OK. Good evening and welcome to the first meeting of trafficking in.
My name is Michael. Allow me to get a quick comment.
And I am the coordinator of the project got out of the heat of the announcement of these new interdisciplinary seminars.
I am delighted to see so many of you today. Thank you all for finding the time to join us for the very first day of access media scrum.
Before starting, I would like to thank those institutions and people.
Without some done these projects, enough will be possible.
The work on institutional strategic support grants and the joint venture funds for countries
supporting their projects that we saw that put us in such a wonderful venue for us together,
for our discussions and are all in Canada,
so pretty handle all the captures books that directness and the complexity of the issues that we will explore in these meetings.
My gratitude goes also to all your colleagues in the UK and the world who have supported my project in various ways,
especially thanks to my team, my Japanese police department today for his invaluable and continues mentorship to report.
I have been following my academic and artistic journey and to align my clients because he asked new directions.
Thank you also to my daddy for accepting my invitation to co-host each event.
Madalena is an apology registrar in our London hospitals, as stated in the programme.
Please note that the seminar will be recorded and made available on the university podcast website and that forecast.
We will also see to take a piece of paper on which you can write down the name and email address,
and if you would like to be added to the mailing list, I now have the pleasure and honour to introduce today's speaker just and track
the official confirmation on medecine at the National Department of Medicine,
University of Oxford. Professor von Trier is co-director of the Oxford Martin Programme on Affordable Magazines,
and that's been made Oxford's The Challenge set up for innovation just to be being a pioneer,
as well as an innovative idea discovery of new drugs for many cancer, metabolic and neuropsychiatric diseases.
Setting up a first image system for Travis County, Texas,
in addition to his eminent academic profile chapter leader the more than 300 invited lectures across the world.
Buncha is an expert in several fundamental charitable research funding bodies,
as well as an advisor for many biotech and pharma giant to solving problems.
In, people follow one of the top innovators, he said.
I really thought that it could be no just another.
Take a seminar series that encourages us to receive and perhaps even present AI concepts of illness and cancellation.
What do medicine accomplish and have in common?
In what sense, and to what extent is translation using context as different as the transfer meaning from one language or media to the other?
The concept of a knowledge foundation and the process of protein synthesis?
How we did not. So the standard of translation help us advance in each area and we see that as well as in clinical research.
In today's talk, Jasper, shall we tackle these questions from the perspective of the next of kin?
Chief Scientist ActionScript Southampton, lead researcher Closer to possibly sustainable scientific advancements and with ethics,
he will explain to us why we are masters at translating that science easily medical
patients and we said yes to which measures we can take in order to improve translation.
So please join me in welcoming transformative. Is it possible to get the projector off, do you think that?
Well, ladies and gentlemen, good evening. Thank you very much for coming. It's nice of you to give up your evenings to listen to me.
That's sort. So the title I gave this talk was we are not very good at translating lab science or data science.
It's a New Mexico.
So when I think of translation, I think that maybe at least three definitions we talk about translating into medicine, rather that it's a need for a.
We're looking to talk about this.
We also talk about taking life science based science that we do in cells and tissues or organs or animals and translating that into action.
So showing that what we live in animal overextended or at is also seeing humans in the cage in healthy individuals and patients we talked
about that is translating science from the bench to that people also talk about translating knowledge and creating benefits for industry,
creating benefit for society, creating benefit for the economy.
So that could be a form of creating new companies, new jobs, helping the local economy, et cetera, et cetera.
The pizza, the maestro that so I will talk about these last two.
So in terms of drug discovery, let me just share with you what I worry about.
I worry that as a community. So when I say community, I mean us as academic scientists,
but also I mean scientists working inside biotechs or scientists working inside pharmaceutical companies.
We as a community are not producing enough new medicines.
I also worry that when we do produce a new medicine, frankly, it is becoming increasingly unaffordable.
I also worry that in biomedical research, there is massive duplication.
Many academic labs, many industry labs, they all work on the same, few ideas in parallel and in secret.
And most of those ideas are destined for failure.
And I also worry that when I talk to my colleagues in the industry, they say that 50, 60, 70 percent of academic literature, they cannot reproduce.
So these are the major problems. Let me kick off, just think about it.
What do patients, what do patients carers?
What do relatives? What do health care providers expect from us and what they fund our research?
They fund it, not the people I make and produce papers and become more famous.
That's not the intention they are giving us funding because they want us to help patients help society.
Now what do they expect from us? Now I think what they want is they want more novel medicines.
They want more effective medicines. They want more affordable medicines.
And they want to quickly. Let me just take each of those in place for a three month assignment.
So in the UK, in the next 12 months, three hundred and fifty thousand people will get diagnosed with cancer.
That is one thousand people every day. That's one person every 90 seconds.
Half of us in this room during our lifetime will have a diagnosis of cancer.
In the next 12 months, 14 million people on the planet will get diagnosed with cancer.
