Today, researchers can sequence a genome in 10 days for $5,000. "In the next few years, you'll be able to get a full genome sequence of your DNA for $500," says Sorena Nadaf, associate director and CIO of the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco (UCSF). "Pretty soon insurance will cover it like another blood draw."
In the near future, "every patient that comes in the door with a cancer diagnosis is going to get clinical-grade, next-gen sequencing," says Warren Kibbe, CIO of the National Cancer Institute (NCI) and director of the NCI Center for Biomedical Informatics and Information Technology. "In fact, it won't even be called next-gen sequencing soon."
That creates incredible IT demand. "It drives huge computational needs," says Kibbe. "It's exciting, but it's challenging because the environment can change overnight." Cloud computing holds promise, particularly for far-flung and smaller institutions. "There is a sea change in the way we operate as IT professionals," Kibbe says. "The ability to achieve true interoperability and utilize infrastructure- and platform-as-a-service in clinical research will revolutionize our ability to determine optimal treatments for new cancer patients."
When working with the scientific community, Kibbe is dealing with with evolving problems and new technologies to find solutions that weren't possible yesterday. Those research systems are as far from enterprise IT as you can get, intimately tied up in the particular research of an individual lab. But as the science matures, Kibbe must figure out how to make those one-off solutions scalable for the rest of the community.
That adds a dimension to the CIO role. "I have to deliver an awful lot of basic services like every other CIO--networks, storage, file services, security. But I have this really exciting additional mission to take into account," he says. "On one side, it's the classic CIO blocking and tackling. On the other, it's how do we interface with the scientific community to further our mission. There's opportunity to do better on both fronts."
Very Big Data
Jack London, director of the informatics shared resource at the Kimmel Cancer Center, says he's been in medical informatics since before it was called informatics. A version of the first mainframe he worked with could be a museum piece. He's seen technology tools evolve to keep up with the demands of cancer research and treatment. For the last few years, he has focused on personalized cancer medicine.
"If you go back to the 1950s until very recently, the way we treat cancer is to give people a set of toxic drugs that kill the rapidly growing cells, and you adjust the dose so you don't kill the patient at the same time. It's the brute-force approach," London says. "But cancer is a genetic disease." From an IT perspective, that means not only analyzing very large sets of genomic information, but also managing specimen banks and their associated clinical data and correlating that with the latest research. "You get [up] to terabytes of data in a very short time," London says.
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