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Re:In Treatment for Leukemia, Glimpses of the Future by tokenadult on Monday July 09, 2012 @12:34PM (#4218956)
Here's some good commentary on this case in a blog post "The future of cancer therapy?" from a cancer physician in today's Science-Based Medicine blog:

http://www.sciencebasedmedicine.org/index.php/the-future-of-...

"While the story is basically one long anecdote that shows what can be done when new genomic technologies are applied to cancer, it also shows why we are a very long way from the true 'individualization' of cancer care.

. . . .

"Taking the results of the sequencing of the entire genome and RNAseq data and analyzing them allows scientists to probe the genome and transcriptome of cancers in a way that was never before possible. It produces an enormous amount of data, too, terabytes from a single experiment. At cancer meetings I’ve been to, investigators frequently refer to a 'firehose' of data, petabytes in magnitude. Indeed, the sheer quantity of data from these experiments challenges the bandwidth of universities doing them, and, in fact, it’s not at all uncommon for the preferred means of sending experimental data to be to load up a hard drive with the data and send it by the quaint but effective method of overnight mail to other investigators because it’s faster and more reliable that way. Not surprisingly, serious computing power and major advancements in computer algorithms have been necessary to develop the methods of analyzing data from these experiments.

"What I’m trying to convey is that what WUSTL did for Dr. Wartman was not a little deal. It was a big deal that took a lot of resources and effort and likely cost well over $100,000. Apparently it was paid for through research grants, and Dr. Ley claims that no patients were neglected while all that sequencing and computing firepower were transferred to sequencing Dr. Wartman’s cancer genome and transcriptome, having done the same thing for a previous patient."

In other words, the glimpse of the future that we may be able to derive from this case shows that the future is still far off, and the steps to reach the future are enormously expensive. More details are available in other paragraphs of the linked Science-Based Medicine post.

Re:In Treatment for Leukemia, Glimpses of the Future by jostmey on Monday July 09, 2012 @04:06PM (#4220122)
I applaud the finical risk the lab took. If they had failed overturn anything significant, then the lab very well might have gone under. Very few researchers take big risks such as this out of fear of not being able to publish anything because nothing could be identified in the data.

But the lab succeeded, and now we have an example that DNA/RNA sequencing may be useful for the treatment of cancer. Not only that but it sounds like we learned something about a particular strain of Leukemia afflicting at least one person, but probably several more. I am sure the Drug company/ies are relived to discover that their drug might be useful for treating other types of cancer.

Re:In Treatment for Leukemia, Glimpses of the Future by fghh45sdfhr3 on Monday July 09, 2012 @12:50PM (#4219027)
I don't know. $100,000 to find a great treatment for one cancer, which previously had no treatment, seems cheap!

And I think a truck full of hard drives hurdling down the highway has had greater bandwidth than most of the world's networking for a while now.

As the future of medicine is clearly personalized I think the costs associates with genome sequencing and other analysis will come down. Or, at least, I hope they do.

Re:In Treatment for Leukemia, Glimpses of the Future by bedris on Monday July 09, 2012 @03:19PM (#4219892)
Just to be clear, this $100,000 was spent to possibly identify a potential treatment for one person's cancer, not one type of cancer in general.

In other words, this was a $100,000 diagnostic test with no guarantee that an actionable diagnosis would result. By that, I mean that the results of the sequencing analysis either (a) might not pinpoint a driver mutation or (b) might pinpoint a driver mutation that does not have an efficacious drug available to act on that mutation. Also, all caveats about tumor heterogeneity and evolution, etc., apply.

An integrating sequencing approach involving the analysis of normal and cancerous cells to identify actionable mutations is the best we have for now, but it is still a hugely expensive, time-consuming, and technically-challenging process with an enormous failure rate associated with it. Nonetheless, I think it's terrific that, in this instance, it yielded valuable and actionable information that resulted in a meaningful clinical result. One step at a time!

Re:In Treatment for Leukemia, Glimpses of the Future by tomjen3 on Monday July 09, 2012 @01:10PM (#4219121)
The future is always expensive (think cars, when they first arrived) and then gets progressively cheaper.

And looking at the price to sequence DNA -- I have seen little, if anything, that ever crashed that fast.

Re:In Treatment for Leukemia, Glimpses of the Future by adrianN on Monday July 09, 2012 @01:32PM (#4219250)
Sequencing is the easy part. The hard part is making sense of the sequencing data. For that we'll need some serious innovations before it becomes viable for everyday treatments.
Re:In Treatment for Leukemia, Glimpses of the Future by jostmey on Monday July 09, 2012 @03:54PM (#4220071)
Sequencing is the easy part? What planet are you from? Practical sequencing of whole human genomes required the inventions of brand new De-novo technologies. The problems facing sequencing weren't just tough and complex, but seemingly intractable. The computational stuff seems challenging, but at least the problems are tractable and straightforward.
Re:In Treatment for Leukemia, Glimpses of the Future by arnsholt on Monday July 09, 2012 @04:52PM (#4220349)
He's right though. Ten years ago it was different, but as the top-level comment quotes, the problem now is sifting through the terabytes or even petabytes of data generated by the sequencing process.

Even worse is the fact that our ability to sequence is increasing faster than our ability to process the data.

Re:In Treatment for Leukemia, Glimpses of the Future by chrisamiller on Monday July 09, 2012 @06:25PM (#4220901)
This, a thousand times. Sequencing is rapidly becoming cheap and routine. Translating that data into clinically actionable insights is the hard part.
Re:In Treatment for Leukemia, Glimpses of the Future by Dn_Ab on Monday July 09, 2012 @05:15PM (#4220516)
To the contrary, I am extremely encouraged by his complaints. Because his problems basically boil down to Hard Engineering problems - nothing he said was a lack that required basic science (hard). If you will recall it was only 10 years ago that it cost millions and ~10 years to sequence one human genome.

And the problems he is listing, all it takes is something like memristors to catch on to lay waste to his worries on data and computational limits and replace them with "I remember back in the day when petabytes were considered a firehose".

Re:In Treatment for Leukemia, Glimpses of the Future by hrq on Monday July 09, 2012 @01:22PM (#4219190)
Seems like people and companies are already starting to address the cost issues to make this a more accessible and scalable process. I'm thinking of things like DNAnexus to help with the computational stuff. Also surprising they didn't mention any of the companies doing this work (i.e. this isn't just an academic exercise anymore).