JPND Scientific Advisory Board Member (2013-2014) – representative of GE Healthcare 

It is widely acknowledged that we need new diagnostic solutions to identify Alzheimer’s patients, in particular those in the early stages of the disease.  You are in charge of GE Healthcare’s efforts in this area. What is your approach?

GE Healthcare is committed to developing tools that improve diagnostics in clinical practice. From a technology stand-point, our approach is very broad, with developments in imaging (e.g. MRI scanners, PET scanners and tracers, image processing) and non-imaging tests. For its research, GE Healthcare often partners with other public or private organizations. A couple of examples: the first one is an active collaboration with a major pharmaceutical company to research a non-invasive test for pre-clinical Alzheimer’s; this may serve as a stratification tool for clinical trials, and in the long term as a potential screening test if effective treatments are developed for this disease state. The second example is a European FP7 project called predictAD; this project assessed how to combine a variety of biomarkers and tests to improve diagnostic accuracy of Alzheimer’s disease.  In addition to products, GE Healthcare is also developing diagnostic solutions by using Information Technology to aggregate information of interest. As demonstrated by the predictAD project, this could be particularly relevant for conditions such as Alzheimer’s disease for which diagnosis requires the combination of clinical information, neuropsychological tests, blood tests and imaging data.

What area of medical devices gets you really excited for the future diagnosis of Alzheimer’s disease?

The first one is PET molecular imaging which can enable the in vivo detection of proteins related to a neurodegenerative conditions like Alzheimer’s disease. The two neuro-pathological hallmarks of Alzheimer’s disease (amyloid plaques and neurofibrillary tangles) were identified more than 100 years ago, but until very recently they could only be seen post-mortem if an autopsy was conducted. PET imaging now enables the detection of amyloid plaques in-vivo, with one tracer already approved in the US and EU, and others under regulatory review. The availability of amyloid PET imaging has the potential to improve diagnostic accuracy in clinical settings, but it can also contribute to improving clinical trials by helping to identify a homogeneous patient population at a very early disease stage. Recently, there have also been very interesting developments in tau imaging, which could help select a therapeutic target by evaluating its impact on this disease hallmark. PET imaging brings high sensitivity and specificity, but it needs to be complemented by tools available on a larger scale, perhaps as entry-level tests in a diagnostic funnel. I am excited by the research in blood biomarkers which has the potential to improve diagnostic accuracy in primary care.

What needs to happen before we can successfully treat the individual causes of neurodegenerative diseases?

What we need is very well described in the EU JPND Research Strategic Agenda.  I would highlight that before we can successfully treat Alzheimer’s and Parkinson’s diseases, we need an accurate understanding of each disease etiology to be able to select appropriate therapeutic targets. As exemplified by JPND, collaboration between multiple stake-holders, funding bodies, public and private organizations, etc. is important to achieving the goal of treating Alzheimer’s and Parkinson’s diseases.

Why do you think there has been so little progress, if any, in developing a drug that can slow disease progression?

Neurodegenerative diseases have extremely complex pathophysiology, so it may be very difficult to have a major impact targeting a single feature. Also, clinical trials to date have mainly been conducted at the dementia stage of the disease, while therapeutic targets might have had a greater impact much earlier in the disease process. New clinical trials are now designed to investigate the impact of earlier interventions, for example in the prodromal stage (mild symptoms), and even in the preclinical stage (very subtle symptoms).

In your opinion, what would be the benefits for GE Healthcare of partnering with JPND?

Partnering with JPND can further expand GE Healthcare’s ability to be connected with the external research community, and may improve its capacity to innovate.   In general, we see a lot of value in developing eco-systems where different partners join forces to tackle challenging problems, each bringing its expertise and maximizing chances of success. This can be a lower risk and more cost effective way to drive progress.