621when the need arises. This is feasible as the cost of sequencing a person’s whole
genome has fallen so rapidly that it is now comparable to the price of a single gene
test. Patients who join the study will have either their WGS read or a subset of genes
that are linked to diseases. Another group will be tested for 83 genes that govern
how the body metabolizes drugs. Through discussions with physicians and counsel-
lors, patients who have WGS will decide how much genetic information they want
to know. Most patients are expected to want to learn only about genetic risk factors
that lifestyle changes or medication can infl uence. Physicians will keep track of the
patients and their prescriptions to see whether WGS or more limited genetic testing,
benefi ts them or reduces the costs of their treatment. The shift towards WGS is
expected to become more valuable as physicians and scientists piece together how
multiple genes infl uence disease and how the body reacts to drugs. WGS will not
only give a fuller picture but also enable drawing of complex interaction pathways,
which is not possible by going after only selected genes.
The Mayo Clinic launched a new clinical center in Jacksonville, Florida in 2013
that uses genomic technologies to tailor treatments to individual patients. Genomics
scientists, genetic counselors, bioinformatics experts, and bioethicists, will work
with physicians to determine whether specifi c patients are good candidates for treat-
ments guided by genetic testing. This multidisciplinary group will provide consult-
ing for cancer patients who have seen standard treatments fail and for patients with
“diagnostic odyssey” cases, disorders that are complex or diffi cult to diagnose but
which appear to be genetic in origin.
Mt. Sinai Medical Center’s Personalized Medicine
Research Program
In 2007, the Mount Sinai Medical Center in New York received a $12.5-million
donation from Andrea and Charles Bronfman Philanthropies that it will use over 10
years to start the Charles Bronfman Institute for Personalized Medicine. The
research center is studying personalized medicine, and the medical center will use
the funds to start “an institution-wide biobank” and a “translational biomedical
informatics center.” The grant will also go toward what will become a $30-million
personalized medicine initiative. The Institute will bridge the gap between genom-
ics research and clinical patient care in the area of personalized medicine. The
Personalized Medicine Research Program will develop and provide essential core
technologies that will enable genome-wide analysis of genetic variation and func-
tion in human DNA, and quantitative biology at the single molecule level for large-
scale studies of genetic associations and predictive biomarkers. Access and training
in these resources will be critical to overcoming current research infrastructure bar-
riers that limit our disease-oriented research centers in deciphering the genetic
underpinnings of, and developing personalized approaches to, complex diseases.
Role of Academic Institutions in the US