Q&A with Vincent Mooser, Canada Excellence Research Chair in Genomic Medicine

"We are at the dawn of something really big in medicine and I want to be a part of it. I want to make my small contribution to the greater effort"
Dr. Vincent Mooser will join McGill this summer as the Canada Excellence Research Chair in Genomic MedicineOwen Egan

On April 17, the Honourable Kirsty Duncan, Minister of Science and Sport announced a new Canada Excellence Research Chair in Genomic Medicine: Genes to Drug Targets for Next-Generation Therapies.

Dr. Vincent Mooser, who will be joining McGill this summer as the Canada Excellence Research Chair in Genomic Medicine, is a pioneer in using genomics-based tools and datasets to develop new target-based therapies to improve human health. Dr. Mooser is one of the few clinician-scientists with over 25 years of experience at the nexus of three domains: academia, the clinic and industry. This unique combination should fundamentally advance Canada’s ability to lead research in translating genomic-based discoveries into new therapeutic options for the treatment of patients afflicted by a number of common diseases.

As part of this program, the University will receive up to $10 million in federal funding over seven years to support research by Dr. Mooser and his team. An additional $15 million from other sources, including McGill University (approximately $10.5 million), Mitacs Inc, and CQDM (Biopharmaceutical Research Consortium), will be added to match the CERC funding.

Before becoming his CERC appointment, Dr. Mooser held various academic positions at Lausanne University, Switzerland, including Head of the Laboratory Department and the Clinical Chemistry Service at le Centre Hospitalier Universitaire Vaudois (CHUV) and Vice-Dean of Clinical Research at the Lausanne University Faculty of Biology and Medicine. He spent a distinguished decade within GlaxoSmithKline (GSK) R&D in Philadelphia and co-founded the CoLaus study – a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome.

In this interview with the McGill Reporter, Dr. Mooser discusses the incredible potential of genomic research; its challenges and risks; and the vital partnership between academia and industry needed to develop and deliver new drugs to the market. He also discusses his ambitious vision for the new Canada Excellence Research Chair in Genomic Medicine, and what he hopes to build at McGill.

What exactly is gene sequencing?

In simple terms, the genome is the material we get from our parents which makes us unique.

Essentially, the genome is a very large book – although it is substantially bigger than a book. It is the equivalent 1,000 Bibles.

But instead of 26 letters there are four letters – A, C, T and G. Genome sequencing means reading the entire book of three billion base pairs in order to make a complete sequence of these ACTGs.

These ACTGs determine who we are, in part. They determine, partly, our health, our susceptibility to diseases and the way in which we respond to drugs.

How is gene sequencing changed our approach to medicine?

Understanding our susceptibilities helps us better predict, diagnose and prevent diseases; and it allows us to detect diseases earlier so that we can cure them before they are in advanced stages.

All this information also allows us develop new drugs.

These promises – prediction, prevention, and production of new therapies – have already been delivered since the first human genome was sequenced in 2001. But there is potential for so much more.

What promise does personalized medicine hold?

Personalized/precision medicine is a very vague term and entails the capacity to adapt patient care according to his or her individual characteristics.

Genomic medicine is a subset of precision medicine whereby we use the genetic makeup of individuals to tailor the healthcare specifically for them.

Can you give us some examples?

We use information from a person’s genome to better predict diseases. An example of that would be BRCA1 sequencing. If the sequence of a gene called BRCA1 is mutated, it can predispose women to develop breast cancer. This is a genomic application: prediction.

Then there’s prevention. We all know the story of Angelina Jolie, who took preventive measures because a genome analysis predicted she had a high risk of developing breast cancer.

The third application is tailored therapy – pharmacogenetics, for example. Pharmacogenetics is the use of genetic information to reduce the risk of adverse side effects when a person is exposed to a new drug.

An example of this is abacavir. Abacavir is an HIV drug which, in three per cent of the people, leads to a bad reaction called hypersensitivity reaction. We now can avoid this by doing a simple test to identify the people who carry this anomaly before they are exposed to this drug.

What are some success stories for genomics?

Genomics science has really made a big contribution so far in two areas. The first is in oncology.

