Francis Collins, MD, PhD
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We are making strides against cancer not enough of course, but you've seen death rates from cancer drop by 1% per year for the last 10 years after going steadily up before that, and we have alot of work to do. What is happening in the basics science of cancer is breathtaking. We really understand at the most detailed level what causes cells to grow out of control.

The challenge is to take that information and change it as quickly as possible into new targeted therapeutics. You can see the leading edge of that already happening, take drugs like perazodin just approved by the FDA in fairly record time to treat people with lung cancer who previously have essentially no effective therapies. It only works for people who have this rearrangements of a particular gene called ALK, but if you're one of those, you're going to have very likely dramatic response. Some of the things that are happening with Melanoma. Likewise, by knowing the BRAF gene is mutated in melanoma, we now have a drug that goes after that specifically targets the myelogenous cell, that's where we need to go.

But I think nobody would imagine for that single drug therapy for cancer is the future answer, it's going to be combination just like we do for HIV/ AIDS and getting to that end point is particularly challenge. The problem with making therapeutics work is the pipeline is too long and the failure rate is too high. If you are an engineer looking at this problem, which is what we are trying to do right now in our age, you try to identify what are those obstacles and how could we get around them?

Not project by project, it's systematically. Take for instance, how we figure out whether a drug is safe before you give it to somebody in the phase I trial, we do that by animal testing, that's the same way we've been doing it for a very long time. We all know it doesn't work very well, it's costly and slow, couldn't we do better? We have this collaboration with NIH and the Defence Advanced Research Projects Agency (DARPA), that's the group that brought us the internet, GPS, and some other pretty high tech things. The goal is to take the revolution stem cells that are happening all around us, where you can take a skin cell for butane and differentiate that into a liver cell, or a muscle cell, or a kidney cell, load those on unto a biochip, outfit them with readouts that will tell you about genetic expressions, metabolized, proteins, and use that as a detector of whether a drug is going to be toxic or not.

Add the drug to the chip and ask the chip, are you happy? And you can tune that system with drugs where you know the answer. That would be revolution. It would allow us to test many more compounds, and I think give us more careful answers before we go into a clinical trial. That's is just one idea.

That would never happen by a single company effort, but between NIH, and DARPA, and companies, and the FDA are working together, we think we could get that obstacle out of the way.

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