Recommendations from the Chairman, President and CEO of Eli Lilly and Company on how to accelerate cancer research. Some of the recommendations reflect industry interests but nevertheless valid. Of course, regulations always struggle to get the balance right between innovation and patient safety. Quote:
…. we’ve learned that cancer is not one disease but more than 200—arising along different biological pathways with countless environmental or genetic origins. We’ve learned that responses to the same treatment for the same cancer vary considerably from patient to patient—depending on an individual’s genetic characteristics.
…. we’ve also learned that there is unlikely to be a single breakthrough that defeats all cancers. No scientist or drug developer I’ve ever met is working on “the cure for cancer.” Instead, they are trying to understand one or more of the myriad ways in which cancer arises, nurtures itself, and spreads. Or they are shepherding through clinical testing one of the nearly 1,000 molecules targeting cancer that are in the pipelines of the pharmaceutical industry. Tying such learning together allows progress against cancer to move forward in small steps. These steps add up to significant progress against cancer over time, but there is no denying that they are stubbornly and painfully slow.
These lessons of the last 40 years tell us something about how sound public policy can help to pick up the pace against cancer going forward. Government funding for basic research remains essential—certainly in the case of cancer research. However, the most important new things that we could do today against cancer don’t involve spending large sums of taxpayers’ money:
- Modernize the regulation of clinical research—to encourage smaller, faster, and less costly clinical trials targeting more narrowly defined patient groups, and trials that can be adapted mid-stream to what is being learned.
- Encourage much greater participation of patients in clinical trials. Deterred by misperceptions, lack of information, logistics hurdles or cost concerns, less than five percent of cancer patients today join clinical trials in the U.S.—denying potential health improvements to them and scientific insights to researchers.
- Break down silos between the regulation of diagnostic tools and drugs—to encourage faster development of what are called “personalized medicines” that target the patient groups in which they will work best, along with new diagnostic tools. This is the path to better health outcomes and fewer wasted expenditures.
- Transform the period after regulators approve new cancer therapies into a hotbed of continuing research on what works, in what groups of patients, and in what combinations and circumstances. To glean this knowledge faster—and to drive better treatment and payment decisions with it—we need to build repositories of patient data and tissue samples and link them worldwide.