SMSC MEETS PRECISION MEDICINE

Lea Wahl, Head of Public Relations SMSC Bern | University of Bern

Florin Kalberer, President SMSC Bern | University of Bern

The Swiss Medical Student’s Convention (SMSC) held this semester, from 24th March - 26th March 2023, was all about precision medicine.

What is Precision Medicine?

Precision medicine is a new paradigm of medical care. It assumes that every person is unique and that these individual patient characteristics should also reflect in therapy planning. Thus, therapies depend not only on disease patterns but also on genetic predisposition, environmental factors, and lifestyle.

Who can we learn from?

It was Prof. Dr. Mark Rubin, who explored the concepts of precision medicine with the participants in the first lecture of the congress.

"Introduction to Precision Medicine" by Prof. Dr. Mark Rubin

Prof. Rubin is an expert and renowned researcher in the field of precision medicine, especially precision oncology. He is the founding director of the Englander Institute for Precision Medicine at Weill Cornell Medicine, and co-leader of the All of Us program for New York City (U.S. National Precision Medicine Program). In Bern, he is the chairman of the Bern Center for Precision Medicine (BCPM), whose mission is to lead towards new approaches in disease prevention, treatment and drug development and to educate the next generation caretakers and scientists about the long-term benefits of precision health care.

Following the lecture of Prof. Rubin, we received interesting inputs from Dr. Anne Gregor about her speciality “precision medicine and rare diseases”. Her research project „Modelling LHX2associated neurodevelopmental disorder in human brain organoids“ was one of the winning projects in the BCPM Young Investigator project call. Additionally, she is the co-leader of the Female Empowerment in Life Science (FELS) Network of the medical faculty at the University of Bern.

We furthermore had the opportunity to listen to Prof. Dr. Andrew MacPherson about his research project „personalized mutualism with our microbiota in health and disease“. Prof. MacPherson is the Clinic Director and Chief Physician of Gastroenterology at the University of Bern and leads the Gastroenterology/Mucosal Immunology Research Group in the Department for Biomedical Research at the Inselspital Bern. Also, he is a member of the Scientific Review Board of the BCPM.

To sum up our first morning at the SMSC in Bern we heard a talk from Prof. Dr. Deborah Stroka. After her studies in New York and Boston and her PhD and Post-Doc at Harvard Medical School, at University of Zürich and at University of Alabama at Birmingham, Prof. Stroka is now the Research Laboratory Head and Group Leader of Visceral and Transplantation Surgery at the Department of BioMedical Research of the University of Bern. Her research project „Single cell analysis for non-invasive biomarker discovery for NASH patients using both protein and transcriptome analysis“ was selected for funding in the project call of the BCPM.

After an intense workshop session at the beginning of the afternoon we finished our Saturday programme with a slightly different perspective on the big topic of precision medicine. Dr. Sabine Österle gave us some insights into her field of work - „Swiss Personalized Health Network: from clinical routine data to FAIR research data“. Dr. Österle is a lecturer in the Ethical and Legal Aspects in the Clinical Trials course at the European Center of Pharmaceutical Medicine (ECPM). Since 2018 she works in the Personalized Health Informatics group of the Swiss Institute of Bioinformatics (SIB) where she is the Team Leader of Data Interoperability. In close collaboration with the SIB, the Swiss Personalised Health Network (SPHN) Management office coordinates SPHN project funding and together, they enable the development of coordinated infrastructures, data interoperability, compatible data management systems and harmonized guidelines, much needed for the practical implementation of precision medicine.

A look into the future?

Our society continues to face a demographic shift with an increase in the elderly and multimorbid populations. At the same time, biotechnological research is producing more and more new and expensive therapeutic options that promise better and more targeted treatment of disease and its risk factors. This progress is further accelerated by the widespread use of molecular analysis methods on genomic, transcriptomic, proteomic and metabolomic basis - which in turn keeps creating a vast amount of sensitive data. In order for the future generation of physicians and researchers - our generation - to successfully master the challenges proposed by this development, we need a solid foundation of values supported by society as a guideline for action. And this foundation of values can only be formed in participatory discourse.

That is why our congress on precision medicine invited representatives from clinical practice, research, ethics, law and politics and the interfaces of these fields to explore the following questions and many more in a thought-provoking panel discussion:

• What do we really mean by the term “precision medicine”?

• What characteristics distinguish modern precision medicine from personalized patient care that is already performed in clinical routine?

• With targeted therapies and rigorous stratification, the number of potential patients for clinical trial groups decreases. Can we still create statistically relevant conclusions with fewer patients?

• What about genetic privacy: Is it desirable to fully anonymise valuable genetic and other sensitive data in order to protect patients’ privacy, but instead hinder medical research progress? Is this even possible?

• Is precision medicine able to omit unnecessary therapy? Or does it add high-tech therapy to standard therapy causing even more costs?

• Are precision medicine drugs profitable for pharmaceutical companies despite their small target group?

• Is it fair and economically reasonable to invest significant parts of the federal and cantonal budget in precision medicine and not in other areas?

• Which factors decide who receives precision medicine therapy? Can we - or do we want toeven afford the development of future precision medicine patient care for our society?