**It is now my great pleasure to introduce you to Dr. Bruce Bloom, President and Chief Science Officer of the Partnership for Cures.
**Dr. Bloom, welcome. First, I will ask a question that I have asked others on my blog, do you believe it is possible that cancer could be eradicated by 2015 like the NCI hopes?
Natalie, under the current cancer research and treatment paradigm I don't think we will eradicate cancer by 2015. First, we're still researching cancer cures as if cancer is a distinct and well defined disease, like a bacterial infection, even though we have overwhelming evidence that there are huge variations in cancer cells between patients with the same diagnosis, within a single patient, and even within an individual tumor. Thousands of researchers are trying to develop ways to block one specific cancer pathway or jumpstart one supportive pathway even though we know that cancer cells almost always develop alternative ways to avoid these single pathway treatments, or even combinations of these single pathway treatments. Most of these pathways are also critical in the function of normal cells, so that blocking them or revving them up has significant side effects. We need to find a better way.
Second, we still use the "maximum tolerated dose" theory of treatment. We give as much drug as we believe the body can tolerate in order to try to overwhelm cancer. The toxic effect of this massive dosing often causes patients lose their fight against cancer. This massive drug dosing destroys the very immune system that is set up to help us fight disease, and this chemotherapy also damages other body systems that are necessary for healing. And even when these massive doses of destructive drugs don't kill the patient directly, most patients still lose the fight against cancer. We need to find a better way.
Third, we still treat cancer patients without considering their total care. We give massive drug doses at a time during the day when it is convenient for the physician or hospital staff, not in a dosing schedule or at a time when it would be most convenient or beneficial for the patient. During the weeks between treatment we leave the patient to fend for himself or herself, requiring them to recognize side effects and determine when things are serious enough to call for help. We often ignore the fact that nutrition, mental health, exercise, and other factors play a huge role in a patient's recovery from disease, especially from cancer. We need to find a better way.
Fourth, most researchers function independent of other researchers and cannot disclose their results until all of the intellectual property and publication protections are in place, so the time it takes for us to share information is significantly delayed, This silo research also causes us to often repeat the same research over and over in different labs, wasting time and valuable resources. We do a lot of curiosity research instead of cure research. We've set up a reward system based on IP and publication success, and we encourage researchers to undertake research that has a long tail so that they can secure funding for long periods of time to support their labs. We don't routinely provide any true incentives to researchers to push better treatments to patients unless they or their institutions or some pharmaceutical company can make a large profit from it. We spend lots of money on things that cannot get us to a cure, and we spend it in multiple places doing the very same thing. We need to find a better way.
There are a number of things we could do by 2015 to improve our chances of conquering cancer. We can put a premium on prevention. Reducing the incidence of cancer or delaying the onset of cancer will affect the morbidity and mortality rates of cancer much more profoundly than any cure we are likely to create in the next 7 years. But these kinds of epidemiological studies don't make a lot of money for anyone, so there is little economic incentive to support this research. We need to government to support much more of this kind of research.
We can continue to focus on early diagnosis. The sooner we know a patient has cancer the better the chances of controlling or curing it. Lots of current research is focused on earlier diagnosis, and we could do more, especially in the way we collaborate to speed this information to market and to patients, and to reduce the amount we spend on redundant research.
In the end I don't think we'll find the "silver bullets" the current research paradigm is looking for. Instead of finding a cure for cancer, it is more likely that we will find a way to turn cancer from an acute, life threatening disease into a chronic, manageable disease. Instead of blasting cancer patients with the maximum tolerated (or often NOT tolerated) dose of drugs, we will give them minimum doses of a large number of drugs, each of which will thwart enough cancer cells to allow the body, over a long period time, maybe many years, to either keep the disease in control or actually remove all traces of the disease from the body. The lower doses of these drugs, combined with nutrition, sleep, exercise, mental health and other supportive care, should create fewer side effects so that patients can live a high quality extended life on these regimens.
I believe we probably already have discovered all the drugs and other therapies we need to create this multiple drug, low dose, holistic cancer control regimen, but we don't have a regulatory, research or reward systems to support finding it or testing it for use with patients. There is no economic incentive to get this done. This kind of multi-drug regimen is not likely to be embraced by a single pharmaceutical company, and it is not likely that a consortium of companies will get together to support it. It will be hard for physicians to embrace this regimen unless there is strong scientific research to back it up. The cost of supporting this massive research undertaking is beyond the support of most individual foundations. The combined efforts of the government, industry, academia and philanthropy could undertake this endeavor, but the economics, politics and bureaucracy are likely to keep this from happening.
**Please tell me a little about yourself and your work.
I am currently the President and Chief Science Officer for Partnership for Cures, a public charity that drive better treatments and cures to patients in 2 years or less, primarily by repurposing existing drugs and other therapies for new uses in new diseases. We believe this is a fast, safe and inexpensive method of helping patients with disease right now. When we repurpose existing drugs, like Rapamycin for the children's disease ALPS (Autoimmune Lymphoproliferative Syndrome), we can often drive an effective, safe and inexpensive medical solution to patients in a very short period of time at a very low cost. This research, undertaken at Children's Hospital of Philadelphia, took less than two years and cost under $100,000! These ALPS children now have an inexpensive treatment for their disease that looks like it might extend life significantly and with good quality.
