ΣΥΝΕΝΤΕΥΞΗ – Dr. Aristides N. Patrinos

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Dr. Aristides N. Patrinos, President of the judging committee of Prix Galien Greece, Emeritus Director for Research, NYU Center for Urban Science and Progress, and Senior Advisor to the U.S. Secretary of Energy Ernest Moniz

I can only hope that what we have accomplished since the sequencing of the Human Genome and the unequivocal demonstration that genomic medicine can revolutionize both the diagnosis and treatment of diseases including cancer will lead to a new era of health care and health delivery. I cannot speak for politicians in the U.S., in Greece, or anywhere in the world. I can only hope, and as an optimist I believe, that they will see the obvious “writing on the wall” and act accordingly.

IMG_9787_optMr. Patrinos, last February you have been invited by the U.S. Vice President Joseph Biden, following the request of President Barack Obama, in order to solicit your advice about the enforcement and better coordination of the running R&D programs concerning cancer known as the “Moonshot” initiative. Please, tell us about this important project.
In his last State of the Union address President Obama announced an initiative (he called it a “Cancer Moonshot”) to significantly improve our understanding and treatment of cancer and asked Vice President Joseph Biden to lead that effort. The Vice President had recently lost his son to brain cancer, one of the reason he decided not to run for President so he was passionate about taking on such an assignment. The President also told the Congress that he is requesting an additional one billion dollars to kick start this initiative. The Vice President swiftly got to work and convened an interagency team of scientists and administrators and set the goal of presenting to the President by 1 November 2016 a plan for the Cancer Moonshot. The Vice President explains the goal in simple terms: ‘figure out what it is that we can accomplish in improving the treatment of cancer in ten years, and then outline what it takes to cut that time in half, that is in five years.” He also insisted that the Moonshot draw from the talents of all the Departments and Agencies and not be confined to just the National Institutes of Health (NIH). As it turned out the Vice President’s enthusiasm was infective because a number of private sector initiatives on cancer were launched by wealthy individuals who both individually and collectively asked the Vice President to provide the necessary leadership and coordination in order to create a whole greater than just the sum of the parts. Although not certain, there is an expectation that the Vice President will continue to lead these efforts after he steps down from office next January.

Although important efforts have been made in the past from both the private and public sectors in the U.S. to face cancer with a total cost of billions of dollars, unfortunately, there has been insufficient coordination and collaboration among those programs contributing to major inefficiencies and miscommunication. In your opinion, what is the reason for this and what are you expecting to succeed by participating in The Cancer Moonshot Task Force?
Yes, I agree that the history of our many campaigns against cancer is discouraging at best. An excellent account of our many crusades against cancer is found in the book,” The Emperor of All Maladies, A Biography of Cancer,” by Siddhartha Mukherjee, that describes the ups and downs of surgery, radiation, chemotherapy, and biologics therapy. The book also covers the failures that can be attributed to the absence of effective coordination and to miscommunication. The fact of the matter is that cancer is not one disease but a family of diseases that are traced to misspellings of our DNA caused by a diverse set of external and internal factors. Moreover, we humans are generally living longer that by itself contributes to an increase in the incidents of cancer.

Still, we should not become discouraged by our past failures but we should redouble our efforts to take on this scourge. Our advances in DNA sequencing and analysis are powerful new weapons in the renewed battles and recent advances in immunotherapy are very promising. I also believe that there is now a growing awareness in both the public and private sectors that increased coordination and enhanced sharing of data and other information can benefit all parties involved even when there are compromises in the sharing of intellectual property. That is why I am optimistic that the Moonshot can catalyze new ways of attacking cancer.

Which is the role of the public and, respectively, the private sector in the U.S. concerning the research of new treatments against cancer?
As I mentioned above, we are breaking new ground in reconciling the competing interests of the public (including academic) and private sectors of the healthcare enterprise dealing with cancer. We are developing the framework of what we call the three P’s that stand for “Public Private Partnerships.” It is wonderfully rewarding to experience the enthusiasm and genuine commitment to collaboration among many prominent philanthropists and private sector senior executives. This is not to say that there won’t be competition and rivalries for the best ideas and products but there is also genuine interest to find ways to share data and experiences. Respected statesmen like Joseph Biden serve valuable roles to bring the various parties together and enable the forging of these important partnerships. One of my principal interests in the Moonshot is to harness the high performance computing capabilities (the supercomputers) of the Department of Energy in order to solve previously intractable problems in cancer research. They include such problems as the accurate simulation of transport of various pharmaceuticals across the membranes of cells. Also relevant would be the application of “Big Data” statistical techniques and “computer machine learning methods” to the large and very diverse sets of genetic, imaging, and clinical information from such agencies as the Veterans Administration. We are exploring new ways to partner with private companies, such as GSK and IBM, to accomplish these very ambitious goals.

According to the WHO, a rising concern is observed about a worldwide increase of 500.000 cancer depended deaths. Especially in the U.S., there has been a significant increase of 18.000 cases in the last 10 years. Based in this research, those deaths are directly connected to unemployment and the cost cuttings in the public health resources. Do you believe this is the reason why American politics have now focused on the fight against cancer?
The reasons for the “increase in cancers” are many and complex. They include that we, in the West, are living longer and that we are diagnosing cancers that may have been obscure in the past. However, there is no question that our society and our political class recognize that cancer is very much on the minds and concerns of all citizens and therefore they need to be more proactive in dealing with them. Despite our many advances, we recognize that new paradigms need to be explored and implemented and that more diverse sciences (such as physics, nanoscience, applied mathematics, supercomputing, etc.) need to be recruited to contribute to our understanding and treatment of cancer.

Which do you personally, as a researcher, and as member of the American scientific community in general, believe are the influencing factors for the increase of cancer disease incidents. Which is the role of nutrition, prevention, the luck of access of patients to treatment, as well as the modern way of living, in the increase of cancer wordwide?
I am both intimidated by the challenges of the cancer challenge of our times and encouraged by the tools that our research efforts are bringing forward to this battle. I believe very strongly that there is no one single solution and that our only chance of success in limiting the scourge of cancer is to employ a multiple front offensive. It includes aggressively pursuing prevention strategies that include better nutrition and lifestyle adjustments, as well as early detection and treatment. Genomic medicine has opened the doors for both novel preventive approaches as well as treatment modalities and we should fully capitalize on these benefits that have come about because of our Human Genome Project.

Do you believe it is now clear to politicians of influencing countries that precaution and research for treatments aiming at the cure of different kinds of cancer can save the life of millions around the world and in the same time reduce health costs for governments?
I can only hope that what we have accomplished since the sequencing of the Human Genome and the unequivocal demonstration that genomic medicine can revolutionize both the diagnosis and treatment of diseases including cancer will lead to a new era of health care and health delivery. I cannot speak for politicians in the U.S., in Greece, or anywhere in the world. I can only hope, and as an optimist I believe, that they will see the obvious “writing on the wall” and act accordingly. ⨯

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