#P4C2014

Solutions for Organ Failure It Takes an Analytics Collaborative

IO Informatics and PROOF Centre

Innovator Presentation

Bob Stanley, Bruce McManus

#P4C2014

Do data analytics matter?

Presidential Election 2012“The Cave” in

Obama’s Chicago HQ

Meteorological Tools

Your Car

#P4C2014

Cancer28%

Heart33%

Kidney3%

Lung12%

All Other NCDs24%

Mortality

Cancer29%

Heart34%

Kidney3%

Lung8%

All other NCDs26%

DALYs

Sources: Global Health Data Exchange/ Institute for Health Metrics and Evaluation Global Burden of Disease Study 2010 – Results by Cause 1990-2010; Bloom et al. 2011 The Global Economic Burden of Non-communicable Disease. World Economic Forum

EconomicsUS $Trillions, North America & EU

Cancer $1.7

Heart $5.4

Lung $1.5

All other NCDs $6.2

The Burden of Heart, Lung and Kidney Failure in North America

#P4C2014

The Burden of Heart Failure

DIRECT COSTS:HOSPITALIZATIONS

Annual costs of heart failure will double in North America in the next 20 years

$ BILLIONS: 0 20 40 60 80

200320102030

$$$

$$$$$

$$$$$$$$$$

70%of all direct costs for heart failure are related to

hospitalization1 in 5

people will develop heart failure

SOURCES: Go et al., 2013. Circulation 127:e6-e245; Braunschweig et al., 2011. Europace 13, ii13-ii17

#P4C2014

The Burden of COPD

0 50 100 150

JapanFrance

GermanyItaly

RussianUK

IranPhilippines

MexicoUSA

EgyptTurkey

BrazilThailand

CongoNigeria

EthiopiaMyanmarIndonesia

BangladeshPakistan

IndiaVietnam

China

Aged-adjusted deaths/100,000

COPD IS THE 4th LEADING CAUSE OF

DEATH WORLDWIDE

>300M WORLDWIDE15.4M NORTH AMERICA

30M INDIA

SOURCE: US BURDEN OF DISEASE COLLABORATORS JAMA 2013

HEALTHCARE COSTS, US

LEADING CAUSE OF MORBIDITY & MORTALITY

IN US

DIRECT COSTS:ACUTE

EXACERBATIONS

#P4C2014

3 Patients, 3 Precious Lives

• Heart transplant, age 19• Dx: Invasive heart biopsies

to monitor for immune rejection

• Rx: Immunosuppressive therapies

• Social: Travels all day for routine tests

• Heart failure, age 45• Dx: BNP, NTproBNP• Rx: Diuretics, ACE

inhibitors, lifestyle changes

• Social: No more square dancing, chronic family stress

TYLER

• COPD lung attacks, age 50• Dx: FEV1• Rx: Bronchodilators, inhaled

corticosteroids• Social: Cannot walk with

friends, cannot sleep laying down at night

VIVIANNEJOHN

#P4C2014

Our Patients Have Urgent NeedsMore accurate, less-invasive, closer-to-home diagnostic & monitoring tools

Reduced patient visits to urgent care for heartand lung attacks and acute organ failure

More effective, timely therapeutics

#P4C2014

Our Emerging Solution• New high quality laboratory tests

– Reduce urgent care visits– Reduce healthcare costs– Improve precision of care

• Bio-signatures – Identify patients with rapid organ decline– Expedite successful drug development

#P4C2014

Cohorts,Biospecimens

SystemsScience

M4EDAL

HTG

AgilentBruker

LifeTech

Zeiss

CARTaGENE

AlbertaHEART

GSK ECLIPSE

CanPREDDICT

BiT

TNFaCan

COLD

Macro

RapidTransition

LEUKO CORE

ICVHealth

Tech Transfer

PROOF IP Committee

US, CdnLegal

Counsel

Bus Dev

HeartLung

Kidney

Blood

Pathways Interact-ions

UVicProteomics

Centre Scripps

IO Informatics

RNA

ProteomicsMetabo-lomics

Epi-genetics

Clinical

miRNATissues

Cell types

Networks

Mining

Ensembles

Blood

ClinicalExpertise

IP, Regulatory

Patients as

PartnersData

Analytics

LaboratoryMedicine

Health Economics,Outcomes

PROOFCentre

Biomarker Development

HeartCOPD

Kidney

Asthma Brain

Spinal Cord

Skeletal Muscle

Pancreas

Bowel

CHEOS

IO Informatics

Biomarker Consort

C2E2

#P4C2014

BIOSIGNATURE LISTS

DATA PREPARATION

PRE-FILTERING

BIOMARKER ALGORITHMS

BLOOD TEST CONTENT

COMBINATORIAL ALGORITHMS

SYST

EMS

SCIE

NC

E

BLOOD ‘OMICS’ DATA• mRNA, miRNA expression (Affy, NanoString, qNPA)• Plasma proteomics (mass spectrometry)• RNA-sequencing (Illumina)• Metabolomics (NMR, mass spectrometry)• DNA methylation (Illumina BeadChip)

CLINICAL DATA

PHENOTYPIC DATA

PATIENT COHORT

What do we mean when we speak of data analytics?