I've been doing this work for the last 6 years. I first became involved with clinical research in the early 1980's when I was a Director of Clinical Research for the National Patent Development Corporation, the company that brought the soft contact lens technology to the US. Later I supervised clinical research for Bausch and Lomb and for a number of start-up biotechs.
I am also the host of The Clinician's Roundtable on ReachMD, XM 157 on XM satellite radio, the channel for medical professionals, and also at www.reachmd.com. I interview scientists about their research, and also focus on the business of healthcare, the history of healthcare, healthcare public policy, and healthcare non-profits. I welcome inquiries from experts interested in being interviewed so that the audience can learn from them.
**I understand you attended 5th State Of The Art Symposium On Hematologic Malignancies. Will you share with us some of the information from the event?
Goldman Philanthropic Partnerships, the foundation that spun off Partnership for Cures, worked with Dr. Phil Greipp and the Mayo Clinic to sponsor the 1st State Of The Art Symposium On Hematologic Malignancies, which at the time was focused only on multiple myeloma. We're delighted with the progress that this program has made over the years, creating a forum for education of clinicians and the dissemination of cutting edge research information.
**In your opinion, what should the research priorities be over the next 5 years?
Changing the research reward systems so that researchers can focus on driving treatments and cures to patients instead of driving intellectual property to patent lawyers and papers to publishers. Until we reorganize and reorient the focus will not be on the patient. We've been working on finding cures for forty plus years under this current system and we're not delivering. There are some examples of how this can get done. The Multiple Myeloma Research Consortium is a good example of how to give researchers incentives to work together to share information and resources, and how to manage IP and publications so that they don't interfere with the focus on patients. Other countries are finding ways to get around these obstacles. Singapore has created a research hub that has motivated some of our best researchers to leave the US.
**In your opinion, what has been the biggest breakthrough in cancer research in the last five years?
Our ability to differentiate one cancer cell from another in what we used to diagnose as a single disease. The human haplotype project and all of the work being done around the world to continue to help us see cancer as a multi-dimensional disease and constantly changing disease that needs a multi-dimensional solution.
**Thank you very much for your time Dr. Bloom.
For more information on Dr. Bruce Bloom, click link below:
http://www.4cures.org/
**Dr. Bloom, welcome. First, I will ask a question that I have asked others on my blog, do you believe it is possible that cancer could be eradicated by 2015 like the NCI hopes?
Natalie, under the current cancer research and treatment paradigm I don't think we will eradicate cancer by 2015. First, we're still researching cancer cures as if cancer is a distinct and well defined disease, like a bacterial infection, even though we have overwhelming evidence that there are huge variations in cancer cells between patients with the same diagnosis, within a single patient, and even within an individual tumor. Thousands of researchers are trying to develop ways to block one specific cancer pathway or jumpstart one supportive pathway even though we know that cancer cells almost always develop alternative ways to avoid these single pathway treatments, or even combinations of these single pathway treatments. Most of these pathways are also critical in the function of normal cells, so that blocking them or revving them up has significant side effects. We need to find a better way.
Second, we still use the "maximum tolerated dose" theory of treatment. We give as much drug as we believe the body can tolerate in order to try to overwhelm cancer. The toxic effect of this massive dosing often causes patients lose their fight against cancer. This massive drug dosing destroys the very immune system that is set up to help us fight disease, and this chemotherapy also damages other body systems that are necessary for healing. And even when these massive doses of destructive drugs don't kill the patient directly, most patients still lose the fight against cancer. We need to find a better way.
Third, we still treat cancer patients without considering their total care. We give massive drug doses at a time during the day when it is convenient for the physician or hospital staff, not in a dosing schedule or at a time when it would be most convenient or beneficial for the patient. During the weeks between treatment we leave the patient to fend for himself or herself, requiring them to recognize side effects and determine when things are serious enough to call for help. We often ignore the fact that nutrition, mental health, exercise, and other factors play a huge role in a patient's recovery from disease, especially from cancer. We need to find a better way.
Fourth, most researchers function independent of other researchers and cannot disclose their results until all of the intellectual property and publication protections are in place, so the time it takes for us to share information is significantly delayed, This silo research also causes us to often repeat the same research over and over in different labs, wasting time and valuable resources. We do a lot of curiosity research instead of cure research. We've set up a reward system based on IP and publication success, and we encourage researchers to undertake research that has a long tail so that they can secure funding for long periods of time to support their labs. We don't routinely provide any true incentives to researchers to push better treatments to patients unless they or their institutions or some pharmaceutical company can make a large profit from it. We spend lots of money on things that cannot get us to a cure, and we spend it in multiple places doing the very same thing. We need to find a better way.
