The Taliaz Health Corporation analyzes databases and customizes medicines according to genetic characteristics, Emedgene has developed a system that aids diagnostics and, at Nucleix, cancer is identified according to DNA. The Israel Innovation Authority is supporting pioneering Israeli companies, active in the field of personalized medicine.

"In the future world of medicine, every person with health insurance will have his or her own clinical and demographic genetic probability profile," declares the scientist Dr. Dekel Taliaz, founder of the Taliaz Health Corporation. "In the not so distant future, every one of us will have his genomic chart stored in the cloud. As soon as it is in the cloud, the technology we have developed can analyze vast amounts of data and produce individual medical value. Not just about the appropriate treatment, but also regarding the future probability of each of us to contract a particular disease and how to prevent it."

"Health systems will use statistical probability to predict the future medical problems in public health, to implement wiser investments and to focus on more efficient prevention and treatments," says Taliaz. Furthermore, “in Israel, a conservative country with regards to the field of genetics, authorization has already been given for hospitals to begin the assembly of a bio-bank.”

Dr. Taliaz and his team at Taliaz Health have developed an advanced technology that uses unique algorithms to analyze large genetic and clinical databases gathered from a large number of sources. The company, operating in the field of personalized medicine, focuses on the customization of effective drugs for brain disease. The company's unique expertise lies in research of neuroscience and the central nervous system which, combined with innovative technologies of genetic sequencing, known as Next-Generation Sequencing (NGS), and calculative learning, accords it a significant advantage in the development of solutions for diseases related to the central nervous system and neuropsychiatric disease.

An innovative test developed by the AlgoSight Corporation is designated to assist the doctor in choosing the best and most efficient anti-depressant treatment for each patient according to his own unique genetic, clinical and demographic characteristics. Dr. Dekel Taliaz, who received his doctorate in neuroscience from the Weizmann Institute, began developing the test while completing his post-doctorate at a children's hospital in Toronto. A team of algorithmists, geneticists, and psychiatrists recruited by the company succeeded, within a short period, in demonstrating a significant improvement in the capability to customize anti-depressant treatment for the patients already from the first prescription. This achievement that transformed it into the only such commercial technology in existence today has been validated vis-à-vis the large global databases in the fields of depression. 

"We examined the predictive capability of AlgoSight versus the world's largest database in the area of depression – the STAR*D," explains Dr. Taliaz, "and we succeeded in proving that our algorithm predicts a reaction to treatment with anti-depressants in approximately eight out of ten patients. That is significantly higher than the current chances of success."

Since its inception, Taliaz has enjoyed the close support of the Israel Innovation Authority and the Ministry of Economy and Industry, including some grants that have enabled the company to establish and advance its research and development. Also, conferences conducted in Israel and overseas alongside meetings with global corporations have allowed Taliaz exposure to investors and other interested parties.

 

Diagnostics Within Minutes

The Emedgene Corporation enables clinical interpretation of patients' genomic data within only a few moments. This capability, compared to the current period of hours or even days, allows clinicians to make the correct therapeutic decisions for the unique genetics of the patient.

Einat Metzer, the company's CEO, and founding partner tells of the development in the field and Emedgene's contribution: "The last decade has been one of the breakthroughs in the area of genomics, in part by state-funded research in the field and also due to a decline in sequencing costs. There is a huge number of discoveries of a large clinical significance for the patients. The current estimate is that more than 80% of the population bears a unique genetic change that exists in only a small number of other patients. The medical world is undergoing a revolution with the gradual understanding that genetics is a fundamental element in the making of therapeutic decisions. Systems that analyze the unique genetic profile of each one of us will in the future become an integral part of every facet of medicine."

"Our company," says Metzer, "provides a decision support system for the performance of diagnostics and treatment of genetic syndromes. Using artificial intelligence technologies, learning algorithms, and revolutionary scientific methods, the platform enables geneticists and clinicians to provide accessibility to advanced genetic medicine at treatment points and helps to bridge the gap between current scientific knowledge and practical possibilities in the clinic."

"It is true that we can sequence an entire genome at a significantly lower cost than in the past. However, the clinical interpretation of the patients' genetic data is still largely unknown. The clinical description constitutes a bottleneck in the capability to improve accessibility to advanced genetic medicine. To date, there are only a few hundred genetic experts in the United States who possess the expertise and knowledge necessary to perform clinical interpretation. The process requires knowledge in a significant number of disciplines, and consideration of hundreds of facts from dozens of information sources."

"Emedgene's system simulates the genetic expert's decision-making process and identifies with high accuracy those genetic changes suspected of causing disease. Furthermore, it also increases accessibility to the scientific and clinical references that support the decision. This system has dramatically shortened the diagnostic process from a geneticist's entire working week in a laboratory to a few short minutes for a clinical geneticist or clinician at the point of treatment. Computerized clinical interpretation is a new category that is almost entirely devoid of competitors – clinical interpretation using a computer."

