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OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) BIOGRAPHICAL SKETCH Provide the following information for the Senior/key personnel and other significant contributors. Follow this format for each person. DO NOT EXCEED FIVE PAGES. NAME: Teri E. Klein eRA COMMONS USER NAME (credential, e.g., agency login): TERI.KLEIN POSITION TITLE: Co-PI & Director, PharmGKB; Co-PI, CPIC INSTITUTION AND LOCATION DEGREE (if applicable) University of California, San Diego University of California, Santa Cruz University of California, San Francisco Completion Date MM/YYYY FIELD OF STUDY 06/1977 BA 06/1980 Chemistry/Biology PhD 06/1987 Medical Information Sciences A. Personal Statement I am the Co-PI & Director of the Pharmacogenomics Knowledgebase (PharmGKB) and the Co-PI of the Clinical Pharmacogenetics Implementation Consortium (CPIC). My area of professional expertise extends over clinical and research pharmacogenomics, the study of how variation in human genetics impacts drug response phenotypes. The PharmGKB resource is the premier repository of curated information about how human genetic variation impacts drug-response phenotypes. We use the contents of PharmGKB to create drug dosing guidelines (CPIC) and new applications in data mining, drug discovery and personal genomics. I have taught, advised and mentored graduate level (masters, doctoral and post-doctoral) biomedical informatics students since my initial faculty position at the University of California San Francisco (Department of Pharmaceutical Chemistry) and at Stanford University (Biomedical Informatics). B. Positions and Honors Research and/or Professional Experience 2015– Co-PI, Clinical Pharmacogenetics Implementation Consortium (CPIC), Stanford University 2014– Co-PI & Director, PharmGKB, Stanford University 2009– Co-leader, Clinical Pharmacogenetics Implementation Consortium (CPIC) 2002 National Institutes of Health (NIH), Study Section Reviewer 2000-2014 Director, PharmGKB, Stanford University 2000– Faculty Member and Executive Committee Member, Biomedical Informatics, Stanford University 2000-2002 Treasurer, International Society for Computational Biology 1996– Co-founder and Co-chair, Pacific Symposium on Biocomputing 1994-2000 Faculty, Department of Pharmaceutical Chemistry, University of California San Francisco 1998 National Institute of Environmental Health Sciences (NIEHS), Site Visit Reviewer Honors and Awards 2001 Fellow, American College of Medical Informatics 2015 Fellow, American College of Medical Genetics and Genomics C. Contribution to Science My bibliography of 124 papers on PubMED (as of 4/13/2015) is present on “My Bibliography” at NCBI at http://www.ncbi.nlm.nih.gov/sites/myncbi/1X_VflkeIyBQm/bibliography/47842419/public/?sort=date&direction= ascending Five key areas of contribution over the last decade include: 1. I have served as the original Director and now Co-PI and Director, of the Pharmacogenomics Knowledgebase (PharmGKB, http://www.pharmgkb.org/) Resource. This is a premier human-curated knowledge base of how human genetic variation impacts drug response phenotypes. It gets 25,00035,000 unique IP hits each month, publishes review articles on drug pathways and genes of significance to pharmacogenomics (and thus precision medicine), and is the basis for several clinical implementation research efforts. We have over 110 papers published as part of the PharmGKB project. a. McDonagh Em, Whirl-Carrillo M, Altman RB, Klein TE. Enabling the curation of your pharmacogenetic study. Clin Pharmacol Ther. 2015 Feb;97(2):116-9. PMC4352230. b. Mazaleuskaya LL, Theken KN, Gong L, Thorn CF, FitzGerald GA, et al. PharmGKB summary: ibuprofen pathways. Pharmacogenetics and genomics. 