Today at the 2017 Research Day ofUniversità Campus Bio-Medico di Roma experts and scientists discussing the future of medicine from the "5 Ps"
Photos of the event freely downloadable
Rome, May 17th – Surgical robots that are increasingly smaller and capable not only of operating with greater precision, but also of predicting and preventing diseases. Translational technologies and tools capable of detecting and analyzing the individual response to drugs. Genetic and epigenetic biomarkers able to improve the appropriateness in the diagnostic and therapeutic field. It is the medicine of the "5 Ps", capable of rewriting the battle against disease. “P” for Precision, but also Predictive, Personalized, Preventive and Participatory.
The new frontiers for human health were discussed at the annual Research DayUniversità Campus Bio-Medico di Roma, this year dedicated to 'Innovation and Technology for human health'. Two great scientists in the field of robotics and pharmacology opened our eyes to the world progress of precision medicine: Garret A. FitzGerald, Professor of Translational Medicine at the Perelman School of Medicine, University of Pennsylvania, in USA, as well as Chief Scientific Advisor di Science Translational Medicine, and Guang Zhong Yang, founder ed editor of the magazine Science Robotics, as well as director and co-founder of theHamlyn Center for Robotic Surgery at l 'Imperial College in London.
The future of surgical robotics
"Surgical robotics, in these 25 years, has evolved from a niche research to an area of greatest development in the field of medical engineering, so much so that in 2020, an investment in the field of surgical and diagnostic robots is expected to be 17,9 billion dollars, with an annual growth rate of 13 percent", has explained Guang Zhong Yang, according to which "the commercial success of the first surgical robots has inspired new smaller, safer and smarter devices, which aim to explore the human body with ever greater precision to predict and prevent disease". "By now Yang continued. robots are being designed with arms the diameter of a hair, capable of seeing inside and under the organs, able to examine cells without the need for biopsies, in order to obtain ever earlier diagnoses". "The trend of the future - he concluded - is that of robots on a nanoscopic scale, specialized in single types of intervention and which begin to make decisions, perhaps by reacting to the surgeon's visual commands only, which however cannot be replaced".
Despite some resistance and considerable costs, there are currently about 90 surgical robots operating in Italy. Over 1999 patients have been operated on since 70 and the numbers are constantly growing. The main advantages of robotic surgery are the ease of access to difficult anatomical areas, the three-dimensional view of the operating field (the surgeon is 'immersed' in the patient's body) and the small incisions which allow for a shorter hospital stay. The most important limit, especially in times of scarcity of resources like the present, is thehigh cost of the equipment, which is between 2 and 3 million euros, to which must be added the annual maintenance expense, around 100 thousand euros. An investment that is justified only with full-time use.
The business shortens the time for animal testing, which then fails by 90 percent
Also "the emergence of translational tools and technologies relevant to the analysis of the variability of patient response to drugs hold promise for precision medicine", he highlighted Garret A. FitzGerald. "The challenge – said the scientist – will now be to ensure equitable access to the benefits of these advances within the current medicines business model". "A model that – according to FitzGerald – pushes towards a more rapid overcoming of the preclinical phase and the carrying out of phase one and phase two of human trials on ever smaller numbers of patients, in order to bring the time to market closer”. And this, according to the discoverer of the cardiological use of aspirin, represents a problem. “So much so that only 10 percent of trials in phase one are successful and access the next phase”. In short, "too much haste driven by business hurts research".
But the pricing model also needs to be reviewed. FitzGerald showed price charts for cystic fibrosis therapies at $750, cancer therapies at tens of thousands of dollars a month. How political is the criterion that determines the price of new drugs, for the scientist, is demonstrated by the fact that "the average monthly cost of new cancer therapies is $8.694 in the US and $2.587 for the same drugs in the UK”. From here "the need for states to adopt outcome-based drug reimbursement policies".
The Research Projects ofUniversità Campus Bio-Medico di Roma
But the Day also allowed the Vice Rector for Research, Eugenio Guglielmelli, to take stock of the state of the art of research intoUniversità Campus Bio-Medico di Roma. A special mention went to three projects.
The one made by belongs to the chemical engineering area Marcello De Falco, UBCM professor of Industrial Engineering, which has created a storage device applicable to air conditioning systems to allow energy savings of 20-30 percent. A work that earned the teacher the award of 'Best Paper' within the ICMSET 2016 – International Conference on Material Science and Engineering Technology, held in Phuket, Thailand from October 14 to 16 last year.
In the field of oncology there are two researches conducted by Daniele Santini, full professor of Oncology atUniversità Campus Bio-Medico di Roma, which have achieved international recognition. On a clinical level, it is one that allows us to trace the natural history of solid tumors with metastases. “A research Santini explains. which will allow for a better understanding of the efficacy of new drugs in the treatment of bone metastases”. The other branch, the translational one, “evaluate the effects of new drugs on the bone micro-environment and on bone metastases not yet visible. This occurs thanks to in vitro co-culture models of pre-tumor bone cells – explains the professor – that mimic the neoplastic niche, i.e. metastases not yet detectable".
Also noteworthy is the work of Mauro Maccarrone, UBCM professor of Biochemistry, carried forward with theHarvard Medical School and the Santa Lucia Foundation IRCCS and published in Science Translational Medicine, concerning the resolvins, those molecules that regulate the final phase of an acute inflammatory process, repairing damaged tissues and thus restoring the body's good health. The hypothesis - confirmed by analyzes on laboratory models - was to verify the possible efficacy of resolvins also in correcting those defective immune processes which lead to a state of chronic inflammation and even to self-aggression of one's own tissues, as in the case of chronic inflammatory or autoimmune diseases. Now the experimentation is continuing on blood samples from patients suffering from multiple sclerosis, with the aim of moving on to tests on three human subjects and of arriving at the development of a new therapeutic protocol in three years.
Finally, the new objectives for the next three years, the subject of an internal tender which will be launched during the year and which will allow the new lines of research to be projected onto an international dimension. The first concerns the "biomarkers for precision medicine”, genetic and epigenetic, able to improve the appropriateness and therefore the effectiveness and economic sustainability, of diagnostic and therapeutic approaches, mainly of oncological and onco-haematological diseases.
The second project is that of “Hospital 4.0", With health services centered on the person and based on the high digitization and automation of health processes. A new hospital model, also distributed throughout the territory, which takes advantage of all the emerging smart technologies: miniaturized sensors, wearable devices, advanced robotics, data storage systems and anything else needed to improve the effectiveness and sustainability of treatment for chronic and acute, but also to promote prevention and active ageing.