I worry a lot about dementia in the UK today, we have 850000 people with dementia.
In 2050, that number will be 2.1 million.
We are going to have to 60 the size of Berlin with dementia.
The average cost of caring for a dementia patient today is thirty two thousand pounds a year.
That's to the tax package. And that's despite the fact that two thirds of the cost is ruled by the relatives.
So if you add that up, we are spending twenty six billion pounds a year just looking after dementia.
Thank you.
All of us who need to more than 80 years of age, one in six of us will have to, which we not come up with a new treatment for dementia since 2002.
And that treatment is purely a symptomatic treatment that works in the first few months of the diagnosis maybe 12 months, 18 months.
And then after that, it stops working.
We desperately need new treatments for dementia, and I don't think we're even close to having something that is effective and safe in patients.
And this is an area that the industry is ploughed over the past three decades, several tens of billions of dollars of research funding.
Mental health. It's a massive talking point across this university, across all universities, across societies across the world.
It's estimated that a quarter of adults during their lifetime some sort of mental health episode.
It's estimated across Europe, probably 20 percent of people have some sort of depressive episode at any one time.
We probably got 83 million people across Europe with some sort of mental health condition.
And I had a horrific figure recently that if you take a 15 year old girls in the UK out of every 150, one of them will be in Iraq.
These are horrific figures. A.J. We've got ageing societies across the planet.
In the next 20 years, we are going to have a doubling in the number of pensioners with no health conditions.
It's going to be a 180 per cent increase in patients with cancer, a 180 percent that's almost triple.
There's going to be a 120 percent decrease in patients with diabetes.
So more than double. These are major challenges. Yeah, these are common diseases.
Now, if you talk about rare diseases across the planet, if you add up all the rare diseases there,
seven thousand diseases, if you add up all the patients, that's about 350 million patients across the planet.
30 percent of those kids do not reach the age of five. It takes anywhere between six and eight years to get a diagnosis.
But would you believe it that 95 percent of those individuals? Absolutely no treatment whatsoever.
Can you imagine being a parent of a child where there is no.
Anti-Microbial resistance in this country, Sammy Davis is now headed Trinity in Cambridge.
Former chief medical officer For the past five, six, seven years, she's been highlighting what a crisis we have in terms of.
We're becoming resistant to existing antibiotics. And she estimated that today, if we at the moment,
about 700000 people across the world are dying because they are resistant to existing antibiotics in 2050, that number is estimated to be in.
And in the O'Neill report, which was published four or five years ago,
he said that if we don't come up with a new generation antibiotics, then by 2050, it's the cost of the planet.
One hundred trillion in GDP. Massive challenges.
Let me just share with you the story from those of the patient, the patient's mother.
So about four years ago, I gave a public lecture of a sudden people living in the Months Institute.
At the end of this lecture, this lady came up to me and she said, Professor answer.
My daughter died earlier this year with a brain tumour.
If you want to study that brain, this is where you can get it for that, she handed me this slip of paper a little.
This paper was that her daughter's name, the date of birth, the day she died.
And what frightens me after this, my wife paid me up and I said to my wife, I just know a complete stranger offered me the great deal.
This is how desperate parents carers are.
We desperately need new treatments. We need more effective treatments.
They might think, Well, why do you say to help all the drugs that are out there affect it?
Well, in 2015, there was a publication where they looked at the treatments we had at the time, the solid tumours.
So at the time, we had 71 treatments with solid tumours, and they looked to see how much benefit these treatments provide.
And the conclusion of this paper was that of the 71 treatments, the average increase in progression free survival was two point five months.
The average increase in overall survival was 2.1 months and also send people in treatment.
They concluded that only 30 of them have clinically meaningful efficacy,
so less than half the drugs that are out there are clinically meaningful at the pace we need for effective treatments.
We also need more affordable treatments. So again, this publication in 2014, they looked at in the UK in the year 2000,
we had sixty nine treatments for cancer of those 50 with cytotoxic agents.
The average duration of treatment was 181 days.
The average cost of the treatment was three thousand pounds and in the two thousand three thousand that estimated to be about 20 percent of our GDP.
They did the same analysis in 2013, so more than a decade later, by now, we had a further sixty three drugs for treating cancer.
The average duration of treatment was not two hundred sixty three days.
So it's gone up from urging you wants to invest. But the average cost of the treatment was now thirty five thousand pounds a year.
It's gone up from three thousand thirty five dollars.
In 2013, 14, thirty five thousand was estimated to be 140 percent of our GDP per capita, up from 20 percent to 40 percent.
And that trend, frankly, is continuing. Last year, Novartis had a drug approved by the FDA for a rare condition.
Now this is a gene therapy. So it's a single injection, and the cost of that single injection is two point one to five billion dollars.
So more than two million dollars for a single injection. Now, even in the U.S., they will not be able to afford it.
You know, in the U.K., I guarantee the NHS will never pay for it and leave aside countries like China or India or in Africa or South America.
