Heretic No Longer? Meet Michael Joyner, Precision Medicine’s Critic-in-Chief

In 2016, after President Obama announced the Cancer Moonshot in the State of the Union, a very outspoken physician researcher from the Mayo Clinic penned an open letter to Vice President Biden criticizing the project and proposing the money be better spent other ways. It included these lines:

“The old idea from the 1990s and 2000s that with genomics we could understand the genetic causes of cancer has been largely disappointed. In 2005 the head of the NCI boldly predicted that as a result of what has come to be branded as “Precision Medicine”, death and suffering from cancer could be eliminated by 2015. Since that time the statistics have barely budged.”

Michael Joyner, the author of this letter and our guest today, has been “calling the bluff” of precision medicine for several years now. Anyone who frequents Twitter will no doubt have encountered his relentless game of offense in attacking what he calls the “underperforming” narrative of precision medicine.

“Genomic medicine or precision medicine is just lacking for the vast majority of non-communicable diseases that kill most of us,” he states at the outset of today’s interview.

We’re excited to have Michael on the program to share his views in a longer form. Good science is science that is continually challenged and not turned into dogma. And “Precision Medicine,” being promoted from the highest levels of government and continually reinforced by an NIH Director who was himself a genomicist, has had as good a chance as any narrative in the history of science of becoming dogma.

Was Michael always a critic of the genomic approach or was there a moment when he grew disillusioned? What alternative(s) does he propose? Today we attempt to hear out his story and offer a couple challenges to his line of critique.

Michael does not just talk the talk (here is his most recent opinion piece), he also walks the walk. He’s a prolific researcher at the Mayo Clinic working in the direction that he thinks we should go: behavior modeling and research into physiology.

Note: Dr. Joyner’s statements on precision medicine are his own viewpoint and do not represent Mayo Clinic’s institutional view. When he shares his position, he is speaking on his own behalf and not for Mayo Clinic.

Nathan and Laura on CRISPRed Babies and Other November 2018 Stories

What a week! And a great time to have on our expert contributors, genomicist Nathan Pearson and genetic counselor Laura Hercher, to talk about what is reportedly a first in history: babies born with a gene altered. They'll be called Lulu and Nana.

So just how pissed, scared, shocked, and curious are we after three days?

Laura says there’s many levels here, and many lines crossed as she quickly joins in the “chorus of disapproval.” She also says there’s many levels of anxiety going on, and it’s helpful to separate them out: there's gene editing anxiety, there's Youtube anxiety, there's science establishment anxiety, some U.S./European anxiety. "Some of them are legitimate and some are not."

Many have talked about how dangerously easy it is to use CRISPR. Nathan tempers that by comparing the use of CRISPR to playing the game "Go," "it's a minute to learn, a lifetime to master.”

We do to talk about other cool stuff this month—the new paper on paternal transfer of mitochondrial DNA, and we end with some suggestions for which genetic tests you might offer as gifts this holiday season.

It’s Halloween to Christmas all in one show.

The Business of Aging and Three Reasons Why the FDA Drug Approval Rate Is So High

We're back in the office after a fabulous vacation, and ready to have some fun. It's Friday, and time for Gene and Tonic.

Yes, we celebrate the news this week that women have their own sex pill. And we make our best guesses as to why the FDA's drug approval rate is up in the stratosphere.

But first, we report on one of the funnest conferences we go to all year, the Rejuvenation Biotechnology Conference put on by the SENS Research Foundation. The study of aging has picked up momentum in the last year, and the conference featured some of the latest science. We heard a few jokes at the conference we want to share, but also we talk about some of the new developments in the field which, you gotta agree, can come off sounding pretty comical as well.

Tim Triche on Using Arrays for Cancer Research

We recently interviewed cancer researcher Tim Triche from Children's Hospital Los Angeles. Tim had two main points: First, microarrays are still a very valuable tool for research and for the clinic. Second, there are perhaps more answers for cancer research to be found in the non-coding portion of the genome than in the genes.

Here, we've compiled Tim's comments on the staying power of arrays.

For the full interview, see Part I and Part II.

Editor's Note:  In this interview, Tim refers to an older generation Affymetrix array (GeneChip(R) Exon 1.0 ST Array).  The newest array (GeneChip(R) Human Transcriptome Array 2.0) is able to measure gene and exon level expression of coding and long non-coding RNA with the ability to detect alternative splicing events.