PROFILE DANIEL S. LEVINE 40 THE JOURNAL OF LIFE SCIENCES FALL 2009 Lost in Translation Eric Topol doesn’t just want to understand the genes that drive illness and wellness, he wants to make sure that such knowledge actually changes the way doctors practice medicine. By Daniel S. Levine hortly after arriving in La Jolla, Califor- the hospital and makes sure you have coffee nia nearly three years ago, Eric Topol and know where the restrooms are,” he says. Sfound himself addressing a room full of Individualized medicine is “not about treating San Diego’s business leaders at the exclusive someone as a VIP.” University Club with its grand views of the city It wasn’t surprising that weeks after landing in below. The former top cardiologist at Cleveland San Diego, Topol would declare that the city’s Clinic had just recently come to town to become future lies in individualized medicine. After all, director of the Translational Science Institute he was leading an effort in translating an under- at the Scripps Research Institute, the world’s standing of human genetics into better medi- largest independent non-prof- cine. But it was not an it biomedical research facili- idle boast. Since he first ty. Topol, who was speaking The future of medicine settled in at the Scripps about the future of medicine, Institute in January told the crowd at the end of his is going to be integrating 2007, Topol has been talk in March 2007, “You folks genomic science into doing everything in are known for wireless and you his power to make it are known for tourism. But in the clinical treatment of so. As a high-profile the future you are going to be individuals and there are researcher and clini- known for the future of medi- cian, his goal is not just cine, for genomics, and indi- not very many physicians to find genes that can vidualized medicine.” make medicine more If Topol succeeds in his who are equipped today predictive, preventive, efforts to lead broad genom- to perform that or to and, individualized. He ics studies at Scripps—that wants also to make sure talk won’t be the last time that bring genomics into the these findings get test- San Diego’s business elite hear clinic. In that sense, Eric is ed in the clinic and put about individualized medicine. into practice. The term refers to whole medi- already a global leader. “The future of medi- cal approach that incorporates —David Gollaher, President and CEO, cine is going to be inte- the knowledge of a particular California Healthcare Institute grating genomic sci- individual’s genetics to deliv- ence into the clinical er appropriate care. “It’s about treatment of individu- being able to understand what makes a person als and there are not very many physicians who Eric Topol, director of the Scripps either susceptible, or protected, or responsive, are equipped today to perform that or to bring Translational Science or unresponsive to various treatments, devices, genomics into the clinic,” says David Gollaher, Institute, is branching drugs, or whatever,” says Topol, who at 55 has president and CEO of the California Healthcare out beyond Institute, a La Jolla, California-based biophar- genomics to include the fit appearance you’d expect in a cardiologist wireless healthcare (at least one you’d trust). Topol, however, bris- maceutical industry advocacy group. “In that technology in his tles at the mention of “personalized medicine,” sense, Eric is already a global leader. There’s no work in the hopes of the more commonly used term for this new question about it. That’s the mission he’s taken translating findings about genes into field, saying it confuses patients. “It sounds like up. He’s the prophet of genomics and genomic improved care for a concierge, the person who takes you around science.” patients 4 1 THE JOURNAL OF LIFE SCIENCES Fall 2009 DANIEL S. LEVINE This is something that’s very near and dear to him. Can we leverage genetics and genomics? That’s one question—can we design drugs or trials that target people with certain genetic profiles. The other one is to maybe leverage wireless technologies. —Nicholas Schork, Director of Research, Scripps Genomic Medicine Program Gollaher notes there is always a big lag between West Foundation to launch the West Wireless basic scientific discoveries and their application Health Institute. The organization is set to con- in the clinic. He points to the 19th-century dis- duct clinical research on the use of wireless sen- coveries of Robert Koch and Louis Pasteur and sors to prevent, monitor, and manage disease the germ theory of disease, which took more in patients. And, he’s mapped out plans for a than a generation to be incorporated into clini- medical