There are a number of things we could do by 2015 to improve our chances of conquering cancer. We can put a premium on prevention. Reducing the incidence of cancer or delaying the onset of cancer will affect the morbidity and mortality rates of cancer much more profoundly than any cure we are likely to create in the next 7 years. But these kinds of epidemiological studies don't make a lot of money for anyone, so there is little economic incentive to support this research. We need to government to support much more of this kind of research.
We can continue to focus on early diagnosis. The sooner we know a patient has cancer the better the chances of controlling or curing it. Lots of current research is focused on earlier diagnosis, and we could do more, especially in the way we collaborate to speed this information to market and to patients, and to reduce the amount we spend on redundant research.
In the end I don't think we'll find the "silver bullets" the current research paradigm is looking for. Instead of finding a cure for cancer, it is more likely that we will find a way to turn cancer from an acute, life threatening disease into a chronic, manageable disease. Instead of blasting cancer patients with the maximum tolerated (or often NOT tolerated) dose of drugs, we will give them minimum doses of a large number of drugs, each of which will thwart enough cancer cells to allow the body, over a long period time, maybe many years, to either keep the disease in control or actually remove all traces of the disease from the body. The lower doses of these drugs, combined with nutrition, sleep, exercise, mental health and other supportive care, should create fewer side effects so that patients can live a high quality extended life on these regimens.
I believe we probably already have discovered all the drugs and other therapies we need to create this multiple drug, low dose, holistic cancer control regimen, but we don't have a regulatory, research or reward systems to support finding it or testing it for use with patients. There is no economic incentive to get this done. This kind of multi-drug regimen is not likely to be embraced by a single pharmaceutical company, and it is not likely that a consortium of companies will get together to support it. It will be hard for physicians to embrace this regimen unless there is strong scientific research to back it up. The cost of supporting this massive research undertaking is beyond the support of most individual foundations. The combined efforts of the government, industry, academia and philanthropy could undertake this endeavor, but the economics, politics and bureaucracy are likely to keep this from happening.
**Please tell me a little about yourself and your work.
I am currently the President and Chief Science Officer for Partnership for Cures, a public charity that drive better treatments and cures to patients in 2 years or less, primarily by repurposing existing drugs and other therapies for new uses in new diseases. We believe this is a fast, safe and inexpensive method of helping patients with disease right now. When we repurpose existing drugs, like Rapamycin for the children's disease ALPS (Autoimmune Lymphoproliferative Syndrome), we can often drive an effective, safe and inexpensive medical solution to patients in a very short period of time at a very low cost. This research, undertaken at Children's Hospital of Philadelphia, took less than two years and cost under $100,000! These ALPS children now have an inexpensive treatment for their disease that looks like it might extend life significantly and with good quality.
I've been doing this work for the last 6 years. I first became involved with clinical research in the early 1980's when I was a Director of Clinical Research for the National Patent Development Corporation, the company that brought the soft contact lens technology to the US. Later I supervised clinical research for Bausch and Lomb and for a number of start-up biotechs.
I am also the host of The Clinician's Roundtable on ReachMD, XM 157 on XM satellite radio, the channel for medical professionals, and also at www.reachmd.com. I interview scientists about their research, and also focus on the business of healthcare, the history of healthcare, healthcare public policy, and healthcare non-profits. I welcome inquiries from experts interested in being interviewed so that the audience can learn from them.
**I understand you attended 5th State Of The Art Symposium On Hematologic Malignancies. Will you share with us some of the information from the event?
Goldman Philanthropic Partnerships, the foundation that spun off Partnership for Cures, worked with Dr. Phil Greipp and the Mayo Clinic to sponsor the 1st State Of The Art Symposium On Hematologic Malignancies, which at the time was focused only on multiple myeloma. We're delighted with the progress that this program has made over the years, creating a forum for education of clinicians and the dissemination of cutting edge research information.
**In your opinion, what should the research priorities be over the next 5 years?
Changing the research reward systems so that researchers can focus on driving treatments and cures to patients instead of driving intellectual property to patent lawyers and papers to publishers. Until we reorganize and reorient the focus will not be on the patient. We've been working on finding cures for forty plus years under this current system and we're not delivering. There are some examples of how this can get done. The Multiple Myeloma Research Consortium is a good example of how to give researchers incentives to work together to share information and resources, and how to manage IP and publications so that they don't interfere with the focus on patients. Other countries are finding ways to get around these obstacles. Singapore has created a research hub that has motivated some of our best researchers to leave the US.
**In your opinion, what has been the biggest breakthrough in cancer research in the last five years?
Our ability to differentiate one cancer cell from another in what we used to diagnose as a single disease. The human haplotype project and all of the work being done around the world to continue to help us see cancer as a multi-dimensional disease and constantly changing disease that needs a multi-dimensional solution.
**Thank you very much for your time Dr. Bloom.
For more information on Dr. Bruce Bloom, click link below:
http://www.4cures.org/