Breast Cancer | Herceptin | drug development | human genome
Changing Medicine’s Dna
by
Robert Mcgarvey
Humer I think we are on the verge of a wave of innovation
derived from the discoveries of the last 10 to 15 years in genomics
and genetics [where the human genome, the underlying blueprint for
human life, has been mapped by researchers]. This will allow us to
integrate diagnostics with therapeutics so we can identify the
right patients for the right medication at the right dose at the
right time.
American Way How far in the future is that?
Humer Take Herceptin, a drug to treat
breast cancer. When we
started to explore that drug more than 10 years ago and did the
first clinical trials, we had very low response rates. Some
patients responded beautifully, others not at all. We were not
quite sure where to go. Then we discovered that this is a drug that
works in breast-cancer patients who overexpress [have too much of]
a certain gene, and if we use that drug exclusively on that part of
the population, which is somewhere between 15 and 20 percent of all
breast-cancer sufferers, then we get response rates of 60 and 70
percent. So that is what is happening today.
American Way What's allowing you to make that shift?
What tests are you doing?
Humer In the case of Herceptin, breast-cancer patients are
tested on their expression of a gene called HER 2 [a so-called
oncogene that regulates cell growth].
American Way How complicated is this test?
Humer To say it's a simple test you can carry out at home
would be an exaggeration, but it is certainly a test that can be
carried out in all major hospitals. Today in the United States,
more than 90 percent of women with metastatic breast
cancer get
tested for that gene.
American Way What's your sense of the level of
understanding of drug development? Do business leaders - oil
company executives or bankers - understand the timelines and
failure rates?
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