Oncology treatment or market for precision medicine

Just as there is not a pair of shoes that can satisfy everyone's feet, a single medicine cannot be applied to everyone. The empiric drug-based, one-size-fits-all drug model will gradually be broken in the future and replaced by personalized medicine. When it was time, precision medicine began to enter people's field of vision.

At present, in the clinical field, precision medicine has involved non-invasive prenatal care, assisted reproduction, single gene disease, neonatal screening, individualized tumor treatment, genetic cancer screening, cardiovascular disease screening, and blood disease screening, among which tumors Treatment is considered by the industry as the largest market in the future.

The traditional medication model will be changed

For precision medicine, the industry has a variety of insights. According to Wu Bolin, a professor at Boston Children's Hospital affiliated to Harvard Medical School, precision medicine is derived from genomics. It refers to the use of genomics at the gene and molecular level, and the various omics derived (proteomics, metabolomics, Performance genomics, etc.) to diagnose the cause or detect the goal of treatment, makes the original "same-as-a-law" treatment program may be turned into an effective treatment for the individual's cause.

"Thousand people and one medicine" not only cause troubles to patients, but also cause waste of resources. Through individualized genetic testing, it can save subsequent medical costs, which has become a consensus in the industry. The market expects that the global precision medical market in 2015 will be approximately US$60 billion, and its growth rate in the next five years is expected to be 15%, which is 3-4 times of the overall growth rate of the pharmaceutical industry, and the growth rate of the gene sequencing industry will exceed 20%.

At present, the United States is in the first echelon of precision medicine. Earlier this year, Obama took it as a national strategy and proposed to invest 215 million U.S. dollars in 2016 fiscal year to promote the development of precision medical care.

At the same time, relevant domestic policies are constantly being explored. In July this year, the National Health and Family Planning Commission released the "Guidelines for Gene Detection of Targets for Drug Metabolizing Enzymes and Drugs (Trial)" and "Guidelines for Individualized Detection of Tumors (Trial)", which was interpreted by the market as the government's substantive development of genes. Detection and precision medical opening signal. In the “Individualized Tumor Detection and Testing Technical Guide (Trial)”, the competent authorities reaffirmed the prediction of drug efficacy and evaluation by detecting biomarker gene mutations, gene SNP typing, and gene and protein expression status in tumor patient biological samples. Prognosis, guiding the practice of individualized treatment, and recommending cancer patients for genetic testing before treatment to guide doctors to use drugs.

"In the future, the treatment of tumors must begin with precise calculations, then have a precise diagnosis, and finally bring us an accurate therapeutic effect." Given by Mao Yimao, senior vice president of Shanghai Yao Ming Kangde New Drug Development Co., Ltd. Predict.

Zhang Wei, a professor at Central South University, one of the drafters of the above-mentioned guidelines, said that precision medicine is not only for patients with diseases, but also for health prevention: for example, pharmacogenomics, that is, using the correct dose at the right time, and also involves prediction of disease, Prenatal diagnosis, newborn genetic testing, etc. In the future, the detection equipment may be as portable as a small blood glucose meter, but for the time being, it will take some time.

Accurate Medical Infusion of Big Funds

From the point of view of drug development, idealized precision medical care is to achieve a treatment policy that is based on the patient's personal genome information, and to grasp individual differences in response such as therapeutic effects or toxic and side effects, and to perform the most suitable therapy for each patient. With the improvement of sequencing technology and big data analysis capabilities, the number of companies involved in precision medicine is increasing.

The Idea Di Medicine Technology Group was incorporated in Shanghai in 2010. The company focuses on the three major areas of precision tumor prevention, precise tumor treatment and new drug research and development. It is understood that the idea of ​​Di in the first three rounds of hundreds of millions of funds, the establishment of a unique large-scale development platform for primary tumor cells and humanized tumor animal model platform. Among them, the preclinical drug development platform for hepatobiliary tumors has been completed. Currently, 3 preclinical compounds have been selected, and one to two years later will enter clinical trials.