The company recently won a tender of the Ministry of Health and was chosen to provide advanced genetic solutions for the entire country. "Israel is a wonderful place to conduct such an enterprise," says Metzer, "among others, because of its unique demography that includes such a wide genetic variety, its advanced health services, its health system's sophisticated IT infrastructure, and the unique structure of its medical services. The data, experience, and the case studies accumulated within the framework of the enterprise will assist the company in positioning itself as the field's international pioneer."

"There is great importance to the Israel Innovation Authority's choice of this area as the focus of particular attention. Israel has the potential to be an international leader in this field by virtue of its academic leadership in bioinformatics, molecular biology, and genetics, in addition to its advanced level of medicine. If we succeed in diverting sources of finance to the field, it will be possible to establish Israel as the center of an entire industry."

 

From the Crime Scene to Cancer Identification

The extent to which the advantages of personalized medicine may be expressed can be seen in the case of the Nucleix Corporation.

Dr. Adam Wasserstrom, one of the three founding entrepreneurs of Nucleix, tells of the early stages: "When we established the company, we worked initially on an innovative project in the field of criminal identification. We came to the realization that on-site criminal DNA evidence can be falsified and we developed a method for ascertaining whether certain DNA traces are genuine or falsified, in other words, whether they originate from the physical body or were synthesized in the laboratory. The method developed leads us to our field of expertise – DNA methylation. During the next stage, we developed a test for cases of suspected rape that identifies whether or not a sample comes from real sperm. The test works fantastically well, faultlessly. However, we made a business decision to place that development on hold when we realized that this ability to identify tissues via methylation analysis could also be utilized to identify cancer. We immediately decided to harness our knowledge toward this objective."

"In general, the DNA sequence in all the cells of our body is almost identical. DNA Sequence identity leads to the question as to how different cells function differently if all the cells contain the same DNA. The method created is where the methylation enters the picture – this is one of the body's methods for providing different identities for different types of cells. In essence, this is a layer that sits above the DNA. CH3 molecules that sit on the letters 'C' in the genome that precede the letter 'G.' Each tissue possesses a unique methylation pattern."

"In cancer, there is a massive disruption of the methylation pattern: areas that were previously methylated become unmethylated and vice versa. To identify cancer, we need to overcome two challenging obstacles. The first is to determine cancerous molecules that comprise a significant minority compared to healthy molecules. A susceptible biochemical method is required to determine the cancerous DNA. We have succeeded in developing the method that, to the best of our knowledge, is the most sensitive in existence: we are capable of identifying one cancerous DNA molecule out of a background of 150 thousand healthy molecules."          

"The second part of the equation is also to know where to look: you have to identify the informative signs that tell us whether a person is sick or healthy. Here we are faced with a giant-sized genome with more than 28 million potential signs of methylation, and we have to decide which to look at."

"Most of the areas in any person's genome, both healthy and sick people, are methylated, and we search for unmethylated signs in healthy people and methylated signs in sick patients to be able to distinguish between them. If there were an ideal indicator (biomarker) that was unmethylated among the entire healthy population and a methylated indicator among all the sick people, we would be able to identify cancer in 100% of cases. Unfortunately, there is no such biomarker. Therefore, because a single biomarker is not sufficient, we need to construct a panel – a group of biomarkers. This task is mainly bio-informatic, and that is something we know to do well."

"A few weeks ago, Nucleix completed a large clinical trial in Europe for our first test – a urine test for detecting bladder cancer under supervision. These are patients who had cancer in the past and were treated and are now tested to ascertain whether cancer has returned. We received European regulatory authorization (CE) and will soon begin selling the testing kit to laboratories. There is already a range of other molecular tests however our results are better than any other such test on the market."

"Another of our developments is a blood test for detecting lung cancer. In contrast to bladder cancer, lung cancer is the second most common and the most fatal of all cancers. In the majority of cases, lung cancer is detected at too late a stage, when it has already spread, and it is impossible to save the patients. If it were possible to detect the disease in its infancy, while still localized, there would be a much higher chance of saving them."

"A tremendous need exists here for a test that can identify cancer at an early stage. Our test is still under development, but we have received very promising results. We intend this test to be a genetic screening test for older people and smokers. Unlike tests for patients under supervision, genetic screening is conducted for individuals with no previous history of cancer and with no symptoms. We believe that we can identify many cases of cancer during its early stages, thereby saving many lives."

 

What Next?

Aharon Aharon, CEO of the Israel Innovation Authority, summarizes the significant challenge posed by the field of digital medicine: "The vision of personalized medicine is to distance ourselves from the traditional perception of medicine treating as though 'one size fits all.' Instead, progressing towards a direction of personalized medicine - a 'personal health suit' customized for the needs of each patient. Such a suit will take into consideration the entire spectrum of parameters influencing the efficiency of various treatments for the patient: genetic, biological, behavioral and environmental."

"Personalized medicine has the potential to dramatically enhance the quality, efficiency, and safety of the medical treatment and services available to the public."