Alisa Gaskell: Leading Precision Medicine Work as Chief Genomics Officer

Long before stepping into the role of Chief Genomics Officer at Children’s Hospital Colorado, Alisa Gaskell was studying for her PhD in Liverpool. Her work focused on a bacterium called streptomyces — an organism involved in producing many of today’s antibiotics.

Streptomyces has an unusual growth cycle. Instead of dividing, it grows long filaments like a fungus, before popping up fuzzy structures that divide into spores. It grows in phases, making it particularly useful in understanding how genetics change over a lifespan. Dr. Gaskell’s work studied how oxygen levels in the bacterium’s growth environment impacted its DNA. In doing so, she opened her mind to new questions and pathways that still influence her work today.

“The bacterium only had two stages, and we have multiple stages, but you can think about all the number of mechanisms and pathways that have to be timed exactly right for us to be fully functional,” Dr. Gaskell, PhD, explains. “No human is an island, and truly our genome is not on an island. It is very receptive to the environment. It's very receptive to everything that's around us. And I think that that really put me on the track of mapping and understanding how that interaction drives functionality.”

At the time, sequencing capabilities had not yet reached the level of sophistication and precision it has today. The human genome had just been sequenced for the first time, and Dr. Gaskell’s work required making informed guesses as to which region of DNA was activated.

“You would make these really big gels, radiolabel the DNA and then use a current to separate the DNA and be able to read really long films,” she recalls. “You would have to be in the dark room to develop that film and then you would read the As, the Ts and the Gs.”

Blending clinical and commercial expertise

After finishing her PhD, she moved on to a postdoctoral position at Memorial Sloan Kettering (MSK) in New York City, where she spent two years diving deeply into the clinical side of genetics research. She took the position as the organization was standing up a center dedicated to molecularly characterizing tumors. From there, she entered the commercial side of genetics research rounding out a skillset that has allowed her to thrive in Children’s Colorado’s Precision Medicine Institute.

“At MSK, I was really focused on supporting those large research efforts and knowing how pivotal they were to bringing that knowledge and results into a clinical setting. In the commercial setting, I was learning how to take the concept of really well mapped out product design to application and being able to deliver it in a way that is digestible, robust and reliable,” she says. “It’s one thing to do an experiment once, but can you make that experiment robust? Can a team of 20 people get the same results?”

Building a new type of genetics lab

With all that experience in hand, Dr. Gaskell was ready to bring them together. In 2017, she came to Children’s Colorado as Scientific Director of the Precision Diagnostic Lab not only because of the hospital’s mission, but also because of the opportunity to build a clinical-first lab to support research and advocacy for the pediatric population. Just this year, she stepped into the role of Chief Genomics Officer, overseeing the Precision Medicine Institute, which supports clinicians and researchers by providing infrastructure, centralized knowledge, shared resources and collaborative opportunities around whole-genome sequencing, novel therapeutics and research.

“I moved here right at the point where molecular work was becoming very informative within the clinical practices, especially in oncology,” she says. “Oncology is the first program that we lifted. Fast forward eight years, and now we process more than 250 samples weekly across the entire spectrum, from all types of cancers to rare disease to prenatal to pharmacogenomics. Our lab is really that hub for all of it.”

Though the field of genetics has changed in staggering ways over just the last decade, Dr. Gaskell says it still hasn’t hit its peak and likely won’t within her lifetime. That’s because so much of the human genome and how it impacts health is still being uncovered.

“Science is beautiful where it doesn't have to be right. It just needs to be able to see and course-correct,” she says. “We know that DNA is not the entirety of who we are as humans. There are other molecules that dictate who we are as humans. We have not mapped all of that. There is still a big unknown.”

That’s why she’s always searching, always welcoming ambiguity and staying both curious and creative. For Dr. Gaskell, stagnation is the enemy. By doing, she says, we do better.