The future of medicine is evolving, and this time, it’s personal
Over the last decade, technological improvements and algorithmic learning have made rapid improvements to many facets of people’s lives. Smartphones can track daily routines and present a morning alarm, weather schedule and traffic or transport report catered to specific daily plans.
Over the last decade, technological improvements and algorithmic learning have made rapid improvements to many facets of people’s lives. Smartphones can track daily routines and present a morning alarm, weather schedule and traffic or transport report catered to specific daily plans. Netflix and Spotify algorithms view our likes and dislikes over years and months, and eventually present content so specifically catered to us that it would often take convincing that there is not entire production studios in existence purely to serve the unique and eccentric taste of minute segments of the population. Camera driven applications also now exist in the market, recognising meals from photographs and creating weekly reports to allow people to hit their dietary goals.
With nearly every facet of life being convenienced, changed and, importantly, personalised to specific needs, it stands to reason that one of the fastest growing industries in the area of Science and Medicine is the field of personalised medicine. Personalised medicine is widely thought to be changing the industry and is considered to be a huge area of growth, with experts forecasting the industry as a whole to be worth $93 billion by 2023.
For so long in medicinal diagnosis, the formula was simple mathematics. One gene equals one trait and one mutant gene = 1 disease. But as we come to understand more and more about the human body, and its astronomical regenerative process, other mathematical equations come similarly into play.
There is an estimated 37.2 trillion cells in a human body. These cells divide, die and regenerate so often that it is popularly acknowledged (despite new cells being regenerated daily) that the human cell map is effectively replaced every seven years. It is hard to estimate completely, but billions of cells die each and every day, and are replaced, with around 200 billion red blood cells alone regenerating daily.
As a comparison, if a typist were to type out the complete works of Herman Melville in a very narrow timeframe, consistently, over and over, one could be forgiven for a “Call mew Ishmael” accidentally slipping through. So this theory applies to the human body. Despite the regenerative process being perfected over billions of years of evolution, with trillions of cell divisions over a lifetime, it is natural that sometimes the human body makes mistakes, which can lead to mutations, and sometimes, unfortunately, cancer.
These mutations have traditionally been treated with a ‘one size fits all’ approach.’ That is, a specific treatment is made for a specific mutation, and applied to all people. This unfortunately leaves out an immeasurable amount of variables including the difference in humans specific cell patterns (not least how much they change over years of regeneration). But also neglects to consider that because of this, the mutations and tumours in different people have their own variables and differing drivers. This invariably leads to poor outcomes.
So what is personalised medicine, and how are researchers adapting it specifically to different people, each of us with our own unique genetic profile? In a sentence, it is a change in mindset. The goalposts of medicine are changing from aiming to treat the specific disease, to deciding the best possible treatment path, and ultimately, a cure, for each and every human being.
More scientifically, personalised or precision medicine takes into account the genetic variables, person to person, and considers further the tumour variability – with the hope that this will lead to more effective outcomes in treating cancer patients and other diseases through synthesised data profiles and accommodated treatments. So far, worldwide test effects have shown positive results, leading to an uptake of interest in the space.
One company who has recently enjoyed success in this area was US listed Loxo technology (NASDAQ:LOXO). Loxo was a company focused on the development and commercialization of highly selective medicines for patients with genetically defined cancers. Loxo looked to pinpoint underlying genomic vulnerabilities that lead to cancer, design specific drug compounds that inhibit the targets, and apply these specifically formulated to the right patients, or an area that has an unmet need.
They recently completed this successfully with their targeted therapy for cancers with the rare ‘TRK’ fusion mutation (this specific drug is called Larotrectinib). The flashpoint for Loxo came in June of 2018, whereby they announced the results of a ‘one trial to launch’ basket study, just four years from their phase one initiation, outlining the drug had significantly shrunk tumours in 75% of patients with cancer in the lung, pancreas, colon or other locations.
This was a fantastic result for their shareholders and even better, in January 2019, Loxo was bought out by industry giants Eli Lilly (NYSE:LLY) for 8 billion dollars. This was Eli Lilly’s largest acquisition in their 143 year history which put Loxo in conversation with companies working in similar spaces like Tesaro (recently bought out for USD 5.1 Billion by GSK), Blueprint Medicines (worth an estimated USD 3.3Billion) and Array Biopharma (worth an estimated USD 5 billion). With news of the successful trial and the acquisition, at the date of publishing, Loxo’s share price has risen in excess of 1000% since 2016.
With regards to Australian entries into this growing and exciting area, ASX listed Prescient Therapeutics (ASX:PTX) is a clinical stage oncology company developing targeted therapies for a range of different cancers also working in the growing space of personalised medicine. They are trialling two similar drugs to Loxo, PTX-200 and PTX-100, which work by inhibiting the survival pathways of two differing mutations. ‘AKT’ is targeted by their PTX-200 treatment and ‘Ras’ is targeted by PTX-100 treatment.
AKT & Ras are growth switches found in cancer cells – when they are turned on, they send a signal to the cancer cells to grow. The treatment works by looking to ‘switch off’ the aberrant “growth switch” typical of cancer cells. The treatment does this with intelligent design and targeted individual therapy.
As for Prescient’s PTX-100, Phase 1 trials are complete and it’s due to re-enter the clinic in the first half of 2019. Interestingly, the company has flagged the possibility of advancing it through ‘basket studies’ of Ras and Rho mutant cancers. This ‘basket studies’ tactic — which can result in a ‘one trial to launch’ process —was successfully employed by Loxo. They have also recently hired Jim Winkler in a BDM role, who was a key member in Array BioPharma’s partnership deals.
As the future becomes more and more catered to specific needs, and as personal tastes continue to evolve with technological adaptation, one can only hope that personal approach to treatment will continue to adapt as we undertake a relative revolution in healthcare, hopefully leading to a healthier, happier version of humanity, deriving equal pleasure from personalised healthcare treatment as algorithmic netflix recommendations as we forge into the future.
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