Nothing except a crazy experimental treatment never before given to a child: Blood was taken out of 6-year-old Emily’s body, passed through a machine to remove her white cells and put back in. Then scientists at the University of Pennsylvania used a modified HIV virus to genetically reprogram those white cells so that they would attack her cancer, and reinjected them. ... commercializing June’s cancer-killing cells would be like no drug development program ever. Scientists call them chimeric antigen receptor T-cells, or CARTs. T-cells are the immune system’s most vicious hunters. They use their receptors to feel around in the body for cells with particular proteins on their surface and destroy them, targeting infected cells and cancer. With CARTs scientists add a man-made receptor–the chimeric antigen receptor–assembled from mouse antibodies and receptor fragments. A gene code for the man-made receptor is inserted into the T-cell’s DNA with a virus, usually a modified HIV. If the receptor sees cancer, not only does it kill it, it starts dividing, creating a cancer-killing army inside the body. ... Downsides: “So far, it’s only blood cancer, it’s high technology, it’s customized therapy, it’s going to require major investment,” warns Clifford Hudis, president of the American Society of Clinical Oncology, who is nonetheless excited about the cells. The current CARTs kill not just cancer cells but any B-cell, the type of white blood cell that goes wrong in leukemia. Patients are likely to get injections of a protein that B-cells make, called gamma globulin, for the rest of their lives; if the treatment becomes popular there may not be enough gamma globulin to go around. ... “It’s a little early to know whether or not the remarkable results we’re seeing will show us whether these are the drugs we’ve been looking for or whether these are the first powerful signals that we’re headed in the right direction,” says Louis M. Weiner, the director of Georgetown University’s Lombardi Cancer Center . Though the cells are “amazing,” says Charles Sawyers, the past president of the American Association for Cancer Research and a Novartis board member, “what we don’t know is how broadly does this scale?”
In some ways, everything had changed, for Schadt now had four hundred people working for him, along with nine gene sequencers at his disposal and a supercomputer named Minerva in the basement. In other ways, however, he remained a guy in shorts, a guy whose face was always agleam in the light of his laptop, a guy whose office walls were decorated with a palimpsest of indecipherable equations. Most important, he remained a guy who never said no—who never rejected anything as impossible—and when he learned that a woman from Mississippi whom Esquire had written about eight years earlier had been told she had terminal colon cancer, Schadt looked up and said: "That's exactly the kind of patient we take." … It was, in the end, the reason he had come to New York. He probably didn't really need nine gene sequencers. He probably didn't even really need Minerva, because he could do supercomputing with Google and Amazon. But as both a lapsed molecular biologist and a lapsed Christian looking to establish a new faith, he needed something he had never had before. He needed patients. He needed someone like Stephanie Lee.
A Ghanaian entrepreneur thinks he has the answer to Africa’s fake medicine problem ... Drug Lane runs through a market in the heart of Accra, Ghana. It’s past the office towers going up to the east of the central business district, past the pushy vendors with fake Louis Vuitton luggage, and past the women selling trays of raw beef under the midday sun. The alley bristles with signboards for pills, powders, and other substances. One store is packed to the rafters with boxes of painkillers and antibiotics. On the wall are two posters: One is for Coartem, a malaria treatment made by the Swiss drug company Novartis, and the other advertises something called Recharger, supposedly made from the male silkworm moth. ... Like 85 percent of the people selling medicine in Ghana, he isn’t a pharmacist. Most of his stock comes from China, India, and Malaysia, imported by Ghanaian distributors who supply everyone from “licensed chemical sellers” like him to actual pharmacies and hospitals. It’s a system so porous that as many as one in three medicines sold on Drug Lane could be counterfeit, according to the U.S. Centers for Disease Control and Prevention, compared with about 1 percent in the U.S. and Europe. The fake drugs often have no active ingredient at all, or just enough to pass quality-control tests, and visually they can be indistinguishable from the real thing. ... MPedigree sells software that manufacturers use to label individual packs of medication with a random 12-digit code hidden under a scratch-off panel on the packaging. When a person buys medicine, she can text the code to MPedigree for free and get an instant reply telling her whether the product is authentic.
