News

Genes Guide Drug Therapy

[ The University of Melbourne Voice Vol. 3, No. 7  8 September - 13 October 2008 ]

By Rebecca Scott and Genevieve Costigan

Macedonia-born Slavé Petrovski grew up in St Albans fascinated with science.

Interested in genetics and “naturally good with computers”, he obtained top marks for VCE Biology and Accounting and revealed his study strengths. When combined later in life, these would earn him several accolades.

“There were many years when I didn’t know where my studies would take me but it all just kind of fell into place,” says Slavé.

He went on to study for a Bachelor of Information Systems / Bachelor of Science (Genetics) at the University of Melbourne. But it was receiving a scholarship to attend Lund University in Sweden to study a Bioinformatics Masters Course that focused his attention on the use of computers to assist in treatments for human illness.

“I had the chance to learn with experts in the areas of bioinformatics which is an emerging area in Australia.”

It was when he returned to Australia and began an honours year under the joint supervision of Dr Cassandra Szoeke and Professor Terence O’Brien in the Department of Medicine at the Royal Melbourne Hospital that he was able to apply his knowledge in patient care.

Petrovski brought his unique skills to a project investigating pharmacogenomics (the tailoring of a medicine regime to take into account the particular genetic make-up of a patient) in epilepsy treatment.

What developed was a computer model which may predict the outcome of drug treatment on epileptic patients. Petrovski says that although the model was developed for epilepsy it is generic and can be used for other conditions.

“Ultimately this is about determining how drugs work on individuals which one day could mean tailored treatments dependent on our own genetic make up.”

His work forms a major component of a patent application which has sparked significant interest from international biotechnology and medical diagnostics companies.

“This project is of major international significance for the field of pharmacogenomics as it is the first time such a model utilising multiple genetic markers has been applied to successfully predict the outcome of drug treatment for any disease,” says Professor O’Brien. “It represents an important step on the road to the development of clinically useful biomarkers of treatment outcome.”

Petrovski developed a computer methodology to identify predictive genetic markers from more than 4000 possibilities. It has the potential to identify important genetic determinants of many diseases and their treatments.

“What was really new in our approach was that we decided to look at how a combination of genetic markers could collectively influence treatment outcome rather than relying on individual genetic markers,” he says.

“Also unique to our study was that our cohort of patients was newly-diagnosed so they hadn’t been on anti-epileptic medication before recruitment. This is important as the fact that the patients have previously never been exposed to anti-epileptic medication allows us to control and look at the specific effects of the various anti-epileptic drugs.”

Patients were followed up at intervals of three months, then at one and two years to determine drug efficacy and what side-effects the patients had experienced on the medication, such as weight gain, skin rashes and neurocognitive side-effects like depression, anxiety, memory loss, and lack of concentration.

“The ultimate benefit of this line of research and model is that a patient could turn up at a hospital, have a genetic test run which would predict whether they are likely to respond well to treatment with a particular medication and then the most effective drug treatment and care regimen could be tailor-made to the patient’s individual genetic make-up.”

It was this research which won Petrovski a place on the Deans Honour roll for his efforts in 2007 and recently the prestigious Larkins prize, an award granted annually to the top achieving honours student in the Department of Medicine (Royal Melbourne Hospital).

This year he has embarked on a PhD in Bioinformatics: Application of Pharmacogenomics to predict epilepsy treatment outcomes, supervised by Professor Richard Huggins (Mathematics and Statistics). On his budding research career, 24-year-old Petrovski says ”It’s about following your passions and although it may not be clear at the time – research can have very rewarding outcomes.”