We need more affordable drugs and of course, we need to quickly.
Tomorrow, it's too late for these patients. They want the drugs that we need more novel drugs.
We need more effective drugs. We need more food because then we need to quickly.
The problem with the way that the drug discovery today, frankly, is too costly, it's too risky and it's too slow.
So let me just take each of those two calls. So in 2012, Forbes did an analysis where they looked at the number of these pharmaceutical companies.
They looked to see how much money they spent a lot of money over a five year period.
And they used to see that finite period. How many drugs did they launch?
I mean, they are true. They divided one number by the other.
Then they came up with an average cost of new treatment. Now that's analysis for AstraZeneca.
The average cost of the new drug was 11 and a half billion dollars, 11 and a half billion dollars.
The best in that analysis was after, but even they were about three and a half billion dollars.
Now, most people accept today that the average cost of a new drug is somewhere between three and four billion dollars.
Bear in mind to run this whole university with the thirty nine colleges and all
the divisions and all the departments and all salaries and all the infrastructure,
it's probably about two billion pounds. So that one of the cheap calls to launch one of these drugs.
But bear in mind, many of these drugs that were launched were not truly novel drugs.
Many of them are what we would call me tubes of new formulations.
And that's not what we need. We need absolutely new treatments for some of these conditions.
So it's too costly. It's also too risky. So again, in 2013, there was a publication where they looked at.
So in the year 2002, across the world, we had five hundred and twenty nine molecules in development for cancer.
So volume development, we read that they were either in phase one study or phase two study for phase two study five of the infection.
They looked to see a decade later in 2013, what happened to the five minutes ideology that they found 45 of them made it to the market.
Ninety five was development, but 389 molecules were terminated.
So we took it as a community. We took three hundred eighty nine molecules into the clinic, into patients and their families.
Can you imagine how much money we spent on those molecules? Can you imagine how much is also how many people's careers went into that?
They can't, even importantly, imagine how many patients were exposed to those molecules before we?
This process is too risky in the same study they looked at,
if a molecule is in phase one for cancer, what's the probability it will make it to the market?
The answer is seven and a half percent less than one in 10 molecules in phase one.
The cancer makes the little they look to see if a molecule is in phase three for cancer.
So these are the final registration studies. What's the probability we'll make it to the market?
The answer is three percent. Only one in three molecules in phase three for cancer makes it to the market.
It is too risky. It's also too slow.
A couple of my colleagues, Stephane Bancel, Michael Silver, a few years ago published a paper.
They looked to see, where did we come up with data that a particular target could be useful in the lab?
And then how long did it take to take that idea into the clinic?
And the answer was anywhere between six years to 30 years, three, zero, three decades.
This process is too costly, it's too risky and it's too slow.
So what this industry, this community employs some of the smartest people on the planet to have access to great technologies.
They have access to great collaborators in the sector. Why is it so difficult?
I think there's a number of reasons, and I would group the group them into making scientific challenges and then maybe organisational challenges.
So let me just take each of those into to scientific. First of all, I do not think the many diseases in the country.
We have a very good understanding of the molecular causes.
Frankly, if I take a patient with schizophrenia or depression or Alzheimer's, there's nobody on the planet.
You could tell me the molecular causes of the phenotype and not one individual.
This is a major problem. These diseases are incredibly heterogeneous.
If we took a hundred patients with Alzheimer's, they would all be different different ages,
different sects, different way, different ethnic backgrounds, different diets, et cetera, et cetera.
But importantly, their symptoms would be completely different. Some of them would have just forgotten where their keys are.
Others will not even recognise that case. Some will be aggressive.
Some will be depressed. Some will be anxious. Some will be agitated, etc. These are incredibly heterogeneous diseases.
We also find many of these diseases. We do not have good biomarkers by biomarkers,
only readouts that we can use in the clinic to assess if a new molecule is effective in the clinical study in Alzheimer's.
You can't say to the patient, though. Is your memory better today than it was last week?
Well, you can't say to a depressed patient, are you less depressed today than you were last month?
We need that survival. We there are also many molecules, drugs that we don't even know how they work.
Paracetamol, acetaminophen, we've all taken it.
Probably today across the planet, 100 million people took paracetamol.
We do not know how the pharmaceutical works. We go into the mode of action we don't know the science of.
So if you don't know how existing drugs work, how can you design better?
And then I'm afraid, animal models now, many of us use them.
Some of you probably use them. I'm afraid I do not believe we will ever, ever have an animal model that truly recapitulate clinical disease.
We will never have an animal model that predicts schizophrenia in the clinical depression in the clinical Alzheimer's,
and I appreciate they have their uses. Know we need to get a sense of some sort of in vivo activity.
We need to get some sort of idea of what the side effects may be.
But I tell you, just because something works in an animal model does not mean it will work.
I have seen many things work beautifully in animal models, and we take that into the clinic and.