Human genomics is just the beginning: the Earth has 50 billion tons of DNA. What happens when we have the entire biocode? ... By 2020, many hospitals will have genomic medicine departments, designing medical therapies based on your personal genetic constitution. Gene sequencers – machines that can take a blood sample and reel off your entire genetic blueprint – will shrink below the size of USB drives. Supermarkets will have shelves of home DNA tests, perhaps nestled between the cosmetics and medicines, for everything from whether your baby will be good at sports to the breed of cat you just adopted, to whether your kitchen counter harbours enough ‘good bacteria’. We will all know someone who has had their genome probed for medical reasons, perhaps even ourselves. Personal DNA stories – including the quality of the bugs in your gut– will be the stuff of cocktail party chitchat. ... Due to satellite imaging, we can see the entire surface of our planet. There can be no undiscovered land masses. The map of the world is complete. And we should expect the same thing for genetics. DNA testing will become so pervasive it will transform the medical, legal and social foundations of society. If blanket genome sequencing takes off, it will be impossible to obscure human relationships or ignore the content of our DNA. ... One of the greatest achievements of the coming century will be the characterisation of the Biocode, not just as a list of genomes of different species, but as patterns of interacting communities. ... By 2050 we should aim to finally have a handle not only on human genetic diversity but on the biodiversity of the planet.
Meet the iChip, a plastic block that helped scientists discover a new antibiotic that kills superbugs. Will it be enough to save humankind from the coming bacterial apocalypse? ... Even more exciting is the innovation used to discover teixobactin: the unassuming plastic blocks. Each one is called an iChip, short for isolation chip, so-named because of how it captures microbes from soil. Until now, scientists hunting for antibiotics haven’t been able to study 99 percent of the world’s microbial species because, when ripped from the outdoors and encouraged to grow under desolate laboratory conditions, the vast majority of bacteria die. The iChip overcomes this problem by keeping things dirty: Burying soil microbes in their natural habitat during the culturing process preserves the organic compounds they need to thrive, enticing previously stubborn microorganisms to multiply under human supervision. ... An investigation by a U.K. government task force estimates that the global toll of antibiotic resistance is 700,000 deaths per year—and that it could soar to 10 million by 2050. In the United States, at least 2 million people are infected with antibiotic-immune bacteria annually; some 23,000 die. (The director of the Centers for Disease Control and Prevention has called the estimate “a bare minimum.”) All that illness and death exacts substantial economic losses, too: The U.K. task force projects that resistance will sap between 2 and 3.5 percent of the world’s GDP—about $100 trillion—over the next 35 years. ... The iChip could prove an essential tool for warding off bacteria’s looming assault on humans, but it’s not a cure-all. ... Rather than trying to determine what biological compounds soil bacteria need to flourish—science still doesn’t have a precise answer—he focused on the simple fact that many microbes are happy in dirt.
Elizabeth Holmes rarely slips out of character. When she responds to questions in an interview or on a conference stage, she leans forward, leg crossed ankle over knee in a half-lotus manspread power pose. She lowers her voice an octave or two, as if she’s plumbing the depths of the human vocal cord. Although she hates it being remarked upon, her clothing, a disciplined all-black ensemble of flat shoes, slacks, turtleneck, and blazer buttoned at the waist, is impossible not to notice. She adopted this uniform, as she calls it, in 2003, when she founded Theranos, a company seeking to revolutionize the medical diagnostics industry by doing tests using only a few drops of blood. ... “I wanted the focus to be on my work,” she says slowly and deliberately. “I don’t want to go into a meeting and have people looking at what I’m wearing. I want them listening to what I’m saying. And I want them to be looking at what we do.” ... She was only too willing to let that propel her through the business media’s star chamber, though she refused to let photographers use a wind machine to blow her hair. ... After several years of Holmes telling the largely unchallenged story of how Theranos intends to change the world, a blast of cold air came ... Most blood work in the U.S. is run on analyzer machines made by companies such as Siemens, Roche Diagnostics, and Olympus. The labs that buy these machines don’t need the FDA’s OK to use them, but the manufacturers need it to sell them. ... FDA clearance alone may not be enough to convince physicians that the tests can be used for all patients, according to John Ioannidis, a professor of medicine at Stanford who’s best known for his criticism of the way scientific research is conducted, in particular for a 2005 paper titled “Why Most Published Research Findings Are False.”