school at Scripps with a focus on trans- cal medicine in the form of antiseptics. “There lational medicine. But that project for now is will be a lag,” he says, “and it will be people like stalled over resolving the issue of a $100-mil- Eric who compress that and make it available lion naming grant. earlier rather than later.” Were all that not enough, he’s been earning Though Topol’s office sits along the fabled Tor- style points, too. In 2008, he was one of 10 medi- rey Pines Golf Course, he says he doesn’t get to cal researchers named a “Rock Star of Science.” play often enough to be any good. It’s no wonder. The distinction resulted in Topol being fea- Topol examines a map Since arriving in La Jolla, he’s been quite busy. tured in a GQ magazine photo spread wear- of the United States Among the accomplishments he can already ing designer garb alongside Sheryl Crow, Seal, that tracks patients check off on his list: He’s brought together basic Will.i.am, Joe Perry, and Josh Groban. It was in the Wellderly Study. His daughter science researchers and clinicians from the dis- part of a campaign by designer Geoffrey Beene Sarah Topol (right), parate arms of Scripps to launch the Scripps called “Geoffrey Beene Gives Back” to call atten- a registered nurse, Translational Science Institute. He led the insti- tion to the contributions of medical research- heads up recruitment of participants for the tute’s successful effort to land a $20-million ers and the need to accelerate the translation of groundbreaking look grant from the National Institutes of Health discoveries into cures. “I never have enough to at the genes of healthy under its Clinical and Translational Science do,” says Topol. “I require a lot of stimulation or people older than Awards program—the only non-university to I get bored.” 80 who have never suffered from chronic date to win such an award. He’s also attracted Boredom shouldn’t be a problem for Topol diseases. $45 million in funding from the Gary and Mary at the Scripps Translational Science Institute. 42 THE JOURNAL OF LIFE SCIENCES FALL 2009 Already, the genomics projects are stacking up. African Americans cannot properly metabolize Among the most compelling is the “Wellderly the drug. The study is being run in conjunction Study,” an examination of the DNA of people 80 with all of the Scripps medical facilities, giving and older who have had no history of chronic researchers access to data from a broad patient disease. The goal is to unlock the genetic secrets cross-section. “They’re taking a drug for $4 a to longevity. Topol says to date, medical research day for the rest of their lives or whatever, and it has largely centered on finding genetic markers doesn’t work,” says Topol, who notes there are for disease. This focus on sickness has neglected other therapies available for such patients. “It’s the genetics of health. an exciting project because using this test could Already, 750 people have enrolled in the study. become the norm some day.” Though the results are preliminary, the findings Topol’s interest in genetics started long before so far are surprising. The wellderly appear to his medical career. Born in Queens, New York have the same bad genes—those that have been and raised in the Long Island suburb of Ocean- linked to such illnesses as Alzheimer’s, heart side, Topol was bored with high school, having disease, and cancer—as everyone else. However, skipped two grades. At just 15, he entered the there is an early indication that they may also University of Virginia in Charlottesville. As a col- have modifier genes that are unique to them. lege student in 1975 he wrote his thesis on “The These genes appear to mediate the expression Prospects for Genetic Therapy in Man.” of the disease-linked genes. He supported himself in college by work- Another major study underway is an effort ing the night shift at the UVA hospital. He had to find out the behavioral impact of personal planned to become a biomedical engineer, but genetic testing on people who want to learn that changed when he saw patients in the inten- their potential risk for developing certain dis- sive care unit. Patients who looked as if they eases. About 5,000 participants have enrolled were going to die eventually transformed and in the Scripps Genomic Health Initiative as became well again. “I said, ‘This medical stuff is it’s called. The study is a joint effort between pretty impressive,’” he recalls. “Of course I was Scripps, software giant Microsoft, consumer seeing the rare bird—the person that was actu- genetics company Navigenics, and genetic anal- ally helped—because most people in the inten- ysis tools maker Affymetrix.