2012 Panel Discussion - Questions and Answers

Wrap up

Can each of you take a final few minutes to tell us where you think genome sciences, its research and clinical uses, will be in 5 years? 10 years?

Variations on the following quote, commonly attributed to Bill Gates but actually of much earlier origins, are ubiquitous on the web:

“We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don't let yourself be lulled into inaction.”

These sentiments undoubtedly apply to genomics, as well as many other facets of life. Change in both the basic science and in practical applications will probably seem modest over the next few years. However, at some point, people will have trouble imagining a time when individuals blithely lived their lives with no knowledge of their genome sequences. Guessing the time scale for this transition is impossible.

Over the next few years, we will finally seriously engage the full complexity of genotype-phenotype correlations in humans (i.e., we will at least scope out the variety of ways in which idiosyncratic genomic variants affect the biology of individuals). Early indications are that the complexity is staggering: mutations in hundreds of genes can, under the right circumstances, have a major influence on particular traits. Within each of these genes, there is a huge number of different, functionally important variants in the population. Given the complexity of the problem, I expect to see much research shift away from attempting to predict phenotype from genotype. Geneticists will go back to what they have always done, which is to identify particular genotype-phenotype links that are scientifically tractable and of particular basic or practical interest. Out of this activity, new approaches to treating many diseases will emerge. However, the path toward actualizing these improved treatments will remain long. Intervals of 10-20 years between basic discoveries and new pharmaceuticals will remain common. In parallel, new approaches to crowd-sourcing studies of genotype-phenotype correlations (e.g., following millions of people over decades during the ordinary course of clinical care) will chip away at the genotype-phenotype problem. Predictability will improve and the number of situations in which early interventions are available will increase. We just need to stay the course, keep the public on board, address the corollary ethical, legal, and social issues, and maintain some confidence that, together, we actually can make the world a better place.