phase III clinical trials, which were the mainstay of approvals over the past few decades, will not work for personalized medicine because we're shrinking things down into n = 1 treatment opportunities. There's nowhere you can do a phase III trial to assess that.
In every part of the pipeline from basic genomics through to validation, through to implementation in laboratories and clinics, into regulatory bodies, we are all going to face challenges. I think the potential benefits for our patients and the health of the nation—if we embrace these challenges and start supporting teams that are taking avant-garde approaches to restructuring around high-content, personalized medicine—will be massive. There's an opportunity for Canada to be an international leader moving forward. I know Marco and I are both really excited about the possibilities of participating and playing a leading role in that process.
At this point, I will be happy to end. We can both address any questions you may have.