Kansas City’s hospitals and researchers are harnessing AI, genomics and precision medicine to create treatments tailored to each patient—changing the future of cancer care and beyond
Medicine has entered the brave new world of precision medicine, and many of Kansas City’s healthcare institutions are at the forefront.
What is precision medicine? A personalized approach to care where treatments are specifically tailored to the patient using advanced technology. Here in KC, researchers are using advances in genomics, molecular biology, artificial intelligence and advanced imaging to identify the right treatment for the right patient at the right time—particularly in diseases such as cancer, where therapies can precisely target a tumor’s genetic drivers.
“It’s such a great time to be in medicine and particularly in cancer medicine because there’s so much going on,” says Dr. Jeffrey Holzbeierlein. He leads a research team at KU Medical Center studying the causes and novel chemotherapeutic drug treatments for prostate and bladder cancer. Holzbeierlein’s lab has screened more than 1,000 drug compounds, all created at KU, with several moving into clinical trials. “I think as a physician who has been here for 24 years, seeing things that didn’t move along for 10 or 15 years, that’s finally changed,” he says. “Within the last few years, the number of new therapies that have come out are changing the face of cancer. It is really quite remarkable.”
These innovations are not just happening in a silo at one area healthcare center; they are coming together via a healthcare innovation corridor where data analytics and clinical trial results are shared among doctors and researchers at KU Medical Center, Children’s Mercy Kansas City, UMKC and Stowers Institute for Medical Research.
For example, UMKC’s tech acceleration program features a community initiative organization, Digital Health KC, and has already awarded eight digital health companies a total of $332,750 to help with technology advancements, product validation and AI integration.
Digital Health Co/Lab, a collaborative initiative between KU Medical Center, the University of Kansas Health System and University of Kansas focuses on AI-guided digital therapeutics and diagnostics, which is often referred to as “theranostics,” a portmanteau that describes the integration of diagnostic imaging and targeted therapy.
In a public-private collaboration announced in February, the University of Kansas Health System, KU Medical Center and Children’s Mercy, working with Bold Advanced Medical Future Health based in Grand Rapids, Michigan, will establish one of the country’s first fully integrated theranostics platforms for adults and kids, bringing together radiopharmaceutical production, molecular imaging, radiopharmaceutical therapy and various clinical trials.
“Theranostics came about because we have been using various tools and methods for the diagnosis of cancer, and some very bright people have come up with the fact that if you can target it by imaging it, you can attach a radioactive molecule and also treat it,” Holzbeierlein says.
Most people are familiar with a PET scan that is used to look for cancer anywhere in your body. “Theranostics is sort of a very specialized, very distinct PET scan,” Holzbeierlein says. “It targets only one type of cancer instead of any kind of cancer. Then, once we can image it, we can treat it. This is a really good example of precision medicine.”
A cancer cell may express something on its cell surface that no other cell in the body expresses, he says, and that makes it able to be targeted without killing other normal cells. “Once we’re able to identify what that is, then we can usually figure out a way to be specific in killing that cancer cell. It’s almost like exploiting the weakness of the cancer cell by identifying what’s unique about it.” Prostate cancer is on the theranostics to-do list, a “really important cancer to figure out,” he says.
Theranostics is also being used for treating non-cancer maladies, such as cardiovascular disease and autoimmune diseases. Holzbeierlein says that one of the first non-cancer therapies that’s going to come out, which he expects relatively soon, will be for Alzheimer’s, which is the fifth leading cause of death worldwide, affecting approximately 45 million people.
Scott Younger is the director of disease gene engineering within the Genomic Medicine Center at Children’s Mercy Hospital. He is doing a lot of work with organoids models, which are tiny 3D tissue cultures ranging in size from the width of a hair to five millimeters. They are made from stem cells, which can be manipulated to resemble miniature lab-grown human body organs. Drug therapies can be tested in a petri dish instead of the organ inside a living human patient.
Researchers have been able to produce organoids that resemble the brain, kidney, lung, intestine, stomach, liver and more. Each organoid is used to see how drugs interact with a particular organ. “They’re real complex little balls of cells that you can grow in a dish,” Younger says. “If we grow neuronal organoids or brain organoids in a dish, we see that those manifest phenotypes (the physical traits of an organism) that are representative of diseases. We are spending a lot of our focus now on epilepsy.”
The work being done by Steven Leeder, senior vice president and chief scientific officer at Children’s Mercy Kansas City, complements Younger’s work to identify the best treatments.
“You start off with the medication that perhaps you’re most familiar with,” Leeder says. “Invariably, not everybody responds to the same medication in the same way, even getting the same dose. So using organoids as Scott described it is one of the ways where we can start to get at which of a series of choices might be the best for a particular patient. The essential question comes down to, ‘Why is it that you can take a group of teens with depression, let’s say, and give them Prozac according to the FDA guidelines, and some kids will respond, and some kids may not?’ So we want to get to what underlies the variability in the response.”
For example, Leeder referenced a study using a drug used to treat ADHD. “We found that half the kids actually responded to the medication quickly and had a sustained response,” he says. “Then there was another group of kids where it didn’t move the needle on their ADHD symptoms at all, implying that there is something different in the way that the drug acts,” Leeder says. “It’s almost like there’s a different type of ADHD, one that responds to the drug and one that doesn’t. Where we’re at right now is trying to sort that out. And the organoid platform provides a mechanism by which we may be able to get at those mechanistic differences.”
Leeder has a vision for precision medicine’s future. “When a child comes here for an appointment, we measure their height, we measure their weight, we take their temperature,” he says. “I envision a future where the fourth test we do is getting a copy of their genome blueprint, to help us design what the care strategy might be for that child. That’s probably not unrealistic within a five- to eight-year time frame, but it could happen sooner. Technology moves amazingly quickly.”
