Nov 7, 2014

Interviewer: A leader in the pharmaceutical industry takes on the job of director of the program and personalized health at the University of Utah. We'll talk with him next on The Scope.

Announcer: Examining the latest research and telling you about the latest breakthroughs, the Science and Research Show is on The Scope.

Interviewer: Dr. Dere, today is your first day at work. Is that right?

Dr. Dere: That's correct.

Interviewer: Congratulations.

Dr. Dere: Well, thank you. It's nice to be here.

Interviewer: Let's start from the basics. What is personalized health?

Dr. Dere: We frequently use, whether it's hyper tension or for a cholesterol or other maladies, we use, sometimes, a one size fits all approach to treating a patient. But we now know that different patients can respond differently to any particular intervention. Patients have different genetic profiles and are impacted by different environmental circumstances and I've been in the pharmaceutical industry so I think mostly in terms of the use of medicines with the use of drugs.
First of all, one example in terms of cancer which many people know about, in terms of women with breast cancer who are HER2 positive and this subset of patients which is about 30% of the breast cancer patients will respond to Herceptin which is a HER2 antibody. When you look at breast cancer, when you look at colorectal cancer now, it is important that we genotype these patients so that we understand their genomic profiles of the tumor and provide much more individualized therapy.

Then more broadly, as you look at personalized health, one could potentially expand our thinking around this towards preventive interventions and by preventive interventions they don't just mean cancer screening or other types of screenings like blood pressure, glucose screenings. But it could mean on different nutritional approaches, on different approaches towards how one looks at weight bearing exercise or the broad arena of what people would put under the generally the wellness category of types of interventions.

Interviewer: And does it always come back to genomics or genetics or can there be other ways to figure out what personalized care someone needs?

Dr. Dere: The short answer to your question is, I think there are different ways. There has been such an explosion of information about the entire human genome and, you know, the expression of different proteins that our bodies form from the human genome, that genetics becomes certainly the center piece of a personalized health approach. So, I think there are different ways ranging from family history and the likes but genetics plays a critical role, In Utah, in that regard, one of the tremendous attractions for returning to Salt Lake City is that the researchers here have really been pioneers in unlocking some secrets of the human genomes through their family studies in cardio vascular disease on the neural sciences.

Interviewer: Yeah, well, that brings me to my next question. You have spent, I think, 25 years in the pharmaceutical industry, the last 11 years at Amgen as senior vice president and you also spent time at Eli Lilly and now you're coming to academia. Why the switch?

Dr. Dere: Some might say maybe it's a midlife crisis, I guess. I think the leadership here is dynamic and visionary. I think the desire to transform the health care delivery system to gradually improve the care that patients receive and that being first and foremost was an important role in the decision making, along with the spirit of trying to translate research findings, whether they're in the genetics arena whether they're in the molecular medicine arena, to something that's tangible that benefits patient. So this link between basic research, findings and impacting patients and ultimately improving the value of our health care system or our health care delivery to patients, kind of that entire package there I found very, very appealing.

Interviewer: And when you talk about moving, say basic research to patient care, do you see this program as bringing basic research to a point where you can then hand it off to pharmaceutical industry or how do you see that playing out?

Dr. Dere: You know that's a great question because I think we're entering into a very dynamic field. We have, I think, not done a particularly job in industry in terms of developing innovated new medicines over the past 20 years. Hopefully, it's not coincident with my time in industry but it has been that time if you look at the data and what does the data show us? When I joined the industry, it took about $250 million for every new drug that was approved by the FDA and right now, when you look at the numbers of new drugs approvals and the cost of the research and development, it's in the $2 billion range. So fundamentally, we're becoming less efficient and less effective in bringing new medicines to the market place.
So, I hope that there is a more blurring, a greater collaboration, a public private partnership in all areas, whether it's for target identification, one of the things you alluded to, yes, I hope that our insights into genetics can help to identify new targets that could potentially interdict receptors enzymes in the like and cure human disease. So I hope for that and also hope for a greater partnership in later phases of development that heretofore have been in the domain of industry but where we, in terms of good clinical researchers in academia, can also play a role.

In a period of time where there is an absolute revolution in terms of biology, absolute revolution in terms of biology and our understanding in deeper understanding of the link between genetics and molecular medicine and the like, but this biologic revolution, this is an extraordinarily exciting time to be still active and still be responsible for, hopefully, doing good things for patients which is our ultimate goal.

Announcer: Interesting, informative and all in the name of better health. This is The Scope Health Sciences Radio.

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