His latest venture, Human Longevity, Inc., or HLI, creates a realistic avatar of each of its customers – they call the first batch ‘voyagers’ – to provide an intimate, friendly interface for them to navigate the terabytes of medical information being gleaned about their genes, bodies and abilities. Venter wants HLI to create the world’s most important database for interpreting the genetic code, so he can make healthcare more proactive, preventative and predictive. Such data marks the start of a decisive shift in medicine, from treatment to prevention. Venter believes we have entered the digital age of biology. And he is the first to embark on this ultimate journey of self-discovery. ... His critics call him arrogant but, having talked to him on and off for more than two decades, I think Venter has earned the right to be bullish about his abilities to build a biotech venture from scratch. ... So far, HLI has amassed the sequences of around 20,000 whole genomes, says Venter (he won’t be drawn on whether it is the biggest cache – probably, but he adds that it depends on the details and that “all kinds of people make all kinds of claims”). But, of course, he wants even more. The company has room for more sequencing facilities on its third floor and is considering a second centre in Singapore, planning to rapidly scale to sequencing the genomes of 100,000 people per year – whether children, adults or centenarians, and including both those with disease and those who are healthy. By 2020, Venter aims to have sequenced a million genomes. ... in about a month, each Illumina sequencer can tear through 16 human genomes at the same coverage in just three days. Each week, these machines pump terabytes of data into the cloud run by Amazon Web Services. ... Venter says their findings have changed his static view of the genome. For instance, he has been able to compare his 2006 genome with today’s, using three different sequencing technologies. “One of the findings that would have shocked me and the rest of the world 15 years ago is that our genome is continually changing,” he says. “We can relatively accurately predict your age from your genome sequence, or at least the age when the sample was taken.” ... Targeted initially at self-insured executives and athletes, a full health scan will be priced at $25,000.
Patrick Soon-Shiong wants to turn cancer treatment upside down. On January 12, Soon-Shiong and a consortium of industry, government, and academia announced the launch of the Cancer MoonShot 2020, an ambitious program aiming to replace a long history of blunt trial-and-error treatment with what amounts to a training regimen for the body’s own immune system. That system, Soon-Shiong argues, is perfectly adept at finding and eliminating cancer with exquisite precision—if it can recognize the mutated cells in the first place. Helping it to do so could represent a powerful new treatment for the disease, akin to a flu vaccine. ... Soon-Shiong has hit home runs before. This past July, one of his firms underwent the highest-value biotech IPO in history. A cancer drug he developed, called Abraxane, is approved to fight breast, lung, and pancreatic cancers in more than 40 countries. Soon-Shiong’s path from medical school in South Africa through residency in Canada, to UCLA professor, NASA researcher and corporate CEO has given him the bird’s-eye view necessary to take on a project this ambitious, as well as the resources to marshal the world-class computing and genome-sequencing facilities that it requires.
- Also: Science Alert - Scientists report "unprecedented" success using T-cells to treat cancer < 5min
- Also: Aeon - Death of cancer 5-15min
- Also: The Conversation - The equation that will help us decode cancer’s secrets < 5min
- Also: The New Yorker - Tough Medicine: A disturbing report from the front lines of the war on cancer. < 5min
- Repeat: Mosaic - What’s wrong with Craig Venter? 5-15min
Samumed is finding it easy to raise huge amounts of cash because it believes it has invented medicines that can reverse aging. Its first drugs are targeted at specific organ systems. One aims to regrow hair in bald men. The same drug may also turn gray hair back to its original color, and a cosmetic version could erase wrinkles. A second drug seeks to regenerate cartilage in arthritic knees. Additional medicines in early human studies aim to repair degenerated discs in the spine, remove scarring in the lungs and treat cancer. After that Samumed will attempt to cure a leading cause of blindness and go after Alzheimer’s. The firm’s focus, disease by disease, symptom by symptom, is to make the cells of aging people regenerate as powerfully as those of a developing fetus. ... Hood, 49, had invented a cancer drug that got his previous company, Targegen, bought by Sanofi for $635 million. He has a distinct take on drug development: He thinks everybody takes too many shortcuts and insists on doing work himself that other companies outsource, including formulating drug chemistry, testing drugs in laboratory animals and running clinical trials. ... The target Hood and Kibar went after was obvious: a gene called Wnt, which stands for “wingless integration site,” because when you knock it out in fruit flies, they never grow wings. It’s a linchpin in a group of genes that control the growth of a developing fetus–whether you’re a fly or a person. Together these genes are known as the Wnt pathway. Trigger the right ones and you might revive old flesh. Some cancers do their dirty work by hijacking Wnt, and blocking it might stop tumors.
There are a lot of directions in which to point fingers. There is Holmes, of course, who seemed to have repeatedly misrepresented her company. There are also the people who funded her, those who praised her, and the largely older, all-white, and entirely male board of directors, few of whom have any real experience in the medical field, that supposedly oversaw her. ... But if you peel back all of the layers of this tale, at the center you will find one of the more insidious culprits: the Silicon Valley tech press. They embraced Holmes and her start-up with a surprising paucity of questions about the technology she had supposedly developed. They praised her as “the next Steve Jobs,” over and over (the black turtleneck didn’t hurt), until it was no longer a question, but seemingly a fact. ... The system here has been molded to effectively prevent reporters from asking tough questions. It’s a game of access, and if you don’t play it carefully, you may pay sorely. Outlets that write negatively about gadgets often don’t get pre-release versions of the next gadget.
