The Revolution of Genomic Medicine

Q: What technologies will lead the adoption of genomic medicine by the healthcare sector?

A: The penetration of these technologies in Mexico will depend on many elements, including the existing capabilities of doctors and sustainable budgets. International pressure on Mexico to incorporate these technologies will also play a role since it will become increasingly unacceptable not to use them in certain medical specialties like oncology. Also, patients and hospital quality systems will demand genomic testing, which will become mandatory for cancer diagnoses.

Other Mexican health institutes are developing initiatives to incorporate these technologies. The only necessary factor is to have a critical mass of trained personnel. INMEGEN trains about five medical specialists and 70 Ph.D students, graduating around 15 per year.

Q: How ready are doctors to incorporate these technologies into their daily practice and what benefits would it bring them?

A: This area is new for most doctors and so far universities have not included genomic medicine into their curricula. Medical curricula have not changed in decades. This is extremely worrying but it is not only a Mexican problem as it extends throughout the world.

Doctors themselves are increasingly approaching us to learn how genomic medicine can support their practice. Doctors are showing interest in keeping up to date and I believe they will increasingly ask for more training. Genomic medicine can have a strong impact in every single specialty but it is much more developed in oncology.

Q: How has INMEGEN contributed to cancer research in Mexico?

A: Regarding cancer, it is necessary to analyze two different scenarios. The first occurs when a patient has been diagnosed and it is necessary to identify the mutation occurring in the patient’s tumor. Using that diagnosis, the oncologist can determine the best treatment course.

The second is predisposition toward cancer, which requires the identification of characteristics specific to a population.

Q: What other areas will increasingly require the incorporation of genomic medicine?

A: An area that I expect will push forward the penetration of this technique into common practice is pharmacogenomics. This area should develop preemptive strategies for care that can predict the body’s response to a medicine.

Testing before a patient takes any variety of medication would be too expensive, so it would be preferable to perform a single test that identifies all genetic variables related to response to a pharmaceutical even at birth. Testing for the complete genome of a newborn can cost US$1,000, but in 10 years that cost will reduce enough for the test to be accessible to many. Once this technology is available to the general public, it can be easily performed at birth and doctors will only have to learn how to interpret the genetic data.

Q: How can INMEGEN’s projects be used to change existing prevention schemes?

A: Prevention plans will be limited and possibly erroneous, without concrete information regarding our population’s genomic data. If prevention plans are designed taking into consideration exclusively international data, their success rate would be much smaller.

This information is useful as it allows us to focus on prevention efforts. For instance, approximately 5 to 10 percent of female patients with breast cancer are genetically predisposed. Knowing which individuals are susceptible will allow us to target prevention efforts toward them.

Q: What is the status of your initiative with PEMEX for the implementation of personalized medicine?

A: In this initiative, financing has been a problem as we have had to use funding supplied by CONACYT, which has also faced cuts. We have an excellent relationship with PEMEX, which will eventually allow us to expand this project to infectious, psychiatric and rare diseases.

We have made progress in the pharmacogenomic study of the diabetes medicine metformin. This is important because the number of diabetics in Mexico is extremely high and not all will benefit from treatment with metformin. This study will measure the correlation of the patients’ genotype and their reception of metformin and other drugs.

Q: What would you identify as INMEGEN’s greatest achievements under your administration?

A: We turned INMEGEN into a solid institution in terms of research and education. Our research core has grown and become stronger, which has also allowed us to train more professionals. The institute has built a significant body of work concerning the genomic profile of the Mexican population, making Mexico the most advanced in this area in Latin America.