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September 1, 2016

Precision Medicine Urges Us To Think Small, Really Small

Posted by Siva Nandiwada (View Profile | View All Posts) at 7:00 AM

Precision Medicine Urges Us To Think Small, Really Small

In the history of human endeavors, the entrepreneur or inventor who thinks big is usually the one who makes a major breakthrough and lasting mark on mankind. More recently we've seen the development of vast Cloud superstructures by a host of top technology firms as evidence that it pays to think big.

In the world of healthcare, however, the future might rest with those who think small. What I mean is that there is increasingly rapid progress in the field of genomics, where scientists are learning that medicine can be more proactive than reactive. That is to say, by manipulating the building blocks of the human body, doctors can "edit out" diseases rather than what has traditionally been done: fight the afflicted area of the body with drugs after the disease has altered the genome in some way.

There is no better example of how doctors view the fight against disease than the development of the liquid biopsy. For decades, traditional medicine dictated that if the doctor suspected the patient to have cancer, he would operate and take samples of the tissue of an organ. Then that tissue would be tested in a laboratory for the presence of cancerous cells. The rationale behind chemotherapy is to flood the body with cancer-fighting chemicals, the only problem being that chemo fights healthy cells as well. That's why cancer patients lose hair, their strength, and are in prolonged stretches of extreme pain.

The liquid biopsy is noninvasive. Scientists have developed ways to screen blood and even a small urine sample for traces of tumor DNA released by dying cancer cells. Currently there are only a few companies that offer such technology. But recent Wall Street analyst reports suggest that what is a $100 million market today could balloon to a $20 billion market within just five years. Usually there is no better barometer to gauge the success of medical technology than how much interest there is from the financial community.

That's not to say the emerging field of liquid, non-invasive biopsies faces no hurdles. Experts generally agree that getting the regulatory approval for a new kind of medical diagnostic tool can be as cumbersome and costly as it is to get a promising new drug through the testing and approval pipeline. There is also the fact that insurance companies don't always embrace new diagnostic technologies immediately, so those who initially benefit from them are patients who can afford to pay for the tests out-of-pocket.

Still, thinking small appears to be the hottest way to transform modern healthcare. Another promising medical technology is bioelectronics which is making news due to a new joint venture between Alphabet's Verily Life Sciences (formerly Google Life Sciences) and pharmaceutical giant GlaxoSmithKline. The company, called Galvani Bioelectronics, appears to be the ideal combination of pharma expertise and computer analytics.

The goal of a company like Galvani is to design and manufacture very small devices that can be implanted into a patient or even swallowed like a pill. The miniature computer could not only relay information back to doctors in real-time, but depending on the kind of device, can send electrical pulses that could help a patient's body defeat diseases such as diabetes, arthritis, and asthma, according to GSK.

The pharma company stated that it has been experimenting with bioelectronics for four years. The new joint venture with Google is a signal, I think, that GSK recognizes the need for more algorithmic and computer expertise to be brought to its research & development process. Bioelectronics and liquid biopsies are both subsets of a greater field: precision medicine.

Precision medicine is quite the opposite of chemotherapy, where the entire body must suffer through injections of strong chemicals in the hope that the cancerous cells die before the entire body succumbs to the treatment. True, micro-devices that can travel through a body have been fodder for science fiction movies for decades. With innovators thinking small, however, the way doctor's deal with disease is evolving into an entirely new paradigm -- one that is quite real and happening now.

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