Hopes and hypes in cancer treatments. Part II

Play God

With immunotherapy leaving the Peak of Inflated Expectations (see Part I), the question arises: what will be next?

“Gene editing” is definitively one of the good candidates for the next Big Thing in the future of drug development, replacing immunotherapy on the hype wave. Let’s see why.

“Gene editing” sounds very simple, illustrative and intuitively comprehensive. It goes to the basics of basics, i.e. to our genes, and, according to the modern paradigm, wrong-edited genes are the origin of [many] diseases. Well, it is not as simple and correct for majority of diseases, that one gene (or two) would cause it or cure it. But it is obvious that DNA mutations are present and may be causative in cancer and several other diseases. So manipulation with DNA (or genes) for treatment of cancer could make sense, and well enough to state that the future in cancer treatment could belong to “Gene editing”. Here is a couple of videos that intrigued the society by promising this new hope (or hype):

https://www.youtube.com/watch?v=OI_OhvOumT0

http://www.bbc.com/news/health-36439260

And the typical type of statement did not hesitate to show up:

“Known as gene editing, this technology has the potential to change the lives of everyone and everything on the planet.”

Bold. This is the current view of many of the world’s leading geneticists and biochemists I’ve spoken to in recent months when working on my latest Panorama – “Medicine’s Big Breakthrough: Editing Your Genes. “

 

Back to earth

It looks like Gene Editing is now at the stage of “Technology trigger”. There have been a couple of exciting investigations within this topic, e.g. for treatment of Duchenne Muscular Dystrophy (http://www.nytimes.com/2016/01/01/science/gene-therapy-muscular-dystrophy.html?_r=0), sickle cell disease (http://news.harvard.edu/gazette/story/2016/09/gene-therapy-for-sickle-cell-disease-passes-key-preclinical-test/) among others. It takes several years (not just decades) for it to come to the top of the hype wave, i.e. when majority of drug developers change their minds and switch their research focus from current “old-fashion” activity to the “most promising” Gene editing area. It can happen that Gene editing potential was the main driver of the merger between Bayer and Monsanto (see my previous article http://blog.doublebp.com/sv/make-cancer-history-bayer/#sthash.gfGZShDZ.dpbs).

What can go wrong? What are the limitations of Gene editing? Ethic issues of course, but sooner or later ethics will be … well, adapted. For the needs of progress. The main problem that can potentially prevent Gene editing from becoming the next Big Thing is that it is quite complicated and expensive – a standard chemical lab is not enough to mess around with this kind of science. Yet.

What about efficiency? When I look in my crystal ball I can see that in the future, when Gene editing passes the Peak of inflated expectations and enters a Plateau of Productivity it will provide best treatments for some diseases, it will take its niche in a wide landscape among other approaches. But what happens if Gene editing is not a panacea (solution to all problems) – what can be next Big Thing in drug development instead?

Well, I still have an idea. [To be continued]

Igor

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