At present, there are 2,000 known and potential gene targets found in the tumor genome. Hundreds of tumor-driven genes have been identified, but not many target drug development targets have been achieved. Not long ago, he received the fourth round of financing ideas. He had his own business model for precision medical treatment of tumors. He relied on big data to expand cancer prevention, diagnosis, and new drug development business, and made a closed loop of cancer prevention and diagnosis to new drug development. "The benefit of closed loop lies in the close links between the links. The development of new drugs guided by the reverse thinking of patient's genome big data will greatly increase the success rate and reduce the development risk." Former FDA Drug Evaluation Center Senior Drug Reviewer, Idea Di Group CEO Dr. Gong Zhaolong explained.

According to media reports, Dr. Xiong Lei, the founder of Ideas Di, disclosed to outsiders that the purpose of financing was to promote the promotion of accurate tumor prevention services, accelerate the nationwide layout of precision treatment services, and advance the preclinical development and clinical reporting of several existing precision tumor drugs. Increase the intensity of data construction. Obviously, Ideas Di has adopted a tactic of fighting from multiple points in the fields of prevention, diagnosis and new medicine.

In addition, the idea of ​​a round of financing was introduced to Tasly. As the only strategic investment institution from the pharmaceutical industry so far, Tasly has sent a senior investment advisor to serve as a director. As a result, in the future, the two sides will enter into a strategic partnership to jointly complete precision drug development and drug marketing, or will not only stop guessing.

There are many problems behind the excitement

“Obama’s accurate medical concept came out and the United States is still relatively calm, but China is showing a fiery scene in every corner. Even the township hospitals claim to be doing precision medicine. Accurate medical centers are also set up like bamboo shoots. The industry does not talk about a few precise medical treatments, for fear that they are considered to be incomprehensible to science.” He Lin, an academician of the Chinese Academy of Sciences and a member of the Chinese Academy of Sciences, has recently become acquainted with the current international standards of precision medicine and future health. Medical treatment splashed a bit cold water.

He Lin pointed out that precision medicine should not be used generically and should not be abused. How to use medication patterns from empirical medications (A not, use B, B, then C...) to personalize medicine (for A, B, C The steady change in the mode of medication for the crowd requires a cold reflection in practice rather than a “great leap forward” type of input that really contributes to health.

Wu Bolin stated that precision medicine provides opportunities for genetic testing and genetic counseling. However, not all projects are "tall," the better, medium and small scales are needed, and they can be recognized by the people and the market. If there is a lot of data in a test report, it looks beautiful, and there is no practical guidance value, and finally it fails to solve the problem for the doctor and the patient.

Zhu Bin, chairman of Shanghai Biao Technology Co., Ltd., also stated that the contents of the report should meet the clinical needs, but at present, because there is no uniform standard, the time and contents of reports after testing by different agencies have affected the doctors to a certain extent. The patient's treatment time and plan, and even the doctor, asked how to use the data.

In addition, during an interview, the reporter found that in the precision medical industry, there are still some products in the market with different price levels, exaggerated efficacy, and Bo human eyeballs.

Zhou Hongyu, academician of the Chinese Academy of Engineering and director of the Clinical Pharmacology Research Institute at Central South University, said that although capital inflow has helped and promoted the development of precision medicine, the industry needs to be calm and persistent in its growth process in order to make this project a healthy project. development of.

Recently, the Chinese personalized medicine-precise medical science industry alliance came into being. Many experts believe that there is still a lot of work in precision medicine that needs to be studied in depth to find out more new biomarkers and provide new treatments for people whose medical needs are not met.

As the industry continues to push forward, it is still necessary to solve the problem of how to implement it, and it has not only stayed at the technical level.

Wu Bing suggested that to apply the principle of applying one to one to genetic polymorphisms associated with complicated diseases that have been independently confirmed by many independent researches, it is necessary to provide the subject with a high-quality and standardized test result interpretation report, and Relevant high-level genetic counseling to assess the risk of morbidity and the individual's possible incidence of the disease, and to design individual disease prevention and health management programs.

In addition, some industry insiders suggested that the need to speed up the improvement of laboratory practices, data storage management, etc. issues involving personal genetic information, data security supervision and ethics and ethics also need to be paid attention to.