The major scientific challenges, then there are organisational challenges, and I touch all these at the stuff.
At the moment, many academics, many scientists in biotech.
Many scientists in the pharmaceutical industry, they all work on the same few ideas,
the same futile society, molecular biology, and they do this in parallel and they do this in secret.
They all read the publication in Nature and then they start working on it.
They all read the same publications that go to the same conferences. They talk to the same opinion leaders.
They go back to their labs and start working on exactly the same idea in parallel, in secret.
Now we know that most of those ideas, when we translate them from the lab into the clinic,
the failure rate is more than eight times of 10 nine out of 10.
I've heard figures as high as 95 percent.
95 percent of our life is from the lab do not translate into the clinic, so you can imagine if you've got 20 companies doing exactly the same thing.
If one of them fails, the other 19 are likely to fail.
The way we're doing drug discovery today, we are wasting a lot of the money.
We're wasting a lot of people's careers.
But importantly, we're exposing patients to molecules that other people or other organisations already know are destined to fail.
This is the consequence of competitive science.
So major challenge, and then I also try to reproduce that there have been some high profile publications from companies like Bio and Jet,
where they said 50, 60, 70 percent of academic reviews.
Now there's no point people like us getting defensive about it.
We just need to do something about the major scientific organisational challenges.
So it's very easy to identify the problems. So what's the solution?
What are we going to do to practise? So let me just share with you what we've been doing in office that over the past 12 years,
I came back for the 22nd of January 2018, so almost exactly 12 years.
So in the past 12 years, what we've been doing is maybe four things.
Firstly, we've decided that we're only going to work out completely normal,
like normal genes, normal proteins, genes and proteins that nobody else is working on.
There's no other publications, et cetera. So we work on these, and what we do is we generate novel tools to reach the genes and proteins.
We purify the human protein. I'm not interested in rats and mice.
We build biophysical biochemical assays. We work out the structure of that protein.
We generate small molecule inhibitors and we generate bodies.
So we work on novel genes and we generate novel tools, and we do this to drive innovation.
But what we've also done is we've pooled resources to share risk.
So currently, we're working with nine large pharmaceutical companies.
Each of these companies has given us five million euros of funding over a five year period.
We're also getting funding now from certain patient groups for Alzheimer's Research UK.
Four years ago, it's 10 million pounds six months ago.
Getting this notifiable because the Wellcome Trust over the past 12 years has given us close to 60 million pounds into our lab,
we were pooling all of these resources to share with.
The third thing we do, and this is probably what makes this the most unique, all of these tools that we generate and these tools are high quality,
not because we're clever, they're high quality because we're tapping into the resources, the expertise of these nine large pharmaceutical companies.
We have access to their whole phone collection of how we develop assays, their high throughput screening, etc., etc.
So what makes this unique is that these tools, which are high quality, we make them freely available,
we give them away to anybody in academia, anybody in biotech may putting in fun.
But the reason we do that is because we believe that's the best thing we can do to facilitate science and therefore facilitate drug discovery.
Now, of course, the consequence of that is that you can imagine every academic who comes into my
office wants to collaborate with us because they know we've got their secrets.
We'll share all of our new and all of our expertise and all of our reagents.
That transparency creates a lot of trust, which is great for collaboration.
It's great for science and it's great for drug discovery. So we're not collaborating with more than 300 academics across all of these labs.
Take these novel tools and then they test them with whatever they are.
It could be a model for cancer or a model of diabetes, or some rare disease or some dementia model or whatever.
And then, of course, academics all they care about is publishing, so they publish this data.
They take the high quality novel tool they test in there and say they publish it.
This is a way of crowdsourcing science, and the full thing we do is that all of our data are all of our knowledge, all of our reagents.
We share them with the world media, so we get a signal at the club months while we're writing the manuscript because in those 12 months
there could be people out there trying to do something that we've already done that would be a waste.
So if I were using it immediately, we're trying to reduce duplication and waste.
So the four things who resources to share with working novel areas generate novel, high quality tools to drive innovation,
make everything freely available to crowdsourced science, and release everything immediately to reduce duplication of the way to.
Let me share with you some of the things that we're now doing. So we've been building lots of links with patient groups.
The patient groups are already very powerful and in future years they're going to become even more powerful.
They are already telling the government where to spend their research dollars, but we're keen to work with patient groups for two reasons.
One, they can help us get patient material, so I'm not interested in testing on molecules in our own walls.
I want to test for the cancer cells in patients or immune cells from patients.
I think that's a much better way to come up with new targets to block this cycle.
But also, if we generate the molecule and I think it's going to be useful, let's say Huntington's disease.
Well, I give you the best. Scientists on the planet are in Huntington's disease.
You can imagine this charity does that, so they will give that molecule to those respective labs to try and accelerate the science.
So getting closer to the patient groups.
The second thing we're doing is we've built this dementia institute and in this institute we're focussing on completely pathways.
