The Soul of Biotech

This post originally appeared as a guest post on the Xconomy news site.

Good morning from Mountain View, CA, and from the close of the 2012 Personalized Medicine World Conference, which brought together thought leaders of business, government, healthcare-delivery, research and technology. Four themes that emerged from this year’s program:

• Greater optimism, triggered by the 2011 approvals of two major oncologic agents paired with companion diagnostics: vemurafenib (Daiichi Sankyo and Roche / Genentech) for patients with metastatic melanoma with a mutant biological pathway known as BRAF V600E and crizotinib (Pfizer) for patients with non-small-cell lung cancer that overexpresses a protein called ALK. Walter Koch from Roche and Hakan Sakul from Pfizer proudly discussed their development processes and speedy approval timelines. Those approvals were also cited by several other talks as examples of major progress made in the quest to deliver the right drug to the right patient.
• Greater clarity from the FDA. Although the FDA was not able to meet its self-imposed deadline of year-end 2011 to finalize guidance to industry on the best practices for developing companion diagnostics, Elizabeth Mansfield reiterated Commissioner Hamburg’s commitment to personalized medicine and told the audience to expect final guidance before the end of June. Mansfield also said that the FDA would provide guidance on how to co-develop a drug & test in parallel, as well as how to “enrich” clinical trials through careful selection of patients, based on their genetics. Both of these important regulatory steps could happen in 2012. The most surprising revelation, though, was Mansfield’s staffing: her group has just four people to evaluate all personalized-medicine-related medical devices.
• More sequencing. Just a few weeks ago at the JP Morgan Healthcare Conference, 800-lb sequencing gorillas Illumina and Life Technologies / Ion Torrent announced that scientists can expect the $1,000 genome by the end of 2012. Piggybacking on that announcement, Mostafa Ronaghi, chief technology officer of Illumina, presented a thorough overview of his company’s progress to date, bragging that 90 percent of all sequences produced worldwide had been produced on an Illumina instrument. Among other projects, Ronaghi’s team is working on techniques to accurately cover the 8 percent of the genome that cannot be sequenced because of repetitive regions. (Ronaghi made his presentation just hours before news broke of Roche’s unsolicited $5.7 billion takeover bid for Illumina.)
• More translational bioinformatics. Given the implied data glut that whole genome sequencing will produce, last week’s conference revealed more accomplishments in the application of bioinformatics to the remedy of disease. One of the unsung heroes of this year’s conference was Elizabeth Worthey from the Medical College of Wisconsin, who walked the audience through a case study of a pediatric patient presenting with undefined inflammatory bowel disorder. Worthey’s whole exome sequencing and variant analysis of the patient revealed a key mutation in the XIAP gene. A cord blood transplant ultimately cured the child, who was eating, drinking and playing again within four months.

Yesterday, I taped a healthcare-focused episode of The MBA Show, hosted by Miro Kazakoff and Tom Rose.

I had a great time prepping the show with Miro and Tom this week. They’re smart, creative and easy to talk to. If you haven’t started watching yet, don’t miss out. Their viewership has been picking up a lot of steam lately.

Next for me: Discussing personalized medicine on The Colbert Report. (Kidding.) (Although I am available, Colbert Report producers.)

The Promise and the Peril of Personalized Medicine from Jeriaska on Vimeo.

Many thanks to Drew Reynolds for taping this and editing together this abbreviated version. The uncut talk was about ten minutes long — I started out explaining what treatment-response biomarkers are, and how they can improve patient outcomes and save money for payors.

My talk starts in half an hour, at 11:45am Pacific time. If you see this in time, you can watch the webcast live right here!

BIL is a new kind of science and technology conference, set up as a more egalitarian cousin to TED. My close friend Lexi Bright, who writes over at Sophisticated Relationships persuaded me to join her in delivering a presentation on the topic of person-to-person networking to the attendees of BIL. (I love speaking in front of groups — she didn’t have to try very hard.)

Anyone who knows me personally is nodding, because they know how enthusiastic I am about meeting someone new and learning all about him or her. When I was a sophomore at MIT, my friend Brian joked, “Jonathan, you’re the one that makes that whole ‘six degrees of separation’ thing work.” Later, Malcolm Gladwell would identify me as a ‘connector’. Who knew.

I’m still trying to figure out what parts to emphasize in the talk. Last night, I showed up at Bagdad Theater on Hawthorne for Ignite Portland, but it was already over capacity. So I walked down the street and ended up having a bite at My Thai, discussing the topic of my talk with my waitress, Emily, as I dug into my massamun curry. Emily graduated from Skidmore last year and drove out to Portland from New York this summer with her old housemates. Now she teaches grade school in Gresham by day and waits tables by night.

Emily and I talked about the nature of networking for a while — she says we shouldn’t use the word, because it gives her the willies. And I know what she means. When we think “networking,” we think of dryly exchanging cards, with the “lower status” person trying to get time on the calendar of the other in order to pitch his product, company, or employability. She suggested that we make sure to divorce the word from its usual meaning and reunite it with the idea of being open, honest and sincere with others. This sounded spot-on with my own interpretation of networking, and I’ll be sure to emphasize it in our talk.

Lexi and I are still writing the talk as we speak, and suggestions are welcome. So tell me what you think. Keeping in mind that the audience will be primarily technically-oriented, what should Lexi and I emphasize in our talk? What should geeks know about talking to strangers?