New advances promise to make healthcare more targeted, effective and less expensive.
Andrew Thompson was strolling through the exhibits at an American Heart Association conference 15 years ago when he noticed something strange. While the world beyond the exhibition hall was being transformed by a digital revolution, there was scarcely a computer in sight in the booths of pharmaceutical companies gathered to attract the interest of world-class medical professionals.
He pulled aside a friend, and said: “We need to figure out how to make a drug talk to a computer when it is swallowed so we can help to personalize medicine.” That was the seed for what became Proteus Digital Health, a 2009 World Economic Forum Technology Pioneer company that made precision medicine history last November when the U.S. Food and Drug Administration approved its schizophrenia pill with an ingestible sensor embedded to help track whether it’s being taken properly. “It’s my belief that this is one of the most important developments in medicine in decades,” says Thompson, the company’s co-founder and CEO. “It’s the beginning of a whole new drug category that includes silicon and software as part of the product.”
Certainly, it’s one of the strongest signals that a new age in which medicine can take into account genetic, environmental, and lifestyle factors for more effective treatments may at last be upon us. Almost 18 years after the human genome was sequenced, the plunging cost of genetic analysis coupled with shrinking electronics and exponentially more powerful computing has created huge buzz around precision medicine, which will be a topic of discussion at the Forum’s annual meeting in Davos, Switzerland, January 23–26. Pharmaceutical companies, venture capitalists, researchers and regulators are scrambling to figure out how — and how fast — to embrace a field that holds the potential to make health care more effective and less expensive. “We are seeing now a recognition that the science and the technology is maturing,” says Dr. Genya Dana, head of Precision Medicine for the World Economic Forum. “It’s getting to the point where we have enough data to make sense of where can really deliver and target our treatments in a more personal way. This has been a dream for a long time.” The Precision Medicine project is based at the Forums’ Center for the Fourth Industrial Revolution in San Francisco, which opened in late 2016. Dana joined to head the project last July after serving for several years as senior science policy officer in the U.S. Department of State.
An “X-ray of the Immune System”
The Forum’s decision to embrace this as a critical topic proved to be well timed. There has been a frenzy of breakthroughs and deal makings driven by precision medicine, including an announcement in early January by Microsoft of a new partnership with Seattle-based Adaptive Biotechnologies, to combine the latest advances in AI and machine learning with recent breakthroughs in biotechnology to map and decode the human immune system. Together, the two companies hope to create a universal blood test that reads a person’s immune system to detect a wide variety of diseases in their earliest stage, when they can be most effectively diagnosed and treated. “Imagine a world with an ‘X-ray of the immune system.’ This would open new doors to predictive medicine, as a person’s immunological history is believed to shape their response to new pathogens and treatments in ways that are currently impossible to explore,” Peter Lee, Microsoft’s corporate vice president of AI + Research, wrote in a blog post.
IBM, for its part, has partnered with the Munich Leukemia Laboratory to combine their respective expertise in AI, genomics and bioinformatics to mine the human genome for data that could create precision medicine treatments for leukemia patients.
In 2017, the Precision Medicine Group in Maryland, which makes tools and infrastructure for researchers and drug companies in this field, raised $275 million in venture capital. Syapse, which makes software to help researchers and doctors manage patients’ genetic information, raised $30 million last year. Illumina Ventures, a new venture capital firm, announced it had raised a fund of $230 million to invest in genomics and precision medicine deals. But the biggest news by far was the announcement in August that Gilead Sciences would pay $11.9 billion to acquire Kite Pharma. Kite was named a Forum Technology Pioneer in 2015 for creating a system that developed cancer treatments by taking genetic information from a patients’ immune system, using it to engineer cancer-fighting cells, and then introducing those cells into the body.
In a conference call with investment analysts to discuss the deal, Gilead’s CEO, John Milligan, hailed Kite’s work on this new line of treatment. “Their work has opened a clear path towards a potential cure for lymphoma patients who have run out of options that are desperately in need of treatment,” he says. To Esther Dyson, an influential startup investor who has focused on genetics and health care over the past decade, this sudden rush of deals is exciting. But she urged caution, noting that even if it seems like the field is accelerating, there is a long way to go before precision medicine makes a widespread impact.
“It’s advanced significantly over the past decade and yet it’s still just at the beginning,” she says. “We understand some subset of the genome. But there’s still a whole lot we don’t know.” There are other challenges as well: Among the issues the project will explore at the Forum’s annual meeting will be how to make sure populations from developing countries don’t get left behind. And then there’s the question from insurers and governments about who is going to pay for research and treatment and whether those costs will truly be justified.
“Some of these questions are not new to precision medicine,” Dana said. “But they’re becoming more pressing.”