JAX experts on harnessing genetics to understand personalized cancer care and regenerative medicine.
JAX’s annual Forum for Discovery is a signature annual event that convenes leading JAX researchers to highlight the impact of their work on the future of human health, and to thank those whose generous support helps make it possible.
This year’s program features Jens Rueter, M.D., JAX’s chief medical officer and medical director of the Maine Cancer Genomics Initiative, and Nadia Rosenthal, Ph.D., FMedSci, FAAHMS, scientific director of the JAX Center for Mammalian Genetics and The Maxine Groffsky Endowed Chair. We sat down with them ahead of the event to learn more about their current work and hopes.
1. Tell us a little about your current work at JAX. What excites you most about it?
Rueter: I’ve served as medical director of the Maine Cancer Genomics Initiative (MCGI) since its inception in 2016. MCGI is an alliance of Maine oncology providers, led by JAX, that brings innovative cancer genomic testing, education and drug access infrastructure to Maine, including partnerships with every oncology practice in the state. It has become a model for delivering personalized cancer care in a rural setting. In just a few short years, the initiative has dramatically changed the delivery of cancer care in Maine. We’re conducting an ambitious new study to determine if our model impacts patient experience and outcomes on a national scale. It’s exciting to see JAX setting this kind of precedent.
Rosenthal: I’ve served as scientific director of the JAX Mammalian Genetics Program in Bar Harbor since 2016. My own lab focuses on regenerative medicine, using mouse models to understand the remarkable variation in people’s responses to injury and disease. We’re currently exploring the differences underlying patients’ variable experience of heart attacks and heart failure by studying heart disease progression in special JAX mouse populations that carry the same genetic diversity as humans and differ just as much as patients in their ability to heal. Because we know each mouse’s precise genetic makeup, we can pinpoint the key features that dictate the outcome of disease. We’ve recently used the same approach to tackle the variability in patient response to COVID-19. We can translate these findings to human medicine by designing precision therapies that are as unique as the patients needing treatment.
2. JAX’s larger mission is to realize the potential of genetics/genomics to transform human health. What does that mean to you as you pursue this work?
Rueter: For my team, it means unleashing the promise of genomic information to provide precision care for cancer patients. Our genomic tumor board program convenes national and international experts in the field of precision oncology, oncologists, pathologists and genomics experts to analyze complex genomic tumor tests that reveal a wealth of information about the cancer. These tests look for genetic changes in cancer cells, because finding certain changes can provide physicians with more information about what is causing the cancer to grow and how to treat it. We’re using genetics to find the best treatment based on a specific patient’s genomic profile. That’s our mission: to translate those findings into something potentially actionable for cancer patients.
Rosenthal: Regenerative medicine is a different way of looking at health. Rather than waiting for the problem to arise in treating cancer or other unpredictable diseases, regenerative medicine attempts to diagnose the underlying issue. When we’re young, skin wounds heal quickly, we replace lost blood, our bones heal well and our brains can rewire themselves after a stroke, but other parts of our body don't do very well when they get injured or old. Compared to the miraculous regenerative abilities of other organisms on this planet, humans have lost these programs somewhere in our evolution. If we could tweak that evolutionary playing card and understand the rules of genetics that limit our capacity to regenerate injured tissue or stave off infections, the implications for human health would be profound. At JAX, we have an unprecedented opportunity to shift the way patients respond to health challenges and to make a difference in the type of care they receive.
3. What role does philanthropy play in advancing your work?
Rueter: With fresh private funding, we could bring more innovative clinical trials and treatment options to Maine. It would enable even deeper partnerships with our clinical partners. It also would enable us to recruit patients and to run the study. We could even utilize private funding to write our own clinical trial that would provide patients with access to targeted cancer therapies. The most immediate opportunity, though, would be to explore new technologies using artificial intelligence and machine learning to improve the efficiency of genomic tumor boards – convening such high-caliber cancer experts in a room is very labor-intensive. Computational tools could help tremendously on that front, possibly enabling us to run multiple boards at once. The goal remains the same: to impact how a specific cancer patient is treated and to improve their chances for survival.
Rosenthal: Research is a step-by-step process that takes time and new ideas. For example, JAX teams currently are creating stem cells from hundreds of genetically defined mouse strains to develop ‘diversity in a dish’ platforms for more effective drug testing. This saves our mice for testing only the most promising therapeutic candidates. Ironically, it’s more costly to develop these cell-based platforms than it is to raise a colony of mice. Success is a question of scale, and private gifts play a tremendous role in accelerating the scale at which we can do our testing. Increasing the scale and speed of our work moves us closer to our aspiration of ensuring that every drug works 100% of the time on the right person. That’s the goal of precision medicine.