These are the thoughts that plague the medicated, the adults in their twenties who take prescription stimulants for attention deficit/hyperactivity disorder (ADHD) and have done so since childhood. By some accounts, the number of 26- to 34-year-olds taking ADHD medication rose roughly 84 percent between 2008 and 2012 alone. ... Prescription stimulants like Ritalin were considered a godsend when they first started being used to help hyperactive, unfocused kids succeed in school. So many children were on ADHD drugs in the ’90s that lines would form outside the school nurse’s office, where students went to take their midday doses. But almost 20 years have passed since Diller predicted that the tidal wave of prescriptions written in the ’90s would come to shape an entire generation. Now, those children are all grown up and living on their own. As adults, many find themselves unable to get off the drugs. Some fear losing their jobs, while others fear losing the only self they have come to know — a self with a prescription drug dependency that’s difficult to kick.
Whether it takes the form of a touch of the Holy Spirit at a Florida revival meeting or a dip in the water of the Ganges, the healing power of belief is all around us. Studies suggest that regular religious services may improve the immune system, decrease blood pressure, add years to our lives. ... Religious faith is hardly the only kind of belief that has the ability to make us feel inexplicably better. ... just as a good performance in a theater can draw us in until we feel we’re watching something real, the theater of healing is designed to draw us in by creating powerful expectations in our brains. These expectations drive the so-called placebo effect, which can affect what happens in our bodies as well. Scientists have known about the placebo effect for decades and have used it as a control in drug trials. Now they are seeing placebos as a window into the neurochemical mechanisms that connect the mind with the body, belief with experience. ... How does a belief become so potent it can heal? ... Most astonishingly, placebos can work even when the person taking them knows they are placebos.
- Also: Aeon - The lizard inside 5-15min
Aching, throbbing, searing, excruciating – pain is difficult to describe and impossible to see. So how can doctors measure it? ... During that period of convalescence, as I watched her grimace and clench her teeth and let slip little cries of anguish until a long regimen of combined ibuprofen and codeine finally conquered the pain, several questions came into my head. Chief among them was: Can anyone in the medical profession talk about pain with any authority? From the family doctor to the surgeon, their remarks and suggestions seemed tentative, generalised, unknowing – and potentially dangerous: Was it right for the doctor to tell my wife that her level of pain didn’t sound like appendicitis when the doctor didn’t know whether she had a high or low pain threshold? Should he have advised her to stay in bed and risk her appendix exploding into peritonitis? How could surgeons predict that patients would feel only ‘discomfort’ after such an operation when she felt agony – an agony that was aggravated by fear that the operation had been a failure? ... There seemed to be a chasm of understanding in human discussions of pain. I wanted to find out how the medical profession apprehends pain – the language it uses for something that’s invisible to the naked eye, that can’t be measured except by asking for the sufferer’s subjective description, and that can be treated only by the use of opium derivatives that go back to the Middle Ages.
What Roberts has just done, in an action that he and people who support him have performed hundreds of times, is to return to a practice that was abandoned more than 40 years ago. He has sampled the environment, hoping to find in the dirtiest, most germ-filled places an answer to one of the most pressing problems of our day. ... Drug resistance—the ability of bacteria to defend themselves against the compounds we use to kill them—has impaired the effectiveness of almost every antibiotic produced since the first ones were developed, in the 1940s. At least 700,000 people are estimated to die worldwide every year from infections that no longer respond to antibiotics. That toll could balloon to more than 10 million a year by 2050 if we can’t slow the spread of resistance or find new drugs; routine surgeries and minor injuries will become life-threatening. ... Yet making the necessary changes to stave off this catastrophe seems to be beyond us. We continue to take antibiotics with abandon (nearly a third of antibiotic prescriptions in the U.S. aren’t actually needed) and feed huge quantities of them to farm animals. And pharmaceutical companies—daunted by how quickly resistance can undermine drugs that may take a decade and a billion dollars to develop—are not rushing to fill the gap. ... He launched his campaign, called Swab and Send, in February 2015. For £5, participants got a sample tube, a mailing envelope, and an explanation of what Roberts wanted them to look for: a spot in the environment where bacteria were likely to be competing for nutrition and room to reproduce. He asked them to use their imagination. The less sanitary, the better.