#P4C2014

Connecting the (‘Big Data’) Dots to Harvest Meaning

• Global frameworks for integrated analytics enable global knowledge creation and sharing

• Linked patients, tissues, assessments (e.g., ‘omics’), endpoints and references facilitates efficient, comprehensive discovery

and promotion of classifiers

• Connecting blood-based signatures to integrated search and

reporting systems improves access and interpretation and reduces response time

#P4C2014

Addressing the Challenge of Acute Cardiac Transplant Rejection

10-20%TREATABLE

ACUTE REJECTION

10-15 BIOPSIES

PER PATIENT

1ST YEAR POST TRANSPLANT

20-30% PATIENTS

OVERTREATED

BIOPSIES

$ 48,000 –75,000

Rx

$ 16,000 –20,000

2,950$

• NOT USEFUL IN FIRST 2 MONTHS POST-TX

• LONG TURN AROUND TIME

CURRENT MOLECULAR Dx

>2000TRANSPLANTS PER YEAR

IN NORTH AMERICA

#P4C2014

M4EDAL

NO REJECTION

LIKELY REJECTION

BIOPSY

Draw blood anywhere

NO BIOPSY

TRANSPLANT RECIPIENTS

Better Tools for Clinic Care

Minimal sample input Fast turnaround time Effective during first 2

months post-transplant

mRNA-basedExclusion of acute rejection

Implement new test

ASK

M4EDAL: Molecular Markers for Modern

Medicine: Emergent Diagnostics and Analytics Laboratory

ASK: Applied Semantic Knowledgebase

#P4C2014

ASK for Faster Cures

• Applied Semantic Knowledgebase (“ASK”)

• Precision Medicine Screening– Interrogate Multiple Data Streams,

Multiple Signatures– Visualize, Test, Refine Pre-

Submission Hypotheses– Score-based Decision Support

#P4C2014

Health Economics Modeling Wealth Creation Strategy Commercialization Strategy Regulatory Approvals

UNMET HEALTHCARE NEEDS DEFINED

BIOMARKER REPLICATION

ANALYTICAL DEVELOPMENT

BIOMARKER DISCOVERY

CLINICAL VALIDATION

CLINICAL UTILITY AND USE

Expert Clinical Care Teams

Patients as Partnersand Biospecimens

Richly Diverse Cohorts

Adjudicated Phenotypes

Expert Clinicians and Imagers

High TechnologyPlatforms

Scripps

UVic Proteomics

Human MetabolomicsProject

Valaista

Data Analytics Crowd

IO Informatics

PROOF Centre

G. Cohen-Freue

S. Baranzini

M. Wilkinson

Laboratory Relevant Resources

HTG Molecular

NanoString

Vela Diagnostics

Workflow Automation

Medical Biochemistry

M4EDAL

Utility OutcomesAssessment

ICV Health / K. Humphries

CORE / L. Lynd

#P4C2014

Improved Diagnostics and Drugs

FASTER CURES

UNMET HEALTHCARE NEEDS DEFINED

BIOMARKER REPLICATION

BIOMARKER DISCOVERY

Expert Clinical Care Teams

Patients as Partnersand Biospecimens

Richly diverse cohorts

Adjudicated phenotypes

Expert clinicians and imagers

High TechnologyPlatforms

Scripps

UVic Proteomics

Human MetabolomicsProject

Valaista

Data Analytics Crowd

IO Informatics

PROOF Centre

G. Cohen-Freue

S. Baranzini

M. Wilkinson

Laboratory Relevant Resources

HTG Molecular

NanoString

Vela Diagnostics

Workflow automation

Medical Biochemistry

M4EDAL

Utility OutcomesAssessment

ICV Health / K. Humphries

CORE / L. Lynd

ANALYTICAL DEVELOPMENT

CLINICAL VALIDATION

CLINICAL UTILITY AND USE

INTERNAL DRUG DEVELOPMENT AND TARGET VALIDATION

COMPANION DIAGNOSTICS

M4EDAL

CDRD

Adiga

AstraZeneca

GSK

viDA

#P4C2014

Help for Other Failing Systems• Troponin of Stroke – Dr. A. Penn/UVic – Genome Canada/BC

• Spinal Cord Injury – Dr. B. Kwon/UBC – Brain Canada

• Muscular Dystrophy – Dr. R. Ng/UBC – Jain Foundation/MRM Proteomics

• Asthma – Dr. S. Tebbutt/UBC – Adiga Life Sciences/Circassia

• Chronic Kidney Disease – Dr. A. Levin/UBC – AstraZeneca

• Lung Function Decline in COPD – Dr. D. Sin/UBC – FNIH

• Diabetes Drug Response – Dr. T. Elliott/UBC – Personal Biomarkers

#P4C2014

Conquering Complexity• SUFFERING: Clarify pressing unmet needs

• SOPHISTICATION: Magnetize the best people, harness the best tools, generate and interrogate the best data

• SOLUTIONS: Push forward openly, fairly, relentlessly, allowing no barriers to goals

#P4C2014

Thank You

#P4C2014

#P4C2014