I'm not interested in working on amyloid and I'm not interested in working on trial because frankly,
the global community has been doing that for 30 years, and we've done 13 or 14 phase three clinical trials in Alzheimer's.
And every single one is there. So we need to move into new areas.
So we're looking at the role of like a and looking at the role of inflammation.
We're looking for the role of epigenetics. We're looking at the role of metabolic pathways, cetera.
So we're trying to come up with completely new approaches to continue to match.
The third thing we're doing is we're now trying to build across the UK a national
initiative to accelerate new therapeutics for multimorbidity associated with ageing.
So we're all aware that elderly patients don't have one disease. They normally have half a dozen diseases.
This is a bit of cancer of the cardiovascular systems compromise that people with compromised.
They have respiratory problems, they have frailty, et cetera, et cetera.
Now we believe that there are pathways that affect multiple morbidity associated with ageing.
And so we're trying to identify targets all those pathways in an attempt to get one drug to treat all of the walk.
This is a completely new approach. This is not something that the pharmaceutical industry is doing.
This is not something that biotech to do.
This is something that's going to be incredibly risky because it's going to involve working with lots of different clinicians at the moment in pharma.
What happens is you come up with a drug for diabetes and a separate one for Alzheimer's and a separate one for cancer.
Here we're not talking about coming up with something, but we're going to measure lots of different readouts in a particular way.
But we now have the technologies that allow us to do that.
So you now when there are companies like, say, the market based in Boulder,
Colorado, where they can take a tiny sample of blood and they're not so good,
but they can measure 5000 different proteins, the $200 the TV is doubling, measuring 10000 in three years.
It will be the whole plan because these platforms have become cheaper, higher throughput, Blackpool and faster.
Then of course, you've got wearables, devices, you know, these wearable devices.
Now you can measure heart rate, blood pressure, respiratory rate,
lots of other parameters continuously 24-7 longitudinally non-invasively noninvasively cheap.
We can generate tens of thousands of data points on each particular patient.
And then, of course, we now got things like air and machine learning to help just put all that data together to make sense of it.
So we're trying to build this national effort. We're working with the University of Dundee because they have lots of chemistry.
We're working with the Medicines Discovery Catapult in Manchester because they have access to patient groups and see our rows.
We're working with the University of Birmingham because they've got access to a catchment of six million patients,
and we're working with the crick because they've got lots of cool biology. So these four centres in Oxford are pulling this national effort together.
We're also having discussions with the Wellcome Trust about generating tools for the whole of the human genome.
So you're aware that in humans there's 20000 to 30000 different proteins, each of those proteins could be a drug target.
Now at the moment, the drugs that are out there probably hit about, let's say,
a thousand of these targets that if you look at what the biomedical community is working on with the land,
they're probably looking at another two thousand. But there's probably ten twelve fourteen thousand genes for which we have no tools.
We have no protein, we have no structure, we have no evidence that we have built an antibody.
So we're talking about how we can create an international consortium to generate
tools for the whole of the human genome in an attempt to accelerate discovery.
So let me sum up now, I think at the moment in biomedical science,
there's too much competition, too much secrecy, too much duplication and too much waste.
What we're trying to do is we're trying to bring together lots of clinicians, lots of academics, lots of pharma companies, lots of patient groups,
lots of funders to work together to come up with completely Typekit new ways
of treating disease in patients new de-risked targets for treating disease.
If we do this, we believe it will be good for industry, obviously, but it'll also be good for patients.
It'll also be good for society and the economy. What we're trying to do is to create a new ecosystem for drug discovery and ecosystem,
which I hope will generate more novel drugs more quickly, more effectively.
But I hope that these drugs will also be more of.
Now, this whole seminar series that Martin sets out, the rough translation and the humanities, et cetera, and I think the market for the coffee,
the one of the things that we need are colleagues in humanities to do to help us in this regard is that we need people to write about this,
to talk about it. I knew I could write plays, write books, write articles, etc.
We need to get people out there to appreciate what a crisis.
We have an anti-microbial resistance, what a crisis we have and people have, what a crisis we have in dementia.
This is the only way we're going to start putting more focus on.
And you know, what's been amazing to me in the past, let's not exceed four years.
It's the power of celebrity. If I think of David Attenborough three years ago, nobody was really talking about plastic pollution.
He does this one programme, and now you've got kids in the holidays cleaning up beaches and everybody's talking about.
Four years ago, people weren't really talking about mental health outcomes Prince William and Prince Harry and Stephen Fry,
and now people are talking about it. This is the power of celebrity.
This is the power of storytelling. This is the power of poetry. And so we need to help with what you and your colleagues.
So, ladies and gentlemen, thank you very much. Thank you for sharing with us.
I hope that was of interest in. Thank you so much just for such a comprehensive talk and nice and thought-provoking show that that fast and awful,
awful fact to be pleading that I actually see no need for conflict or anything.