2015; 25(2):96-106. PMCID: PMC4355401. c. McDonagh EM, Clancy JP, Altman RB, Klein TE. PharmGKB summary: very important pharmacogene information for CFTR. Pharmacogenetics and genomics. 2015; 25(3):149-56. PMCID: PMC4336773. d. Whirl-Carrillo M, McDonagh EM, Hebert JM, Gong L, Sangkuhl K, Thorn CF, Altman RB, Klein TE. Pharmacogenomics knowledge for personalized medicine. Clin Pharmacol Ther. 2012 Oct;92(4):414-7. PMCID: PMC3660037. 2. I am the co-apiof the Clinical Pharmacogenetics Implementation Consortium. The Clinical Pharmacogenetics Implementation Consortium (CPIC) was formed in late 2009, as a shared project between PharmGKB and the Pharmacogenomics Research Network. CPIC guidelines are peerreviewed and published in a leading journal (in partnership with Clinical Pharmacology and Therapeutics) with simultaneous posting to PharmGKB with supplemental information/data and updates. CPIC's goal is to address some of the barriers to implementation of pharmacogenetic tests into clinical practice. We have published clinical dosing guidelines for 29 drug-gene pairs. a. Relling MV, Klein TE. CPIC: Clinical Pharmacogenetics Implementation Consortium of the Pharmacogenomics Research Network. Clin Pharmacol Ther. 2011 Mar;89(3):464-7. PMCID: PMC3098762. b. Johnson JA, Klein TE, Relling MV. Clinical implementation of pharmacogenetics: more than one gene at a time. Clin Pharmacol Ther. 2013 May;93(5):384-5. PMCID: PMC3716458. c. Caudle KE, Klein TE, Hoffman JM, Muller DJ, Whirl-Carrillo M, Gong L, McDonagh EM, Sangkuhl K, Thorn CF, Schwab M, Agundez JA, Freimuth RR, Huser V, Lee MT, Iwuchukwu OF, Crews KR, Scott SA, Wadelius M, Swen JJ, Tyndale RF, Stein CM, Roden D, Relling MV, Williams MS, Johnson SG. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process. Curr Drug Metab. 2014 Feb;15(2):209-17. PMCID: PMC3977533. d. Hicks JK, Bishop JR, Sangkuhl K, Müller DJ, Ji Y, Leckband SG, Leeder JS, Graham RL, Chiulli DL, LLerena A, Skaar TC, Scott SA, Stingl JC, Klein TE, Caudle KE, Gaedigk A. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors. Clin Pharmacol Ther. 2015 May 13. PubMed PMID: 25974703. NIHMSID 689584. 3. We have helped demonstrate how whole human genomes can be annotated, and the issues of genome annotation in the context of next generation sequencing. This leadership has been through highly collaborative papers showing the first clinical analysis of a whole human genome, the analysis of a family quartet of genomes, an analysis of a series of genomes with an analysis of accuracy, and papers on the appropriate interpretation and triage of variations discovered in genome sequencing applications, both for pharmacogenomics and more broadly. We have 14 papers published as part of these efforts. a. Daneshjou R, Zappala Z, Kukurba K, Boyle SM, Ormond KE, Klein TE, Snyder M, Bustamante CD, Altman RB, Montgomery SB. PATH-SCAN: a reporting tool for identifying clinically actionable variants. Pac Symp Biocomput. 2014:229-40. PMCID: PMC4008882. b. Altman RB, Whirl-Carrillo M, Klein TE. Challenges in the pharmacogenomic annotation of whole genomes. Clin Pharmacol Ther. 2013 Aug;94(2):211-3. PMCID: PMC4058909. c. Dewey FE, Chen R, Cordero SP, Ormond KE, Caleshu C, Karczewski KJ, Whirl-Carrillo M, Wheeler MT, Dudley JT, Byrnes JK, Cornejo OE, Knowles JW, Woon M, Sangkuhl K, Gong L, Thorn CF, Hebert JM, Capriotti E, David SP, Pavlovic A, West A, Thakuria JV, Ball MP, Zaranek AW, Rehm HL, Church GM, West JS, Bustamante CD, Snyder M, Altman RB, Klein TE, Butte AJ, Ashley EA. Phased whole-genome genetic risk in a family quartet using a major allele reference sequence. PLoS Genet. 