It might surprise some to learn that Delaware is a leader in the gene-editing technology CRISPR (that’s clustered regularly interspaced short palindromic repeats), but to Dr. Eric Kmiec, director of the Gene Editing Institute at ChristianaCare — the only gene editing institute in the country embedded in a community cancer center — the small, diverse state is ideal.
“Delaware is the health laboratory of the country,” he told Technical.ly. “We have the [population] percentages of minorities that are reflected in the nation, so we take advantage of that here, and build the technology based on the diversity of the population. We consider that to be a critical part of developing this breakthrough technology.”
It’s not the way the field often works.
“A lot of my colleagues [in other areas of the country] develop these great things and then have to apply them to the diverse population,” he said. “Here, we don’t do that. We start with a diverse population and build out technology on that platform. It’s more challenging, but that’s one of the great things about Delaware.
The Gene Editing Institute started four years ago, when Kmiec decided to leave his position as professor of biotechnology after 12 years for the clinical setting of ChristianaCare’s Helen F. Graham Cancer Center & Research Institute. His lab group got the invite to come into ChristianaCare by its medical director, Dr. Nick Petrelli, as well as support from President and CEO Dr. Janice Nevin.
“It has changed the way we look at everything,” Kmiec said. “We are down the hall from oncologists who are treating patients, we are two floors above the chemotherapy suite, we are seeing patients coming and going and we also now are broadening into other sections of the hospital to look at cardiovascular disease and infectious disease.
“So while it’s wonderful to be at a university as great as [University of] Delaware and I cherish those times — I’m actually still a faculty member there — if you want to get into applying your technology to patients, you have to be embedded in a cancer center or a health system. It’s easy to see them too simply when you’re in a basic science lab.”
"Most breakthrough technology developed rarely reaches minority communities. We are going to break that."
At the cancer center, Kmiec and his team currently focus on using CRISPR to improve quality of life for cancer patients — something they found oncologists looked for when treating patients.
“Most drugs at universities are developed from the top down,” said Kmiec, “which almost never works, but it’s a continuing model. We do it differently. We came in and spent a long time talking to oncologists here about how we could we help them, not how they could help us by recruiting patients for clinical trial.”
What his team heard is that treatment can feel almost as hellish for patients as the cancer itself — and not just for chemotherapy, but even immunotherapy, which Kmiec called a breakthrough.
“They told us that if we could reduce the amount of chemotherapy that some of our patients take, particularly in lung cancer or esophageal cancer, that would improve their quality of their life, so that’s where we began,” he said. “A patient who is on chemotherapy often develops a resistance to that treatment — it’s often effective up to a point, then what happens is the body rejects the chemotherapy. There are a lot of genetic reasons for that. CRISPR is being used by us to knock the genes out that prevent chemo from working.”
Meaning that CRISPR, at this point, isn’t directly curing cancer, but is injected into patients as part of a larger treatment plan.
“We want to make sure we set out goals on achievable endpoints,” Kmiec said. “In the future, it may be that it’s a preventative, it may become its own treatment. But we keep our expectations realistic and it’s an organic thing from the bottom up, because we’re listening to the oncologists.”
In the future, gene editing will become less of an unusual job, and it’s not as far away as some might think. Thanks to a partnership with Delaware Technical Community College, students have been learning gene editing in accessible and affordable associate’s degree programs that will prepare them to be the “next wave” of research technicians, using some of the tools and systems developed by Kmiec’s team.
“That program really started organically,” he said. “I picked up the phone and called and John McDowell, head of the [Del Tech] biotechnology program, and he said, ‘That’d be really cool.’ We worked on it for about a year and brought it to the National Science Foundation and they awarded us a million dollar grant. Oddly enough, our grant, while it is heavily for science, actually turns out to be a workforce development grant because they believe that kids who know how to do this technique will be picked up by hospital systems, pharmaceutical companies, universities — and the metrics have been really good on that.”
Such programs help with what Kmiec stresses is a vital part of CRISPR development: diversity and inclusion.
“It must reach minority groups,” he said. “Most breakthrough technology developed rarely reaches minority communities. We are going to break that. We are dedicated to moving CRISPR so that everyone who needs treatment with CRISPR or education with CRISPR will have that afforded to them.”
So, while some of the goals for CRISPR in the coming future involves the technology itself, “it’s bigger than just the technology,” he said.
“One of my objectives has been to get it into the school districts” — think gene-editing education programming for high school students.