And I totally agree with you that we're going to be mine, he said.
Then back to the same stories. Let's see if we have not done any one of those photos or stories.
The story got quite a lot of DNA, it says we hopefully as humanity is going to also connect the diagnostic and therapy as well as,
you know, a documentation of it.
So thank you so much. It was such an inspiring look.
And I like I never like to ask this audience whether there are any immediate responses to Chelsea's talk.
Uh, yes, it course. Enjoyed it very much was because it recalls a time I spent in the electronics industry and I had a very similar problem.
And open innovation suddenly appeared on the scene. Just like you, you're trying to do it here.
But the missing ingredient in your field seems to be the collaboration between companies in the electronics area.
Things like roadmaps for the next generation of CDs and DVDs, or cover televisions or whatever they appeared.
And you've got a lot of collaboration between the companies that used to fiercely compete with each other.
So this open innovation model accelerated products to market by a factor of two.
I suspect, is anything like that happening in the pharmaceutical and drug discovery at the request.
It is a great question. I think the community is getting better, but I don't think it's as advanced as your community, if you like by,
I mean, certainly we've now got nine follow companies working together, but this is the very early stage.
I mean, one of the things that worries me like the leader in your field.
I mean, sort of there are many farmers, you know, now there's 200 drugs out there for cancer and there are many companies.
They are just sticking combinations together with a couple of them,
just either because they've got them in their own portfolio or they're partnering with another company.
They've got their asset and they just try it and see that it's not a rational way to do it.
You know, at the end of the day, you know, if I was a patient or a carer of a patient and I thought,
you know, we were doing this speculative experiments in patients, you know,
I would both be happy, etc. So we do need to come up with a rational,
more efficient way of doing this because I think this combination will be effective, but it needs to be well thought through.
And I think we have a lot to learn from people like.
So we try and sort of we make that happen.
I mean, the lessons you've learnt, the challenges you went through, some of that we need to communicate those to the community that I work.
Yeah. So thanks for us. Thank you so much.
If there anyone else? Yes. All right.
So you mentioned earlier that the example of Alzheimer's disease research and how 30
years of research was spent on kind of spent research and nothing really came of it.
Can you tell us more about what happened there and the mistakes made there have any lessons for other subjects or.
Yeah, I'm we're in the master's course in clinical neuroscience and we've heard this story many times,
but no one can really tell us what exactly this happened.
So it's a great question that we sort of, you know, we started working on that amyloid in, let's say, the late 90s.
And so the hypothesis was that this protein unalloyed accumulates in the brain.
As a consequence of this accumulation, you get the generation, you get cognitive decline, you get dementia.
So what everybody's been trying to do for the past three decades is either stop the synthesis of that
protein or increase its breakdown or increase its removal from the brain gets clearance from the brain.
And frankly, after 30 years, we know we still got positive clinical data.
I can share with you a story, and I think he was probably about 2014 15.
I was at a meeting that was organised by the New York Academy, the FDA and the NIH, and they wanted a bunch of us.
I think there's about 30 of us to think about a clinical trial in Alzheimer's for prevention.
So at the time, the thinking was that the treatments we've been giving in these clinical studies, it was just too late,
you know, so all these clinical trials were done when the patients demonstrated some sort of cognitive decline.
And then after that, of course, they just spiralled down.
But of course, we now know that you can detect amyloid in the brains of patients maybe 10 to 15 years before they show any symptoms.
So the idea was to do a prevention trial. Now, of course, if you do a prevention trial, the trial is going to be much longer.
It's going to require a lot more patience and it's going to be a lot more expensive.
So already one of the phase three clinical studies that Libby did cost 750 million dollars to do,
one of these prevention trials would be a multi-billion dollar experiment.
But you know, the biggest challenge is that and I believe it's fair to say,
even with all the clinical trials that are being done, you know, these are expensive experiments.
A lot of that data is not available to us.
So, you know, either the data is not published if either the publish or it's not published quickly enough or it's not published in enough detail.
So basically, people are doing the next experiment with that before they learnt from the previous failures, etc.
And that's something that we need to try and change.
Now, I think things are getting better. Industry is publishing more of that data.
But you know, it's good knowing that all the cold ban didn't work because what you need to know is what dose did you give?
What exposures did you get? What were the biomarkers you Typekit you select the patients.
Which centres did you do the trial, all of that sort of stuff.
So there's so much detail that you need to understand and compare these studies, and that's that's the big challenge.
You've spoken a lot about the development of science in the masses of data and sharing resources.
And I just wondered what your opinion was on preregistration and how that may potentially influence collaboration between
different industries that fit into types of studies of investigators that be around before the data is actually being produced.
So sorry, I thought that what you're saying is that the drug is taken to the market and and then you tested it,
lots of patients, and that's when you get final approval.
So as in like before you start carrying out your studies of the drug, you pre-register your hypothesis.
And how you aim to carry out study is something that's starting to be done in the field of psychology.
