Dr. Phelps is the inventor of the Positron Emission Tomography (PET) scanner. With UCLA colleagues and students, he developes in vivo biochemical assays for PET to provide molecular imaging diagnostics of the biology of disease. Dr. Phelps is a member of the National Academy of Science and the National Academy of Medicine, published 720 peer-reviewed articles and 4 textbooks, and has been the principal investigator of $245 million in grants. He has received recognition for his scholarship, such as George von Hevesy Prize, Chaired the 1983 Nobel Symposium; S. Weir Mitchell Award, Academy of Neurology; Rosenthal Foundation Award, American College of Physicians; the Enrico Fermi Presidential Award by President Clinton; Kettering Prize, General Motors Cancer Research Foundation; gave the Keynote Address, 2007 Nobel Symposium. Read his full bio.

Interview with Michael Phelps of UCLA

Q: You invented the PET scanner that changed the lives of millions of patients with cancer, brain and heart diseases. What are the potential benefits to patients of combining PET with radio-ablation technologies?

A: PET provides imaging assays of the biology of disease in many diseases today. It provides these assays with imaging probes in near massless amounts – tracers – that do not impose any significant mass effects on patients nor the biological process being assayed. About 60 million clinical PET studies have been performed without a reported complication due to the imaging probe.

While there is an ever-increasing diversity in PET imaging probes and assays they provide, more recently, there has been an increase in assays demonstrating the capability to phenotype cancer cells in patients to determine whether the protein targets for radioablation are expressed on the cancer cells. This approach is referred to as Theranostics, in which the probe is labeled with a radioisotope for PET imaging, and the same probe is labeled with long-lived radioisotopes that emit beta or alpha particles for radio-ablation of cancer cells. These diagnostic- therapy combinations have moved from pre-clinical research to clinical trials to clinical practice with remarkable therapeutic benefit for patients. These probes are small peptides, small molecules, and antibodies. In both cases, the probe is injected IV and travels throughout all tissues of the body to locate and bind to the target protein for imaging or treatment. For example, prostate cancer cells express the Prostate Specific Membrane Antigen (PSMA) that is targeted with PET imaging to select patients for treatment with 177Lu or 225Ac labeled probe. Patients without the target do not qualify for the treatment. After treatment, PET imaging is used to determine if the cancer cells have been ablated. Thus, PET imaging of target expression provides measurement for stratification of patients for radioablation treatment.

If one uses a signal (responders) to noise (nonresponders) analysis to assess the relative number of patients needed in a therapy trial where a molecular diagnostic is used to enrich the patient population in responders, the following relative advantage can be achieved:

If the patient population has 20% responders (normal for treatment trials), 100 patients are required for the therapy trial.

If a molecular diagnostic provides enrichment to 40% responders, 25 patients are required.

If a molecular diagnostic provides enrichment to 80% responders, 7 patients are required.

This reduces the cost and time for trials by these same factors, and spares exposure of patients to risk of the therapeutic without adding value to the trial. Of course, this same benefit is realized by integrating the molecular diagnostic and therapeutic in-patient care. Theranostics demonstrates this realization in trials and patient care.

Q: Immunotherapy agents are rapidly changing the standard of care in cancer. How can PET immuno-oncology imaging be used to improve cancer care?

A: Immunotherapeutics are fundamentally different from other treatment modalities because they involve the patient’s immune system. PET provides two key advantages – the capability to detect very specific molecules (such as the CD markers on immune cells, or specific nutrients/metabolites intrinsic to immune system activation), along with the ability to examine all cells throughout the body of patients for these target molecules.

PET imaging of glycolysis with [18F]deoxyglucose (FDG) is fundamental to differentiating health and disease because of the defining importance of glucose metabolism, as well as assays for specific diseases (e.g. cancer, Alzheimer’s, etc.). There are, however, many specific diagnostic – treatment decisions requiring assays of specific biological processes.

Immunotherapeutics represent one of many examples requiring specific PET imaging assays to answer specific clinical questions that define treatment selection and assessment of treatment responses. This area of PET imaging is called ImmunoPET. Novel PET probes for immunotherapeutics include nucleoside analogs for assessing shifts in metabolism that occur preferentially in just the immune cells. Another class of tracers are immunoPET probes, based on antibodies or engineered antibody fragments (e.g., minibodies & diabodies) that detect specific markers on key cells such as the CD8 cytotoxic T cells that directly kill tumor cells. This area of ImmunoPET imaging is being used to assess the checkpoints that block immune responses, as demonstrated by groups in Europe using radiolabeled versions of the FDA-approved drugs nivolumab and atezolizumab.

Importantly, using newer PET probes to detect specific immune cell types, or assess molecular markers of immune system activation, can provide a faster and much more specific readout as to whether an immunotherapy is working, compared to current clinical imaging which focuses on non-specific assessment of tumor size (e.g., CT & MRI cannot differentiate malignant, necrotic & edematous tissues). The availability of specific readouts of immune system activation can help physicians and patients determine which immunotherapies to use, and how well they are working.

Q: What are the current challenges and opportunities for PET technological advances in clinical and preclinical imaging?

