National Taiwan University Cracking the Genetic Code to Create a New Era of Precision Medicine

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Precision health will be an important next step for the development of biomedicine in Taiwan. The research focus of the National Taiwan University Center of Genomic and Precision Medicine is to reduce the incidence and mortality rate of infection-related cancers. The Center has made breakthroughs in primary research on lung cancer, hepatitis, COVID-19, and other diseases. 

Established in 2004, the NTU Center of Genomic and Precision Medicine (the “NTUCGM”) is a key Ministry of Science and Technology subsidized university research center. Distinguished Professor Yen-Hsuan Ni, Dean of the National Taiwan University School of Medicine and NTUCGM project coordinator, accepted an exclusive interview with the MOST Center for Global Affairs and Science Engagement. He shared how NTUCGM is integrating academic and clinical advantages and collaborating with industry to become a strong support team for national precision health.

Three major research directions: Cancer, Infectious Diseases, and Stress Medicine

As Professor Ni puts it, NTUCGM has two treasure troves to tap: National Taiwan University Hospital, and National Taiwan University. The team is almost evenly split between physicians and researchers. NTUCGM aims to promote genomic medicine and multidisciplinary translational medicine research; target cancer, infectious diseases and stress medicine as their research orientations; and propose new treatment and prevention technologies and strategies. Since its establishment, NTUCGM has established ten core laboratory technology platforms that focus on genetic medicine to provide researchers with state-of-the-art technology services. In addition, NTUCGM has a teaching resource center to coordinate talent training and integrate teaching resources.

The essence of precision medicine is formulating diagnosis and treatment plans based on comprehensive patient information. Professor Ni said that when information is assembled using big data, diseases can be more precisely predicted and healthier lives developed. With the example of cancer, its essence is the uncontrolled proliferation of cells caused by the accumulation of random mutations in genes. With rapid breakthroughs in gene sequencing and big data analysis technology, NTUCGM can not only quickly conduct human gene sequencing at a reasonable cost, but also expand the technology to microorganisms and viruses. By grasping the full picture of genetic mutations, appropriate treatment can be administered.



 

Highlight research: Reducing cancer incidence and mortality

NTUCGM has achieved outstanding research output in diseases such as lung cancer, hepatitis, and enterovirus infections. In 2020, the Center published a total of 75 papers, including 15 high-impact papers. Take hepatitis as an example. Hepatitis-related diseases could be called the national diseases of Taiwan. Hepatitis B virus-related liver cancer accounts for a major proportion of liver cancers in Taiwan. After surgical removal of tumors, one-third of liver cancer patients will relapse within the first year, thereby decreasing the overall survival rate. The NTUCGM research team is collaborating with biotechnology companies to develop Cell-free DNA Tumor Markers for Liver Cancer, which would allow recurrence of liver cancer after surgery to be tracked by using blood tests. In clinical trials, this technique was able to detect tumors as small as about 1.5 cm. In the future, the technology can be further applied to treatment outcome assessment and prognosis tracking for other cancers that are related to DNA viral infection. This research result has been patented in many countries, and was published in the internationally renowned Journal of

Hepatology in 2020. Furthermore, the NTUCGM team has also established a testing platform for developing cancer immunotherapy research.
The establishment of the NTUCGM coincided with the SARS pandemic. The infrastructure they established then happened to come in handy; they were able to focus on the control and management of SARS and related medical research. Then, at the beginning of 2020, the COVID-19 pandemic broke out. As with SARS, the research team once again became the first local team to isolate the strain of the COVID-19 virus. They helped Taiwan become the fourth country in the world to successfully isolate and complete DNA sequencing analysis, thus clarifying possible origin and routes of transmission of each COVID-19 strain. The research team has also developed the Mobile Rapid Lung Screening Device, which has been put into use at NTU Hospital’s Intensive Care Unit and Emergency Department. The device allows determing asymptomatic coronavirus infection in less than 30 seconds, thereby safeguarding the front lines of medical defense.

Multinational, multidisciplinary cooperation; moving toward precision health

NTUCGM is also working hard in industry-academia cooperation and multinational research exchanges in order to develop Taiwan's international advantage and influence in science and technology. In terms of industry-academia cooperation, 13 industry-academia joint research initiatives were conducted in 2020, with cooperation funds from domestic and foreign enterprises exceeding NT$22 million. Multinational research exchanges included participation in the short-term Cancer System Biology course offered by the Center for Complex Biological Systems (CCBS) at the University of California Irvine, which helped strengthen Taiwan's clinical resources and features. NTUCGM also collaborated on a research project with Professor Jean-Marc Egly (academician of the French Academy of Sciences, Taiwan Yushan Scholar, and a member of the Institute of Genetics and Molecular and Cellular Biology (IGBMC) in France) to study cancer progression and the development of precision therapeutic drugs. 

Precision health will be the next important development for Taiwan's biomedicine. Precision health is defined by the accurate prediction, prevention, diagnosis and treatment of diseases, based on individual genes, environment, lifestyle, and diseases’ basic molecular differences. All this will allow developing healthier lives. Professor Ni further explained, “If we can find common factors in the human body that can resist pathogens, and increase those factors when the body is invaded by foreign pathogens, then that ability may become an important prevention and treatment method for fighting emerging infectious diseases in the future.”

However, prolonged life expectancies will come with the challenges for an aging society and a higher number of elderly persons. Therefore, based on the foundation of immunogenetic research, NTUCGM will continue to deepen stress medicine-related aging research, to better understand the relationships between aging and cancer. Professor Ni hopes that NTUCGM can construct a platform for precision medicine research, development, and consultation, as well as Taiwan’s brand, to lead Taiwan's medical care towards precision health and the top standards in the world.

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