And it's that sort of setting up the precepts that you aim to produce how they can influence.
I think that that could only help.
I mean, if what you're saying is if I work in a lady or Pfizer and I'm planning on doing a clinical trial in Alzheimer's, I share that protocol.
I share what I intend to do. I get people in the industry, in the academic community to critique it, whatever.
I think that can only help.
But the challenge, of course, is that, you know, a lot of these companies are competitive, and if they're working on the same target,
then they're not necessarily going to want to share the trial design or details of that molecule, etc. So I'm not sure how we have to stop this.
Yeah, I was wondering what your advice would be to young people who haven't yet differentiated or
specialised in any particular sector and kind of what sector do you think is most ripe for?
I guess change or disruption along the pipeline of transition?
So I mean, the one thing I would say is that I encourage all my academic colleagues to go work in the industry because I think you learn so much.
You learn to speak the language. You understand what the issues are, what the priorities are.
You grow your network. And if you do come back into academia that you will continue to work together, et cetera.
So I think I would encourage all of you youngsters because you're all going to live to the age of 100 and you're going to have multiple careers,
just move around and get lots of experiences.
Spend a bit of time in academia, a bit of time in industry, maybe a bit of time and a charity,
a bit of time with a venture capitalists or whatever, et cetera,
et cetera,
and understand each other's perspective because I think the only way we're going to succeed in this game is if we break down into these silos.
This is a team sport and you know, I, you know, I don't like people in academia criticising people in industry and vice versa,
etc. You know, I genuinely believe that people in the industry have tried to do the best they can,
but we all have our own constraints and our own priorities, etc., etc. So we just need to understand each other's perspective, but just work together.
The yes, of course, this is also a problem of land.
Yes, and we're going to speak each other's language. You would hope on the phone the device would be in line with these people.
How do you envisage, if at all, eye rolling on the minds of people in the city and specifically in the development of new drugs?
Well, I'm not quite sure, but for her to answer that question, let me try this way.
You know, I love working with patient groups and patient groups because they are just desperate for a new case.
You know, they do. They don't want to hear excuses. They don't want to hear people like me say, Oh,
it's the regulators or the hurdles are too high or they just want the drugs and they have this absolute razor sharp focus and we just have.
And so I think, you know, it's very easy as an academic just to make excuses.
As long as we produce a few pages and get a few problems, it's all fine.
But, you know, I genuinely think we are here not just to produce papers,
but it is very much to translate as it translates and to create benefits for patients, the society for the industry and for the economy, etc., etc.
You know, we work in a very privileged environment, you know, sort of we're surrounded by awesome people.
We attract the best students and the best researchers. We have access to wonderful infrastructure.
We have lots of research funding. We have great convening power.
Our alumni network is global.
My God, if we call them the to probably this problem of West, they the something that very much both the sciences and humanities and showing.
We need to do something to demonstrate to businesses, can we take some more questions?
I can, probably. Yeah, that's all right. I was wondering what you think the role of government and policy could be in?
Taking this process and having more transparent.
You know, I I think I think many of these problems that we're trying to tackle global problems, the global challenges.
And I think they require critical mass.
They require lots of innovation, entrepreneurship risk Typekit doing things that nobody's even dreamt of, global sorts of etc.
I think it involves people working with individuals from other disciplines.
You know, I often say to colleagues, many said in the next 10,
20 years is going to get completely transformed, not necessarily by biologists or chemists,
but war by engineers and computational scientists and materials scientists and data people, et cetera, et cetera.
They're going to completely transform this area. And so we need to work with other disciplines.
We need to work with other institutions. We need to work with all the stakeholders, you know, industry patient groups, regulators, funders.
You know, one of the things I you know, I believe the funders need to do is and I think they started doing it.
I think one of the great things that David Cameron did do was set up this dementia research
institute in the U.K. So this was two hundred and fifty million pounds into dementia research.
And I understand from talking to John Bell is like. He got to be another 500 million coming in that area.
But I think that's the sort of scale of funding we need to tackle some of these problems, but it needs to be done.
A lot of these things, you know, even in Oxford, we don't have all the expertise, the resources, et cetera, et cetera.
We have to work with each other. I have to. We have some we have time for some questions.
What are your items like paper and another voice of humanity?
Actually, two questions that they're sort of combined. He said that you're sharing immediately the results of your research and work.
Could you say how actually to do it, if not through publishing papers and articles and send it before making another question?
Sort of combined with this one and more towards the actual translation of the very basic understanding of the work.
You mentioned that you work closely with the patients organisations.
Do you actually make any effort? And I know it might not be crucial in your work,
but you actually make any effort to translate your scientific what's called meta language into common words
that would be understood by patients who are essentially involved and interested in the results of your work.
So the first one actually rapidly descended on me, so we talked about a lot of data.
We share our tools immediately, we publish it on our website.
So that's the way we can simulate it in terms of the language with patient groups.