A: The greatest challenge for providing the unique PET molecular imaging of the biology of disease is to overcome dogma and fixed beliefs. The dogma in medical imaging is still that imaging tumor lesions is more relevant than PET molecular imaging assays of the biology of disease, and as being demonstrated in Theranostics, imaging tumor phenotypes and ImmunoPET imaging, as well as enzyme assays of many metabolic processes. This is evidenced by the insistence of regulatory bodies that sill use non-specific lesion size changes (e.g., lesions in cancer can increase in size during treatment due to necrosis (cell death) that are mistakenly judged as a treatment failure) as outcome markers in cancer therapy trials. This needs to be changed to use PET molecular imaging of the biological processes of disease and phenotyping of cancer cells through the body. Disease is a biological process and treatments are fundamentally designed to modify or terminate the biology of disease. Today, almost all PET scanners are PET/CT or PET/MRI that can simultaneously provide both the biological and traditional sizing of lesions.

Because of the risk of therapies, clinical trials must begin at the latest, and most complex stage of disease that is most difficult to treat. New in vivo and in vitro molecular diagnostics informative of the critical and controlling phenotypes of disease provide the means to lead therapeutics to earlier and less complex stages of disease where treatment can be more effective, and as discussed above, to enrich the patient population with responders with all the benefits this provides.

PET imaging assays have the capability to interrogate all cells throughout the body of patients for the expression of therapeutic targets to provide an informative and productive benefit in developing more effective therapies, and providing direct measures of their pharmacologic effectiveness.

Q: Can you give some examples how PET technology has helped in the development of new pharmaceuticals?

A: There are many and growing examples of the informative value of PET molecular imaging of the biology of disease in the development and use of new therapeutics. An illustrative example of the many attributes provided by PET are in the use of labeled peptides, small molecules, and antibodies to phenotype tumor cells of patients for radioablation of cancer, as discussed above. For example, 68GA-DOTATATE is used with PET for targeting cancer cells expressing the somatostatin receptor that are treated with therapeutic analogue 177Lu-DOTATATE with remarkable therapeutic benefit that has now been FDA approved and reimbursed. Following this are diagnostic and therapeutic combinations for prostate cancer targeting PSMA in FDA trials, although already used in patient care in Germany and Australia. These Theranostic results will be presented.

There is an ever-increasing world-wide growth in academic and commercial Theranostics, including ~ $6B in acquisitions of Theranostics companies by pharmaceutical companies over the last year.

There is, however, ever increasing progress in integrating in vivo and in vitro molecular diagnostics of the biology of disease with therapeutics that target critical proteins of disease to guide the discovery and development of therapies, and to bring them integrated together into the practice of medicine.

Interview with Shannon J. McCall of Duke University

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend?

A: After several years of the promise of precision medicine and abundant clinical trial work, the recent FDA approval of solid-tumor-agnostic therapies dependent on molecular biomarkers has catapulted genomic/precision medicine into the standard-of-care for late stage cancer.

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Interview with Tao Chen of Paragon Genomics, Inc.

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling for clinical Dx. How soon, do you think, will we see accelerated growth and what can we expect?

A: For whole genome sequencing to be a reliable clinical tool, it will largely depend on the cost of sequencing the genome and our ability to interpret the data.

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Call for Action: The Time is Now for Patient Data Interoperability

The use of new technologies can provide breakthrough benefits for both patients and providers. However, with increased sharing comes increased risks to the security and privacy of patient data. Currently data is being accumulated across many organizations and initiatives but is often either siloed or simply not accessible. Researchers suggest that patient education tactics can help quell security concerns during patient data sharing.

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Interview with Andrew Magis of Arivale

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling. How soon, do you think, will we see what kind of accelerated growth?

A: I think the acceleration has already begun. Large sequencing projects such as NHLBI Trans-omics for Precision Medicine (TOPMed) and NIH All of Us are sequencing 150,000 and 1 million individuals, respectively.

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Interview with Emily Leproust of Twist Bioscience

Q: NGS is enhancing patient care through improved diagnostic sensitivity and more precise therapeutic targeting. Prominent examples include cystic fibrosis and cancer. What other clinical areas NGS will most likely to change the standard-of-care in the near future?

A: Preventative medicine – using genetic data to identify traits that have the potential to cause harm in the future.

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Interview with Michael Phelps of UCLA

Q: You invented the PET scanner that changed the lives of millions of patients with cancer, brain and heart diseases. What are the potential benefits to patients of combining PET with radio-ablation technologies?

A: PET provides imaging assays of the biology of disease in many diseases today.

Read More

Interview with Daniela Ushizima of Lawrence Berkeley National Lab

Q: Artificial intelligence (AI) techniques have sent vast waves across healthcare, even fueling an active discussion of whether AI doctors will eventually replace human physicians in the future. Do you believe that human physicians will be replaced by machines in the foreseeable future? What are your thoughts?

A: I really hope that human physicians will not be replaced by machines in the foreseeable future.

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Interview with Amy Compton-Phillips of Providence St. Joseph Health

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend? What technological advancements are driving this change?

A: Genomic medicine is poised to move quickly from the research realm into integration with healthcare delivery, but there is always a time lapse between technology advances and what we do with those advances.

