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What we can learn about cancer drug development from the COVID-19 approach | COMMENTARY

PHARMACEUTICAL COMPANIES DELIVERED PROMISING COVID-19 VACCINES | The pandemic wreaked havoc on everything from the economy to people’s personal lives, so when talks of a promising vaccine were heard, the entire country rightfully breathed a sigh of relief. On Nov. 16, pharmaceutical company Moderna announced that preliminary data showed the COVID-19 vaccine developed in collaboration with the National Institute of Allergy and Infectious Diseases was 94.5% effective. The update followed a similar announcement from Pfizer and BioNTech, which showed their COVID-19 vaccine was also 95% effective.  Fast-forward into December, and the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention have approved the use of Pfizer’s vaccine for people over the age of 16, and more than 20 million people could get vaccinated before year’s end. While the vaccine doesn’t mean a return to normal life, it’s the biggest step forward yet.
PHARMACEUTICAL COMPANIES DELIVERED PROMISING COVID-19 VACCINES | The pandemic wreaked havoc on everything from the economy to people’s personal lives, so when talks of a promising vaccine were heard, the entire country rightfully breathed a sigh of relief. On Nov. 16, pharmaceutical company Moderna announced that preliminary data showed the COVID-19 vaccine developed in collaboration with the National Institute of Allergy and Infectious Diseases was 94.5% effective. The update followed a similar announcement from Pfizer and BioNTech, which showed their COVID-19 vaccine was also 95% effective.  Fast-forward into December, and the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention have approved the use of Pfizer’s vaccine for people over the age of 16, and more than 20 million people could get vaccinated before year’s end. While the vaccine doesn’t mean a return to normal life, it’s the biggest step forward yet. (LINDSEY PARNABY / Contributor/Getty Images)

As an oncologist, I recognize the arduous path to make a new drug. It is a hard trek that lies between the bench and the patient’s bedside. Ordinarily, it takes five or more years just to get a new drug into the clinic for testing. Similar time is needed for clinical trials. Then comes Food and Drug Administration (FDA) approval, followed by the time it takes for licensing, manufacture, distribution and adoption by physicians.

Ordinarily, this means that 12 or more years might pass before the FDA even begins its evaluation of a new drug or regimen. This is before any therapy becomes part of our disease-fighting armamentarium.

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Witness the difference, however, when public-private interests meet in formal partnerships to accomplish the extraordinary. More than one COVID-19 vaccine became available in less than one 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 had never been tried before. By comparison, it took four years to get to market the mumps vaccine that was until now the shortest time for vaccine development.

These partnerships brought together government experts at the National Institutes of Health and elsewhere with other scientists and clinicians who work in the academic and biopharmaceutical sectors. These partners moved at breakneck speed. And now public-health, policy and logistics professionals in both the public and private sectors must join again for an effective vaccine delivery system to get a shot into everyone’s arm.

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Now, imagine how difficult the task is for deadly cancers. Unlike COVID-19 with a single viral cause, cancers typically arise from multiple genetic changes. As a cancer doctor I know firsthand this dismal statistic that speaks for itself: Only about 1 in 20 promising cancer drugs that enter the clinic ever win FDA approval. And the development costs are enormous. We need better and faster results. But this is not easy to do.

First, we need a cancer drug target that when altered gets rid of a cancer. Then we must find a compound to do the job. They are discovered by probing millions of structures for the rare ones that affect the target in the desired way. The early ones hardly ever turn into drugs to give to patients. They might not be selective enough, have inadequate drug levels, have too much toxicity or side effects, or are tricky to make.

Overcoming these shortcomings takes time. A different approach is required.

Public-private partnerships are a solution. They look beyond any single person’s skills to bring together experts with diverse talents and robust resources. United, they collectively attain feats that were previously beyond their reach. We saw the success of this tactic against COVID-19. Let’s now use the same plan in our fight against cancer.

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A growing number of organizations are taking advantage of the power of partnerships. These are efforts like the National Cancer Institute’s Chemical Biology Consortium, the Innovative Medicines Initiative in Europe and Open Targets. This is a start.

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

Consider how real-world experiences of cancer sufferers could be mined from their medical charts. Sophisticated artificial intelligence tools can unleash insights that are hidden in these records. This could lead us to find new cancer therapies.

COVID-19 is a global health crisis. It called for an international collaboration to find the first remedies. Cancer, like this pandemic, flouts national borders. Large-scale cooperation between nations could accelerate our progress against cancer. And this might model how best to uncover solutions to other big problems that we face like repairing our infrastructure or confronting climate change.

By banding together, the public and private sectors can make an even greater difference in the lives of those stricken with cancer. Only time will tell whether this approach will triumph. But all of us have a stake in its success. Otherwise, too many of us or our families must still endure the awful burden of cancer.

Physician-scientist Ethan Dmitrovsky (ethan.dmitrovsky@nih.gov) is president of Leidos Biomedical Research and Director of the Frederick National Laboratory for Cancer Research.

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