Gene editing will evolve to help us overcome our genetic destiny, says Sam Santhosh, a US-based entrepreneur with over 20 years of experience in the software industry and the last 15 years in the biotech industry. “I’ve explained this in more detail in my book Sam’s Twelve Commandments: for the Indian Entrepreneur’ , he told businessline in an interview.
Santhosh currently focuses on genomics leveraging NGS (next-generation sequencing) technologies, and is in Thiruvananthapuram to attend a scientific seminar to launch the Kerala Genome Data Centre.
Genomics research and implementation have altered the landscape of human health and disease. What will the next decade bring?
The next decade will bring major developments in the landscape of human health on two fronts:
(i) Diagnostics: Cheaper and improved genetic testing will make diagnosis much better. Liquid biopsy in Cancer and Non-invasive Pre-natal testing (NIPT) in reproductive medicine will see widespread adoption. Improved NIPT tests will help to reduce inherited diseases significantly.
(ii) Treatment: CAR-T therapy and other methods of cell and gene therapy which are now prohibitively expensive will become cheaper and accessible. Gene editing will also start getting accepted for specific rare diseases. Better and more cost effective drugs will be available for providing precision medicine for cancer and a host of other diseases.
It is argued genetic characterisation is not enough to support novel drug development in most disease contexts. Your view?
If the novel drug development is based on a new target, then genomic characterisation alone will not be sufficient. Both phenotype data and longitudinal clinical data of the patient cohort will be required. Further, considerable lab and animal studies will be needed to figure out if the target is druggable and what the other side effects of the drug can be. On the other hand, if the target is already well known and studied, the novel drug development becomes relatively easier. The type of disease and the pathways involved also matter, but genomic data will always be a major component to support drug development.
Are age and socioeconomic status not captured by genomic technology, as they should have been?
Genomic testing per se is more or less independent of age or socioeconomic status but for diagnosis and research not only age and socioeconomic status, but many other factors such as sex, familial history, food habits, co-morbidities, environment, and the microbiome will be very important.
Will genomic data by itself fulfill the promise of ‘predictive risk assessment’?
Very unlikely. Since risk is dependent on many factors as explained above. However, for some diseases like cardiac problems and diabetes, polygenic risk scores are becoming useful especially for capturing the high- risk (top five per cent) patients.
Could this data also go to deeply impact therapeutic areas beyond oncology?
Absolutely. Genomic data will become critical in all therapeutic areas as we learn more about the human genome and the microbiome.
What safeguards need to be built into the system while using genomic data?
Bio-ethics becomes very important while using genomic data. Important laws need to be in place to make sure that people are not discriminated at work or for health insurance based on any genetic defects.