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Since then, the company has tested preclinical and clinical trial samples from more than 400 companies. “They continue to come back after finding biomarkers for unintended or intended consequences,” Benson says.
Working together, Myriad and Myriad RBM are helping investigators with studies that may identify the molecular mechanisms behind disease, and reveal differences between patients with the same outward symptoms. Using this data, drug developers seek to identify the patients most likely to benefit from therapies targeted at specific disease mechanisms. They can also try to eliminate those least likely to benefit in clinical trials of an experimental drug.
The ultimate goal of this molecular-level diagnosis is called personalized medicine or “precision medicine”—the use of treatments tailored to each individual’s disease state, not to a catchall diagnosis.
NIMH director Insel is advocating this type of approach for the physically based mental disorders known by terms such as schizophrenia, bipolar disorder, and major depressive disorder. Guided by the DSM, psychiatrists now diagnose these brain disorders by observing behaviors such as disordered thinking, loss of emotion, and hallucinations. But patients with these varied diagnoses can have similar symptoms, and their diseases may share some of the same root causes in genetic variations.
As Insel said in his April post, NIMH now plans to support research that zeroes in on specific symptoms and their related biomarkers, no matter what traditional diagnosis patients have received. But he acknowledged that biomarker-based diagnosis is still only a goal in psychiatry, because robust tests have yet to be commercialized.
Myriad RBM is working on it, along with other disease diagnostics. Benson says most illnesses can be traced to the DNA code of an individual as well as the pattern of proteins produced by that individual under the influence of the environment and other factors that affect gene expression. He says Myriad RBM’s protein screens and Myriad’s gene-based tests can help pharmaceutical companies to learn more about how their drug is metabolized in the body, predict significant side effects, find new uses for old drugs, and possibly get a failed drug back on track by identifying the right patient population for it.
Myriad RBM customers can pick cafeteria-style from a selection of standard protein tests that are useful for general discovery, or choose specialized panels for research in specific diseases. Clients can also order customized combinations of several multiplex panels to evaluate their samples. The tests are run at RBM’s lab in north Austin, which employs 100 workers. The Myriad subsidiary also has product development and manufacturing units at Saranac Lake, NY, and Reutlingen, Germany.
Myriad RBM contributed $23.6 million to Myriad’s $496 million in revenues for the year ended June 30, 2012. The RBM acquisition also gave Myriad access to new sets of patient samples as it develops its pipeline of molecular diagnostic tests, the parent company said in its 2012 annual report.
The Texas subsidiary is moving toward commercialization of its own clinical diagnostic products, including companion diagnostics for new therapies in development by its pharmaceutical company clients.
Among the tests in the works are biomarker assays to show molecular-level differences between schizophrenia and bipolar disorder. Another experimental test makes distinctions between bipolar disorder and major depressive disorder.