2011 Sep;7(9):e1002280. PMCID: PMC3174201. d. Ashley EA, Butte AJ, Wheeler MT, Chen R, Klein TE, Dewey FE, Dudley JT, Ormond KE, Pavlovic A, Morgan AA, Pushkarev D, Neff NF, Hudgins L, Gong L, Hodges LM, Berlin DS, Thorn CF, Sangkuhl K, Hebert JM, Woon M, Sagreiya H, Whaley R, Knowles JW, Chou MF, Thakuria JV, Rosenbaum AM, Zaranek AW, Church GM, Greely HT, Quake SR, Altman RB. Clinical assessment incorporating a personal genome. Lancet. 2010 May 1;375(9725):1525-35. PMCID: PMC2937184. 4. I have led international pharmacogenomics data consortia for warfarin, tamoxifen, clopidogrel, and selective serotonin reuptake inhibitors. The goal for each consortium was to determine the role of pharmacogenomics for each of these drugs with respect to possible efficacy and adverse events. We have published our results in peer-reviewed journals including New England Journal of Medicine, Lancet and Clinical Pharmacology and Therapeutics. a. International Warfarin Pharmacogenetics Consortium, Klein T E, Altman R B, Eriksson N, Gage B F, Kimmel S E, Lee M-T M, Limdi N A, Page D, Roden D M, Wagner M J, Caldwell M D, Johnson J A. Estimation of the warfarin dose with clinical and pharmacogenetic data. N Engl J Med. 2009 Feb 19;360(8):753-64. PMCID: PMC2722908. b. Perera MA, Cavallari LH, Limdi NA, Gamazon ER, Konkashbaev A, Daneshjou R, Pluzhnikov A, Crawford DC, Wang J, Liu N, Tatonetti N, Bourgeois S, Takahashi H, Bradford Y, Burkley BM, Desnick RJ, Halperin JL, Khalifa SI, Langaee TY, Lubitz SA, Nutescu EA, Oetjens M, Shahin MH, Patel SR, Sagreiya H, Tector M, Weck KE, Rieder MJ, Scott SA, Wu AH, Burmester JK, Wadelius M, Deloukas P, Wagner MJ, Mushiroda T, Kubo M, Roden DM, Cox NJ, Altman RB, Klein TE, Nakamura Y, Johnson JA. Genetic variants associated with warfarin dose in AfricanAmerican individuals: a genome-wide association study. Lancet. 2013; 382(9894):790-6. PMCID: PMC3759580. c. Province MA, Goetz MP, Brauch H, Flockhart DA, Hebert JM, Whaley R, Suman VJ, Schroth W, Winter S, Zembutsu H, Mushiroda T, Newman WG, Lee MT, Ambrosone CB, Beckmann MW, Choi JY, Dieudonné AS, Fasching PA, Ferraldeschi R, Gong L, Haschke-Becher E, Howell A, Jordan LB, Hamann U, Kiyotani K, Krippl P, Lambrechts D, Latif A, Langsenlehner U, Lorizio W, Neven P, Nguyen AT, Park BW, Purdie CA, Quinlan P, Renner W, Schmidt M, Schwab M, Shin JG, Stingl JC, Wegman P, Wingren S, Wu AH, Ziv E, Zirpoli G, Thompson AM, Jordan VC, Nakamura Y, Altman RB, Ames MM, Weinshilboum RM, Eichelbaum M, Ingle JN, Klein TE; International Tamoxifen Pharmacogenomics Consortium. CYP2D6 genotype and adjuvant tamoxifen: meta-analysis of heterogeneous study populations. Clin Pharmacol Ther. 2014 Feb;95(2):216-27. PMCID: PMC3904554. d. Province MA, Altman RB, Klein TE. Interpreting the CYP2D6 results from the International Tamoxifen Pharmacogenetics Consortium. Clin Pharmacol Ther. 2014 Aug;96(2):144-6. Review. PMCID: PMC4147833. 5. I led research efforts designed to construct a robust and relevant predictive model of the disease Osteogenesis Imperfecta based on genomic, structural, functional and clinical data, and knowledge. We worked towards identifying the common elements that result from mutations in genes that lead to OI phenotypes and affect response to treatments. Increased knowledge of collagen structure and genes involved in the OI disease process could benefit the study of other genetic collagenous disorders and diseases such as chondrodysplasis, aneurysms and Ehlers-Danlos syndrome where alteration of collagen structure is the primary determinant of phenotype. a. Bodian DL, Chan TF, Poon A, Schwarze U, Yang K, Byers PH, Kwok PY, Klein TE. Mutation and polymorphism spectrum in osteogenesis imperfecta type II: implications for genotypephenotype relationships. Hum Mol Genet. 