Newby heads MURDOCK Study at NCRC, and pens article on "precision medicine"

Newby heads MURDOCK Study at NCRC, and pens article on "precision medicine"
Reporter Emily Ford
Reporter Emily Ford

KANNAPOLIS, NC (WBTV) - There are big things going on at the North Carolina Research Campus in Kannapolis, even if the facility isn't on the news everyday.

Emily Ford won many journalism awards over the years during her time on staff with The Salisbury Post. Emily now chronicles news at the NCRC, sharing her stories with the media so that we can share them with you.

In her most recent article provided to WBTV, Emily tells the story of Dr. Kristen Newby and her role at the NCRC, particularly when it comes to the MURDOCK Study. In addition, following Emily's article, we've included a column written by Dr. Newby:

Eight years after she helped create Duke University's health research project based at the North Carolina Research Campus, Kristin Newby, MD, MHS, has become the lead scientist for the MURDOCK Study.

Newby, Professor of Medicine at Duke and faculty member of the Duke Clinical Research Institute, replaces Rob Califf, MD, as the MURDOCK Study's principal investigator. Califf was recently named deputy commissioner for Medical Products and Tobacco at the U.S. Food and Drug Administration.

Newby's new role comes on the heels of her prestigious induction in January into the Association of University Cardiologists (AUC). AUC members are elected by their peers and gather once a year to share their research and welcome new members. Membership is limited to 125, and those elected are considered among the best academic cardiologists in the U.S.

"Dr. Newby is the perfect fit for filling such a vital and significant leadership role as PI of the MURDOCK Study. Her breadth of experience with the study dates back to its earliest days when she consulted on the study's design, provided the scientific know-how to lead the research on cardiovascular disease for biomarker discovery and implemented the Community Registry and Biorepository," said Victoria Christian, operational founder of the MURDOCK Study and chief operating officer for the Duke Translational Research Institute, which manages the ambitious project.

"She is not only dedicated to developing the MURDOCK Study into a catalyst for precision medicine, she is well-respected by her peers inside and outside of Duke as evidenced by her recent notable award," Christian said.

Newby, who has been involved with the MURDOCK Study since its inception in 2007, helped create the population health research initiative that she says has reached a turning point.

"This is an exciting time for the MURDOCK Study, an exciting time to take this next step in my career," Newby said. "I have nothing but great hope and confidence in the future of the MURDOCK Study and where we are headed."

With more than 11,200 people enrolled in the Community Registry and Biorepository, MURDOCK Study researchers are beginning to generate and analyze data from biological samples, which are stored in Kannapolis, as well as from health information provided each year by participants. In collaboration with the Dole Nutrition Research Institute, the David H. Murdock Research Institute and other partners at the North Carolina Research Campus, the MURDOCK Study during the next five years will increase its focus on studies of nutrition and the effects on health and illness of food and exercise, Newby said.

In the coming decade, Newby said she expects the MURDOCK Study to make major contributions to understanding the fundamental underpinnings and refined classification of health and disease, contributing to the discovery and development of new treatments and their targeted use. The MURDOCK Study will bring to fruition the promise of "precision medicine," the concept that doctors will know how to use a person's genetic, clinical, social and environmental characteristics to tailor prevention and treatment strategies to that patient's unique characteristics and needs.

The MURDOCK Study has matured to the point that analyses are being initiated with the clinical data and biological samples that have been created. Many research grants have been submitted to use the MURDOCK resources—clinical information and samples contributed by the participants—to better understand such common diseases as high blood pressure, memory loss and Alzheimer's disease, physical function and aging, coronary disease, kidney disease and cancer.

Already, researchers using MURDOCK Study samples have learned about how regional and cultural differences influence the assessment of cognitive function, information that will be important in future wide-scale research in memory loss and Alzheimer's disease. In multiple sclerosis research, MURDOCK Study investigators are discovering how small molecules in the blood called metabolites are related to the disease and how these profiles may be different between women and men with MS.

Newby said the MURDOCK Study is possible thanks to generous participants who have contributed their biological samples and health information not for personal gain but to create a resource that qualified medical researchers can use to learn about health and the illnesses that commonly affect people, ultimately improving the health and well-being of future generations.

"You have committed your time, your blood and your data, and we thank you," she told participants at a recent research update in Kannapolis.

