The Cardiff Hub has run its first webinar, on the topic of The Future of Translational Medicine. An international audience of around 300 from 28 countries participated in the live session.
Professor Péter Hegyi MAE, Director of the Centre for Translational Medicine, University of Pécs (Hungary)
The Cycle Model for translating scientific results into community benefits
Professor Péter Hegyi MAE opened the session with an overview of the Translational Medicine Cycle, a model which has been developed over the past year.
Every year, a large number of people die from preventable or treatable diseases. In 2016, for example, 1.7 million people in Europe died under the age of 75, yet 1.2 million of these were avoidable deaths (source: Eurostat). Addressing this challenge requires a new model that can translate scientific knowledge in ways that work to the population’s benefit. Academia Europaea launched an initiative in 2018 to rethink the model for Translational Medicine (TM). The University of Pécs is a critical player, working with other key experts and partners. The aim is to organise knowledge and to communicate outcomes effectively to policymakers and patients:
Pécs has been testing and improving its model since 2016. It involves an interdisciplinary team that includes not only researchers but also other specialists such as lawyers, communications experts and data managers. TM requires a combination of basic research, clinical activity and a range of methods and techniques, such as study groups, patient clubs and meta-analysis. It is also crucial to inform and educate everyone involved in the process, including patients, doctors and policymakers.
There is already evidence of beneficial outcomes. For example, an international study on pancreatitis, involving 23 countries, demonstrates immediate advantages, such as reduced use of antibiotics, decreased costs and lower mortality. Hungary has also established a coronavirus study group, translating scientific knowledge for policymakers and politicians, who have to take key decisions.
All elements of the TM cycle are therefore crucially important.
Professor Ole Petersen MAE, Vice-President, Academia Europaea
Why many discoveries in basic science have not progressed to patient care
In his presentation, Professor Petersen took a more philosophical approach to the challenges being tackled by Translational Medicine. He cited a number of reasons why basic science is not being used for patient benefit. These include a lack of funding opportunities for further development of the science, inadequate communication between basic scientists and clinicians, clinical trials that are ended too early, and occasionally basic research of insufficient quality.
Professor Petersen referred to the Making Sense of Science for Policy report, led by Academia Europaea on behalf of the SAPEA consortium. It sets out important considerations that can be applied to the translation of basic science into medical benefits. Science is a systematic search for evidence, based on rules of enquiry and rigour that is subject to continuous review. A degree of uncertainty in the evidence base is inherent, by its very nature. Good science must therefore be conducted with integrity, honesty, a focus on accuracy and intellectual humility.
Giving the example of Covid-19, Professor Petersen remarked that basic science may not have helped much so far. For example, we know how the Covid-19 virus gets into cells and how to block it, but this has not been exploited effectively to date.
Knowledge is accumulated in different ways and extends beyond peer-reviewed published research. It is therefore critical to understand how knowledge can be used to best effect in providing advice to policymakers. In Germany, academies have been particularly active in providing advice.
Professor Stephen Holgate MAE, Professor of Immunopharmacology, University of Southampton
Delivering personalised medicine for patient benefit
The last speaker, Professor Stephen Holgate, spoke about some of the uses of Translational Medicine, an approach he terms Stratified Medicine. It involves taking a complex disease and establishing what the key drivers are behind the heterogeneity of disease expression. These can include the diversity of populations, differing biological processes and underlying genetics. Ultimately, Stratified Medicine is about ensuring that the right patient receives the right therapy at the right time. It can be used in a variety of ways and one size does not fit all.
Professor Holgate gave a number of examples, based on a range of diseases. Cancer treatment has been the pioneer in the field of Stratified Medicine. In understanding the biology of cancers, we now know that tumours vary in their causal mutations in the same tumour occurring in different people. This means that to identify and treat the tumour often requires a range of specialists. A good example of identifying and then targeting specific mutations is the UK National Lung Matrix Trial, which is the world’s largest precision medicine trial in non-small cell lung cancer. A further example is asthma, where we now know that different inflammatory pathways leads to different disease sub-types that can be targeted with highly selective biological therapies. A final example is schizophrenia, where sophisticated functional brain imaging has revealed different molecular subtypes of the condition.
The Medical Research Council has published a framework for the development, design and analysis of stratified medicine research, which presents a pathway for Stratified Medicine across all types of human health. In short, Stratified Medicine is shaping profoundly how we diagnose and treat patients.
The audience submitted a good number of questions via the Q&A facility including:
- A true basic science lack of funding is there, but additionally lack of cooperation in professionals is also hindering. How about overcoming this?
- “Back to nature medication” is also on the rise. Upon developing drugs of the bioactive-fraction extract from herbal plants, we are challenged to show that the plants have historically been used in traditional treatment. Often we discover a bioactive-fraction that can be used to treat certain medical conditions but there is no record in historical use of the plant for that (or, it is used in communities with no writing culture for their historical record). How could TM be useful to solve this issue?
- I am involved in basic research and also teach in University Medical faculty students. It is sometimes a challenge to give those medical students this feeling, that they will need to understand some of molecular biology. Any suggestions on how to shape the student’s attitude towards basic courses? They all want to get to the patient as fast as possible.
- How about enhancing your vision towards Asian countries? (Science and academia cooperation)
- The “normal way” of collecting data, ontological definitions and decision rules are a very practical way to go forward in solving today’s medical problems involving all the stakeholders from the scientists, clinicians, nurses and patients. In the future will the way not be another? From data – collected by biosensors – directly to decisions via intelligent algorithms (machine learning, AI)?
- In the standard drug development process (preclinical to phase 4), in which phase TM would be the most appropriate? In this case of COVID-19, for example, how could TM speed up the process?
Watch the webinar
The webinar is available to watch in full or skip to:
- 4.15 to see Peter Hegyi talk
- 16.36 to see Ole Petersen talk
- 27.52 to see Stephen Holgate talk
- 39.11 to hear the discussion
Feedback on the webinar
The event was extremely well received and has since received great feedback:
- “This was a very interactive and fruitful webinar.”
- “Thanks to all the speakers! Wonderful talks!“
- “Thank you very much, great discussion!“
Academia Europaea‘s Translation Medicine project brings together basic researchers, clinicians, academics, science publishers and communicators and experts in Translational Medicine to discuss how to turn scientific knowledge into innovative therapies, medical procedures and diagnostics that benefit patients and healthcare systems and become everyday best care practice.
The project has been supported by a two-day workshop which took place in September 2019 and the subsequent publication of a position paper in the leading open access journal, the Journal of Clinical Medicine in May 2020.
This webinar was held on 29th June 2020.