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signature of K9 lymphoma (in the works), she’ll be able to match that signature to signatures in the NCI-60 to discover which of the 110,000 tested drugs will likely work best with K9 lymphoma. Then, staying always within the bounds of compassionate care, she can test the promising drugs that COXEN picks in CSU’s K9 patients. It’s a short step from a dog-proven drug to humans.
Dan Theodorescu, MD, PhD, director of the CU Cancer Center.
B I G - P HAR M AN D LITTLE D R U G S This biomarker-driven cancer care is also forcing academia and industry to step quickly out of the box of drug development mechanics it’s been in since the 1950s. Sure, bigpharm is willing to pony up the $100 million needed to push a big drug through the process of FDA approval—but what about a small, targeted cancer therapy? If a drug is meant to eventually target 100 people a year as opposed to 10,000, will big-pharm still pay for it? For example, imagine if a biomarker target and a drug to nix it were found for heart cancer. Yes, it killed Eric Carr, drummer of the rock band Kiss, and yes, it’s a leading candidate for Catherine of Aragon’s death in 1536, but only a handful of cases are seen each year in the United States. The same is true as we split big cancers into their smaller subsets: Would big-pharm fund development of a drug to target, for example, a biomarker present in only 0.5 percent of lung cancer patients? “Personalized medicine, driven in part by matching drugs to biomarkers, is forcing industry and academia to reevaluate how we do business,” says Andrew Thorburn, PhD, deputy director of the CU Cancer Center. What he means is this: don’t expect bigpharm to pay for little drugs. That is, unless academia can give it to industry as a slam dunk. Thorburn says this slam dunk depends on matching drugs to biomarkers before a drug’s first human trial. “If you give a targeted drug to a general cancer population, the proportion of people who respond might not be high enough to make the drug look effective,” Thorburn says. In this way, drugs that could have helped the 0.5 percent die in development. The fix? Thorburn says it’s in the deep science of picking apart patients’ genomes for predictive biomarkers—the genes that hint at who will and who won’t respond to a drug, and then testing the drug with only this high-responding population. It’s a task, says Thorburn, for which academia and not necessarily industry is best suited. “That’s why some cancer centers, the CU Cancer Center included, would like to put in place the infrastructure that would allow us to take a drug through phase I clinical trials in-house, in some cases before courting industry involvement,” says Thorburn. “But to do so, we’ll need the generosity and vision of philanthropists.” The CU Cancer Center has molecular biologists on hand discovering biomarker targets, synthetic chemists making the arrows, and innovative animal researchers taking drugs to the tipping point. “What we don’t have are experts who can make drugs usable for humans or the institutional money to fund clinical trials,” Thorburn says. And this monkey wrench of money in the cogs of drug development mechanics means that a biomarker with potential, matched with a drug that has potential, may stay as that: potential. Currently academia can produce the frog footmen with jam-smudged lips and the Red Queen to yell “Off with his head!” In most settings, it lacks only the final axe to get the job done: money.
Learn about the CSU Animal Cancer Center www.csuanimalcancercenter.org Make a donation to support the CU Cancer Center http://giving.coloradocancercenter.org
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