Now the very diagnosis of cancer relies not only on histology, making microscopic analysis of the tissue, but also on the DNA changes of the tumour. As well, the second line therapy treatment for some cancers is now based on the genetic makeup of the tumour.

Another area where genomic sciences have made a big impact is in rare diseases.

Until recently patients with a rare disease faced all kinds of uncertainty. Sometimes it would take years for doctors to put a name on a particular disease, because the molecular basis of the disease was not known. They knew that something was wrong but had difficulties in proper diagnosis.

Now, when a doctor has a patient in which they suspect something is wrong, they can immediately sequence the genome and find the molecular cause – the molecular proof – of the disease and make the right diagnosis. It’s a real revolution in patient care.

What’s next for genomic medicine?

The next challenge for genomic medicine is common chronic conditions, noncommunicable diseases.

In developed countries these noncommunicable diseases – such as arthritis, depression, COPD, asthma – eat up to 80 per cent of healthcare resources.

We know that, generally, half of these diseases is caused by the environment and the other half by the genome. But it isn’t a single gene that is responsible for these diseases, it’s a series of many genes which together predispose people to develop these diseases in a particular environment.

The challenge now is to use genomic medicine to address – and help alleviate – some of these common chronic conditions.

Why did you choose McGill?

In all honesty, it was a very difficult decision. I’m happy in Switzerland and I’ve been successful in Switzerland.

At the same time, this really is a rare opportunity. I think the environment at McGill, with the affiliated hospitals, is optimally positioned for this effort. It has the people. It has the patient population. It has the laboratories. It has the IT infrastructure. It has the clinical research centre. It has the institutional willingness to succeed.

Everything is here, it’s just a question of catalyzing the synergies. I think I have the capacity and experience to make that happen.

My dream is that, by the end of seven years, we have built a platform here in Canada – at McGill in particular – whereby industry, Pharma, biotech and academia will be working together seamlessly.

I should also mention, however, that none of this would have happened if not for my wife. She was the one who encouraged me to apply. She said to me ‘I will follow you to Montreal if you get this job.’ [Laughing] She’s the one who made this happen.

How important is the partnership between academia and industry?

It is absolutely vital.

The outcome of our efforts will take two shapes: diagnostics and therapies.

Diagnostics are usually discovered by academics but developed and marketed by industry because it is very hard, very expensive and very risky to put a diagnostic marker into the market. Only industry can do this.

It is the same thing for drugs. Lots of drugs are identified in small labs and biotechs. The full development, which usually costs between one and $2 billion, is a very risky endeavour. Academia does not have the shoulders to carry this risk, so, the risk must be shared.

So, potentially we are speeding up drug discovery in a significant way?

Absolutely. The CERC is for seven years. We have a very specific objective – how can we use genomic sciences and the capabilities of McGill and associated institutions, to support the process of discovering and developing new drugs.

I think with this CERC we have the potential to have an impact on the way drugs are developed. I am confident it has the potential to improve probability of success; and to make this process faster and potentially cheaper. Most importantly, at the end of the day, patients will have better, more timely, access to new therapies.

You’ve been doing this for 25 years. What keeps you motivated?

We are at the dawn of something really big in medicine and I want to be a part of it.

[Laughing] It would be horrible to retire and miss out. I want to make my small contribution to the greater effort and make things happen.

How do you see the role of the mentor?

All my life I’ve been very lucky. I’ve worked on four different continents and I’ve had wonderful people train me, challenge me, grow me and guide me.

I’ve also been lucky to be in the position to help others develop. At this point in my life, everything we build and any success we may enjoy is really for the institution and the next generation. The future is the next generation.

The fact that my vision has been validated by the CERC people tells me that we are on the right course. Now we have to find the right talent – people who really have the appetite for building something big and important that will continue after we’re gone.

What are your impressions of Montreal and McGill?

One thing that has really impressed me is the collaborative spirit, which is absolutely essential. The challenges we are facing are so big that there is no way a single lab can address them. We need to collaborate, to combine our resources, forces and knowledge in order to reach our common goal. I see that spirit here in the City and at the University. It’s very exciting.

With files from Katherine Gombay