Precision Health and Targeted Therapies

At Cedars-Sinai, scientists and physicians utilized advanced technology, big data and specialists across multiple scientific disciplines to provide personalized and effective healthcare. Through research, clinical practice and philanthropic funding, experts are rethinking how to treat diseases and optimize outcomes by targeting illnesses at the molecular level.

Healing Hearts

In laboratories across the campus, scientists forged new ground in proteomics, which uses molecular biology, biochemistry and genetics to analyze the structure, functions and interactions of proteins. These investigators leveraged proteomics to help predict how specific patients will respond to different treatments, just as gene mapping can help predict the likelihood of developing a disease.

Jennifer Van Eyk, PhD, director of the Advanced Clinical Biosystems Research Institute, director of Basic Science Research in the Barbra Streisand Women's Heart Center and the Erika J. Glazer Chair in Women's Heart Health, blazed a trail in this area. Her laboratory played two major roles in a cutting-edge, $10 million U.S. Department of Defense-funded study* exploring a cell therapy for patients with heart failure with preserved ejection fraction. The study aims to:

Determine which blood protein can best provide information about how a patient responds when treated with stem cells. Investigators plan to test a number of biomarkers and then correlate the results with advanced imaging of the heart and other clinical findings.
Look at how the stem cells exert their powerful effects. To date, research shows that, when treated with stem cells, heart cells seem to recreate themselves by turning on and making new proteins, while turning off other proteins. Investigators hope to deepen their understanding of how these proteins function.

The Van Eyk laboratory also demonstrated significant progress in finding new potential biomarkers for cardiac disease and, specifically, women's heart disease.

Van Eyk and her colleagues also advanced their remote protein biomarker monitoring project using a simple blood spot mail-in method. This success led to a $1.2 million grant from the California Initiative to Advance Precision Health. The grant supports a four-month study monitoring about 200 individuals at mid-risk of having a major advanced cardiac event (such as heart attack or hospital readmission due to worsening heart failure) using smart devices for physiological readout, stress and other lifestyle aspects.

Many of the ideas that were a result of these accomplishments can be applied to areas beyond heart disease research. A collaboration is currently underway with the Cedars-Sinai Board of Governors Regenerative Medicine Institute to find protein biomarkers generated from induced pluripotent stem cells (derived from a patient's skin or blood) for treating diseases in motor neurons. Developing these kinds of targeted therapies was an essential focus of The Campaign for Cedars-Sinai, which deepened the institution's investment in individualized medicine as an effective means of transforming community health.

*in animal models

Innovations in Inflammatory Bowel Disease

Cedars-Sinai Precision Health is a new initiative that aims to leverage the latest technology and best research to increase the availability of personalized treatments—and to do it as rapidly as possible. Launched in 2016, the program is directed by Dermot McGovern, MD, PhD, director of Translational Research in the F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, the Joshua L. and Lisa Z. Greer Chair in Inflammatory Bowel Disease Genetics, assistant clinical professor of Academic Affairs and professor of Medicine.

During the campaign, McGovern's research shaped the field through:

Publishing findings in Gastroenterology showing that African-Americans have unique genetic risks for inflammatory bowel disease (IBD) that are traceable to their African heritage.
Co-leading an international study, with results published in The Lancet, proving that genetic variation in patients with IBD appears to play a major role in determining how sick they will become—which could provide a roadmap for more effective treatments.
Helping direct a study*, published in Science, demonstrating that a major type of IBD may be caused in part by genetic variants that prevent beneficial bacteria in the gut from doing their job, and uncovering the protective role some bacteria can play in disease management.
Showing that having an appendectomy after an ulcerative colitis diagnosis may be associated with a higher risk of patients needing a colectomy.

*in animal models

Cedars-Sinai is one of the world's leading IBD centers.

Cedars-Sinai is identifying ways to improve current therapies for IBD, which are limited to antibiotics, corticosteroids and immune-modifying agents, all of which come with serious side effects over the long term. Stephan Targan, MD, director of the F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute and the Feintech Family Chair in Inflammatory Bowel Disease, is a national leader in this research. His group successfully partnered with colleagues across Cedars-Sinai to create intestine replicas in the laboratory. Institute investigators were the first to define a role played by intestinal fungus in IBD, opening a novel area of study and potential treatments.

Other research successes include:

Helping to define the processes by which TL1A, a master regulator of inflammation in IBD, regulates intestinal scarring, or fibrosis, that contributes to structuring, a complication of Crohn's disease involving the narrowing of the intestines and a hallmark of severe disease.
Identifying that the gene RNASET2 is decreased in patients with medically resistant Crohn's disease, suggesting that RNASET2 may be a diagnostic marker of disease severity as well as an indicator that patients not responsive to current treatment strategies may benefit from alternate therapeutic approaches.

Pioneering Radiation Oncology

During The Campaign for Cedars-Sinai, scientists and physicians made important strides in the field of radiation oncology. Research advanced by Cedars-Sinai indicated that adding hormonal therapy to radiation treatment can significantly improve the average long-term survival of men with prostate cancer who have had their prostate gland removed. According to the study (led by Howard Sandler, MD, professor and chair of the Department of Radiation Oncology and the Ronald H. Bloom Family Chair in Cancer Therapeutics), and published in the New England Journal of Medicine, the regimen can also reduce how often the cancer spreads. Another study showed a mild hypofractionation approach (i.e., delivering more doses of radiation per treatment) with 28 treatments is as beneficial as longer treatments. This can significantly improve patient quality of life by reducing the traditional treatment length and potentially diminishing side effects.

These advances, and countless others like them, contribute to Cedars-Sinai's reputation as an institution focused on personalized approaches to health and wellness.