During the AUC annual meeting in January, Newby presented her research on "Moving Cardiovascular Risk Assessment Beyond a Single Biomarker." Her talk chronicled her work on using biomarkers for risk assessment and highlighted recent lessons learned from simultaneously assessing nearly 60 putative biomarkers of risk in 550 people with suspected coronary artery disease from the MURDOCK Horizon 1 Cardiovascular Disease Study. She and her collaborators found that certain smaller clusters of biomarkers and clinical variables that were strongly associated with death or myocardial infarction during a median 2.5 years of follow up could be distilled from the larger pool of information.

"While this reflects an important step forward, these methods and results only scratch the surface of what is needed and soon may be possible to bring the promise of 'stratified medicine' to fruition," Newby said.

Her work in biomarkers for risk stratification began with research on troponin and the first use of a "multimarker strategy" with Magnus Ohman, in the mid-1990s, as a new cardiology faculty member. It extended to broader collaborative efforts through the MURDOCK Cardiovascular Disease Study and Community Registry and Biorepository.

Newby said she believes the evolving efforts among Duke University, Stanford University, and Google on the Baseline Study hold great promise to address limitations of research to date and bring integrated clinical and molecular characterization to bear on health care.

The following is the article written by Dr. Newby:

Cardiologists generally prescribe four or five specific drugs to help heart attack patients avoid having another attack. I know because I prescribe them myself.

The drugs can be very effective and have helped save many lives, but it's hard to predict exactly how they'll work with specific patients. Sometimes patients take a drug and have a heart attack anyway. Sometimes they don't take the drug and are fine. Sometimes a drug causes side effects in one patient but not in another.

In a recent speech at the White House – one largely overlooked amid the latest crises in the Middle East and other news – President Obama laid out a vision for a new kind of medicine in which we could identify more precisely which patients are most likely to benefit from a drug and least likely to have dangerous side effects. Each person's treatment would be based on his or her specific genetic, clinical, social and environmental characteristics.

The president called this "precision medicine" and, for some of us on the front lines who confront disease routinely, it felt like the medical equivalent of President Kennedy's vow to reach the moon within a decade. It's an idea with the potential to transform medical care -- not just for heart disease, but also for cancer, diabetes and many other conditions.

As things now stand, it typically takes decades and billions of dollars to bring a drug to market. Only one in 5,000 drugs makes it through this process, with many failing in clinical trials. Despite the tremendous progress we've made in biomedical science, the drug development process still relies heavily on trial and error, with researchers testing one compound after another to see which works.

Precision medicine would improve these odds greatly by basing drugs on a deeper understanding of what exactly causes disease in a particular person.

It's not a new concept, but recent advances in technology and medicine have moved it beyond the theoretical to the threshold of widespread application. Already we're seeing powerful new kinds of treatments and therapies for cancer. The rest of us who treat patients in other fields would like to see similar and even faster progress.

The president's $215 million initiative would help make that happen. It has high goals, including the creation of a large new research program in which a million or more people would confidentially share their medical information for the common good. Simultaneously, the National Cancer Institute would identify more genetic links to cancer.

I know this approach can work because I've been part of a research team that's been doing something similar on a smaller but still impressive scale. Since 2007, our MURDOCK Study has gathered biological samples from 11,000 volunteers in North Carolina, using massive computing power to compare their genes, proteins, personal histories and other factors. The resulting analyses are beginning to help us understand both health and disease with much greater precision. We're also learning about healthy aging and longevity.

More recently, some of us at Duke and Stanford universities have teamed up with Google to tackle the complex task of mapping the human body to better understand what a healthy person really looks like. Building on the original human genome project, which analyzed just a few people, we're looking at many thousands, along with other variables. It's a new kind of medical discovery, one that combines the powerful new techniques of "big data" with insights from emerging biomedical fields. It's essentially the "precision medicine" the White House is backing, and we're optimistic it can work.

I'm a medical researcher, not a politician, and I know we live in an era of political gridlock. However, this is one idea everyone can support. My colleagues and I have been heartened by the initial bipartisan support that both Congressional Republicans and business leaders have voiced for the president's plan.

Personally, even though I am proud of the excellent care we now provide our patients, I am eager to take advantage of this historic opportunity to pursue a new level of personalized care that will save even more of their lives. Any American who anticipates getting sick in the future should want that, too. The president has proposed an ambitious, incredibly complex project, to be sure, but it's one that both political leaders and ordinary Americans should embrace.

Kristin Newby, MD, MHS, is a cardiologist at the Duke Clinical Research Institute in Durham, N.C. She is principal investigator for the MURDOCK Study, based at the North Carolina Research Campus in Kannapolis, N.C.