2009 Feb 1;18(3):463-71. doi: 10.1093/hmg/ddn374. Epub 2008 Nov 7. Erratum in: Hum Mol Genet. 2009 May 15;18(10):1893-5. PMCID: PMC2638801. b. Chan TF, Poon A, Basu A, Addleman NR, Chen J, Phong A, Byers PH, Klein TE, Kwok PY Natural variation in four human collagen genes across an ethnically diverse population. Genomics. 2008 Apr;91(4):307-14. PMCID: PMC2737816. c. Radmer RJ, Klein TE. Severity of osteogenesis imperfecta and structure of a collagen-like peptide modeling a lethal mutation site. Biochemistry. 2004 May 11;43(18):5314-23. PubMed PMID: 15122897. d. Mooney SD, Klein TE. Structural models of osteogenesis imperfecta-associated variants in the COL1A1 gene. Mol Cell Proteomics. 2002 Nov;1(11):868-75. PubMed PMID: 12488462. D. Research Support Active R24 GM061374 04/01/2000-06/30/2019 NIH / NIGMS PharmGKB: pharmacogenomic knowledge for precision medicine Since 2000, the Pharmacogenomics Knowledgebase (PharmGKB, http://www.pharmgkb.org/) has become the premier repository of information about how human genetic variation impacts drug response phenotypes. Goals: to extend the activities of the PharmGKB by implementing a plan of curation, tool-building and collaborations that address the key challenges to the field. Role: Co-PI and Director NIH 8-UHG0073436A (PI: Bustamante, Carlos) 09/23/2013-07/31/2017 NIH Clinically Relevant Genome Variation Database The goal is to create the world’s premier database of genetic variants relevant to clinical care (Clinically Relevant Genomic Variants or CRGVs). We will provide transparent data synthesis and consensus opinion on the clinical utility of a given genetic variant across a spectrum of genetic lesions including single nucleotide changes, small indels, structural variants, and epigenetic changes. We will integrate with ClinVar, PharmGKB, and OMIM and draw upon NHGRI initiatives including the Genome Sequencing and Analysis and Mendelian Disorders Sequencing Centers, and the Clinical Sequencing Exploratory Research Centers. Role: Co-Investigator R24 GM115264 (PI: Relling, Mary) 07/01/2015-06/30/2018 NIH / St. Jude’s Children’s Research Hospital Subcontract Clinical Pharmacogenetics Implementation Consortium (CPIC) This group is responsible for contributing to the evaluation and writing of the gene-drug guidelines, the development of the translation tables, the dissemination and integration of the dosing guidelines on the PharmGKB website, the CPIC working group website and outreach. Role: PI Completed 1 R01 AR051582-01 (PI: Klein) 08/05/2000-06/30/2009 NIH NIAMS Linking Collagen Genotypes to Molecular Phenotypes The long-term goal of this proposal is to determine the chemical, physical and structural properties of biopolymers in the context of natural sequence variation. Mutations in type I collagen lead to an array of minor to lethal disorders. Osteogenesis imperfecta (OI) is the most common clinical result of mutations in the two type I collagen genes, COL1A1 and COL1A2. As diagnostic strategies for OI move from the clinical picture to evaluation of mutations in genes, there is a paucity of data on which to base coherent counseling decisions in that the relationships between genotypes, molecular phenotypes, and clinical phenotypes are unknown and poorly understood. An understanding of the physiochemical properties of native and mutated collagens will provide the basis to comprehend the molecular etiology of OI phenotypes. Information that is critical for the development of useful genetic counseling protocols when only DNA based diagnostic information is available. Role: PI