What we can learn about cancer drug development from the COVID-19 approach – Twin Cities


As an oncologist, I recognize the tough road to making a new drug. It’s a tough hike that is between the bench and the patient’s bedside. Usually, it takes five years or more for a new drug to be clinically tested. Similar time is needed for clinical trials. Next is Food and Drug Administration approval, followed by the time it takes for licensing, manufacturing, distribution, and adoption by physicians.

Normally, this means that 12 years or more can pass before the FDA even begins evaluating a new drug or regimen. This is before therapy becomes part of our disease control arsenal.

Witness the difference, however, when public-private interests come together in formal partnerships to accomplish the extraordinary. More than one COVID-19 vaccine has become available in less than a year since the DNA sequence of the COVID-19 virus was deciphered. And the RNA-based technology used for the first two COVID-19 vaccines to cross the finish line has never been tried before. In comparison, it took four years to bring to market the mumps vaccine, which has so far been the shortest time for vaccine development.

These partnerships have brought together government experts at the National Institutes of Health and elsewhere with other scientists and clinicians working in academia and biopharmaceuticals. These partners were moving at breakneck speed. And now, public health, policy and logistics professionals from the public and private sectors must join together again for an effective vaccine distribution system to reach everyone.

Now imagine how difficult the task is for deadly cancers. Unlike COVID-19 with a single viral cause, cancers typically result from multiple genetic changes. As an oncologist, I know firsthand this dismal statistic that speaks for itself: only about 1 in 20 promising cancer drugs that go into clinical practice get FDA approval. And the development costs are enormous. We need better and faster results. But it is not easy to do.

First, we need a cancer drug target that when changed kills cancer. Then we have to find a compound to do the job. They are discovered by probing millions of structures for the few that affect the target in the desired way. The former hardly ever turn into medication to be given to patients. They may not be selective enough, have inadequate drug levels, have too much toxicity or side effects, or be difficult to manufacture.

Overcoming these shortcomings takes time. A different approach is called for.

Public-private partnerships are a solution. They go beyond the skills of one person to bring together experts with diverse talents and solid resources. United, they collectively achieve feats that were previously beyond their reach. We have seen the success of this tactic against COVID-19. Now let’s use the same plan in our fight against cancer.

Never before have scientists and clinicians had so much knowledge about cancer and so many formidable tools to make progress against this scourge. Huge public and private databases store knowledge about drug testing experiences, genetic data and clinical outcomes. The emerging force of ultra-high performance computing, machine learning, and artificial intelligence can probe this data for answers that might not be easily found.

Consider how the actual experiences of people with cancer might be pulled from their medical records. Sophisticated artificial intelligence tools can release information that is hidden in these records. This could lead us to find new therapies against cancer.

By coming together, the public and private sectors can make an even bigger difference in the lives of those affected by cancer.

Physician-scientist Ethan Dmitrovsky is President of Leidos Biomedical Research and Director of the Frederick National Laboratory for Cancer Research. Email: [email protected] He wrote this column for the Baltimore Sun.

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