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Interview with James Taylor of Precision NanoSystems

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: Patients are already receiving treatment using novel gene and cell therapies.

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Interview with Julie Eggington of Center for Genomic Interpretation

Q: Together with Robert Burton you founded the Center for Genomic Interpretation (CGI), a non-profit organization. Can you tell us more about CGI and the mission behind it?

A: CGI’s mission is to drive quality in clinical genetics and genomics. CGI works primarily with laboratories, health insurance payers, clinicians, and patients/consumers.

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Interview with Deven McGraw of Ciitizen

Q: Patient healthcare data aggregation and analysis is seen as both the panacea for tremendous breakthroughs in precision medicine and as one of its biggest challenges. Are both true and how so?

A:Yes, both are true. Achieving breakthroughs in precision medicine will require a lot of data – and yet it is often difficult for researchers to amass all of the data needed to advance precision medicine discoveries.

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Breaking News: CMS Takes Actions to Lower Prescription Drug and Other Healthcare Costs – Seema Verma Speaking @PMWC19

The cost of healthcare has been rising at an annual rate of 7% be it company-sponsored health insurance, public insurance such as Medicare and Medicaid, or private insurance. As such, healthcare was top of mind for many individuals this 2018. In the November midterm election many items related to healthcare such as Medicaid expansion, provider pay and indirect effects on the Affordable Care Act could be found on the ballot.

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Did You Catch All 6 of These Big Genomic Medicine Headlines in Recent Weeks?

Genomic sequencing, the driver of modern genomic medicine has come a long way in a short time, and its potential to continue driving innovations in precision medicine is enormous. PMWC 2019 Silicon Valley Jan. 20-23 in the Santa Clara Convention Center will focus on topics that are in the headlines and on everyone’s minds, in NGS and in precision medicine.

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Interview with Christopher Hopkins of Nemametrix

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: We should all be working towards integrating these technologies into routine patient care as quickly as possible, because genomic medicine has the capacity to make profound impacts now.

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Interview with Kristine Ashcraft of YouScript

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: It’s certainly hard to predict, but our goal is to see precision medicine tools in the hands of most providers in the next five years.

Read More
Johns Hopkins
University Of Michigan

The Precision Medicine World Conference (PMWC), in its 16th installment, will take place in the Santa Clara Convention Center (Silicon Valley) on January 20-23, 2019. The program will traverse innovative technologies, thriving initiatives, and clinical case studies that enable the translation of precision medicine into direct improvements in health care. Conference attendees will have an opportunity to learn first-hand about the latest developments and advancements in precision medicine and cutting-edge new strategies and solutions that are changing how patients are treated.

Agenda highlights:

  • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
    • AI & Data Science Showcase
    • Clinical & Research Tools Showcase
    • Clinical Dx Showcase
    • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
    • Digital Health/Health and Wellness
    • Digital Phenotyping
    • Diversity in Precision Medicine
    • Drug Development (PPPs)
    • Early Days of Life Sequencing
    • Emerging Technologies in PM
    • Emerging Therapeutic Showcase
    • FDA Efforts to Accelerate PM
    • Gene Editing
    • Genomic Profiling Showcase
    • Immunotherapy Sessions & Showcase
    • Implementation into Health Care Delivery
    • Large Scale Bio-data Resources to Support Drug Development (PPPs)
    • Microbial Profiling Showcase
    • Microbiome
    • Neoantigens
    • Next-Gen. Workforce of PM
    • Non-Clinical Services Showcase
    • Pharmacogenomics
    • Point-of Care Dx Platform
    • Precision Public Health
    • Rare Disease Diagnosis
    • Resilience
    • Robust Clinical Decision Support Tools
    • Wellness and Aging Showcase

Agenda highlights:

    • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
      • AI & Data Science Showcase
      • Clinical & Research Tools Showcase
      • Clinical Dx Showcase
      • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
      • Digital Health/Health and Wellness
      • Digital Phenotyping
      • Diversity in Precision Medicine
      • Drug Development (PPPs)
      • Early Days of Life Sequencing
      • Emerging Technologies in PM
      • Emerging Therapeutic Showcase
      • FDA Efforts to Accelerate PM
      • Gene Editing / CRISPR
      • Genomic Profiling Showcase
      • Immunotherapy Sessions & Showcase
      • Implementation into Health Care Delivery
      • Large Scale Bio-data Resources to Support Drug Development (PPPs)
      • Microbial Profiling Showcase
      • Microbiome
      • Neoantigens
      • Next-Gen. Workforce of PM
      • Non-Clinical Services Showcase
      • Pharmacogenomics
      • Point-of Care Dx Platform
      • Precision Public Health
      • Rare Disease Diagnosis
      • Resilience
      • Robust Clinical Decision Support Tools
      • Wellness and Aging Showcase
  • Luminary and Pioneer Awards, honoring individuals who contributed, and continue to contribute, to the field of Precision Medicine
  • 2000+ multidisciplinary attendees, from across the entire spectrum of healthcare, representing different types of companies, technologies, and medical centers with leadership roles in precision medicine
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