New Imperial centre heralds age of precision medicine

A new research centre at Imperial College London aims to help doctors diagnose illness more efficiently and choose the best treatments based on a patient’s individual metabolic and physiological characteristics.

Technologies that analyse the chemical makeup of a tissue or body fluid sample have been used extensively in research, but their power to provide information about someone’s physical condition or disease state is only beginning to be exploited in medicine.

In a paper published in Nature today, leading researchers at the new Centre describe how such biochemical data could inform each stage of a patient’s treatment and also enhance clinical trials of new therapies.

The new Imperial Clinical Phenome Centre, based at St Mary’s Hospital, brings together a unique collection of state-of-the-art technologies for rapid molecular analysis to the hospital setting, aiming to put them at the heart of clinical decision-making. The “phenome” describes the individual products of a person’s genetic profile and their lifestyle habits and environment.

The Centre includes technologies based on mass spectrometry deployed in the operating theatre to give surgeons useful diagnostic information in real-time. One of the tools, being developed by Dr Zoltan Takats, is the “intelligent knife”, which analyses the smoke produced when the electrically heated surgical blade cuts into tissue during an operating procedure. Research has shown that the profile of the chemicals in the smoke provides detailed information about the disease state of the tissue, such as whether it is cancerous, otherwise diseased or non-viable.

Other projects at the Centre will develop diagnostic methods based on tissue samples and fluids such as blood and urine. The profile of chemicals present in a sample provides a read-out of the patient’s disease classification and severity. This information can inform doctors how the disease will progress in an individual patient or how the patient is responding to a particular drug and could potentially be used to predict therapeutic outcomes.

The Imperial Clinical Phenome Centre is jointly funded by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre and industrial partners including the Waters Corporation and Bruker Spectrospin GmbH. It will be equipped with three nuclear magnetic resonance (NMR) spectrometers and six mass spectrometers plus a new research staff core.

This is the second phenotyping research centre to be established at Imperial this year, and both are the first of their type in the world. The new Centre will be closely linked with the MRC-NIHR Phenome Centre, a collaboration between Imperial and King’s College London, which is more focussed on population screening and is due to open in early 2013 at Imperial’s Hammersmith campus. A major Metabolic Phenotyping Research Centre which has been running for many years at Imperial’s South Kensington campus provides research and development, data processing and international training support for the two new Phenome Centres.

Professor Jeremy Nicholson, Head of the Department of Surgery and Cancer at Imperial College London, said: “These analytical technologies are now very mature and are immensely powerful for telling us about someone’s physical condition and disease state. Bringing them fully into the clinical setting will help doctors make a more informed diagnosis, choose the best treatment based on the individual characteristics of the patient, and monitor their progress more precisely. It is the dawn of a new age of ‘precision medicine’.”

Professor Lord Ara Darzi said: “As a surgeon, I’m tremendously excited by the potential to provide real-time diagnostic information in the operating theatre. Last year we brought the first solid state NMR spectrometer into the hospital at St Mary’s and we have already begun using it to analyse tissue samples from surgical patients to tremendous effect. With the extra resources in the new Centre, we plan to extend this research to help guide clinicians at each stage of the patient’s journey. In the longer term, the ability to provide real time diagnostics during surgery could have a major impact on surgical outcomes and improve the quality of care that patients receive.”

“We at Waters continue to be impressed with the innovative vision of Imperial scientists and are excited to be the mass spectrometry partner of the new Clinical Phenome Centre at St Mary’s Hospital,” said Dr Rohit Khanna, Vice President of Worldwide Market for the Waters Division. “The opportunity to further extend real-time clinical diagnostics capabilities with new mass spectrometry applications offers significant impact on patient care.  We congratulate Imperial on the announcement of the new Clinical Phenome Centre and look forward to continued innovation success together.”

Dr. Manfred Spraul from Bruker commented: “At Bruker, we have been working intensively over the years to build the NMR technology needed to enable fully automatic analysis of complex mixtures like biofluids and tissues. To see this reaching the point of providing care analysis in the hospital is extremely exciting for us, as it opens up a new field with significant potential for NMR far beyond the already established pharmaceutical applications of metabolic analysis. It is our explicit hope, that being in the hands of the very strong, integrated team of scientists from hospitals, phenome research and industry, the newly developed technology will reduce the cost of healthcare in the future.”