You know, it's interesting one of the things I learnt when I talked to some of these patient representatives.
You know, it is incredible how much they know about the science. You know, they have read every single paper like they can get ahold of.
And that's a sign of desperation. And so we it, we have to do that, to be honest.
But the one thing I am convinced of, though, is slightly related.
Comment is, you know, often at the moment when, for example, a patient with Parkinson's or outside is goes to see their GP.
Now they may see their GP every three months to ten minutes or something like this,
etc. You cannot expect the GP to have a very good understanding of that patient's symptoms, et cetera, has to be resolved.
But I tell you, the people who really have a good understanding is usually the carers.
Often their spouses do you know? And so we need to listen to that thinking if the project projects just yes.
Yeah, yeah, yeah, you're definitely right.
I think there are the humanities can do a lot to get rid of a few misconceptions that are on both sides.
Oh, sorry, yeah. Misconceptions that are on both sides.
I mean, the scientists believing in total objectivity or, you know,
aspiring to some executive definitive solutions that theoretically would resolve problems for everybody
in the same way and have the same degree of efficacy and also the expectations of patients from science.
I think but both sides should become more aware of their limits and of how much more they can do by,
you know, helping one another in ways that are not directly connected with markets, the results.
So I think that's something the humanities is indeed entitled to do, but it's difficult.
For example, eight years ago, if I may just mention something personal,
I was very interested in Alzheimer's in observing how linguistic decay happened in Alzheimer's.
Suffer suffer. In that particular case, it was my father and I got some money to do some some sort of research academy in New York,
which then developed into something very literary how emissions work in literary and literary works.
And I was surrounded by neurologists, and of course, I could not believe my luck.
But they probably want to understand what I meant by coming from a literary point of view.
So, you know, I tried to make myself as understandable as possible,
but there's a lot that we could do and absolutely glad that our and authors are trying hard to translate medicine into literature and literature to,
of course, to take it as humanities into into the scientific visions of I don't know how that can be possible, but I just want to thank you for it,
for prompting us to want to write about it and make people more aware of of how vast the, you know, the questions still are.
But it's exciting for us human beings who suffer from all kinds of diseases.
Well, let me just share this with you. You said so.
About three or four years ago, I was asked to go to a charity event in London where they were trying to raise money for Alzheimer's research.
So this event was organised by a young musician who played the violin,
and he was telling us that he was one of 10 grandchildren and he played his grandfather's violin and his grandfather had just died.
And that's what prompted him to organise this event. And his grandmother would could not remember the names of the other nine grandchildren.
But if she could remember his name and he was convinced it was purely because he played her husband's violin.
I've also heard, you know, some of the musicians, either sometimes you go into these sort of care homes, et cetera.
But some of these poor individuals, they're just sort of sitting on a chair and just staring at the wall, etc.
And but if you go in and you see the solemn little place of music that they loved when they were 20 years old or 30 years old,
they simply get up and start dancing. The facial expression just completely changed.
So there's something about music, which.
I don't understand it. I a certain degree you want to to me that this is going on and they maybe this number one question, I do see that and a.
Do I? Yes, please. So this has made a question.
The humanities people here. It strikes me that one of the most important things that we sometimes don't translate
to the general public as scientists is the the idea that but to some degree,
the low-hanging fruit in pharmacology ought to be dealt with.
So it comes back to you. What about expectations?
So, you know, we're about 20 metres away from where Howard Florey spent the last three years of his life having developed penicillin.
So the penicillin is a sort of the poster child really in terms of pharmacology.
A single drug massively effective against its target and killing it.
And saving millions of lives and vaccines similarly massively effective, saving millions of unnecessary premature deaths.
It may be the case that pharmacology has no equivalent drug for Alzheimer's.
Has that lucrative drug for even those cancers that we really do understand quite well and clean, clear cell reading cell carcinoma.
We know is driven by a mutation in a gene that encodes a protein that is in the potent machine that destroys other proteins.
We know that. But you know, the smart money says that it's probably unlikely to be a drug or target.
So, so maybe there isn't a drug that will do the same thing for set for that particular treatment.
So do you think one of the biggest problems and challenges we face as a community and this goes probably further along
the room is in trying to help everyone on the planet to understand the pharmacology may not have all the answers.
I mean, let me answer this in two ways.
I think you're right that sometimes as scientists, we like to be touched and always especially to fund the research,
and we need to be careful not to need to be responsible for it.
The second thing is that I do think patients want and their carers want hope that is important.
The third thing is that, you know, I fully accept the disease like Alzheimer's, which you could argue is massively affected by environment.
It probably started when the individual was conceived, and it's been building up over the past 50,
60, 70 years, etc. So it's a very complex, multifactorial disease.
I fully accept that. I I also I worry that I mean, I've never worked in the antibiotic resistance.
But, you know, I always used to think that if you've got a bug in the dish and you've got a volunteer killer kills that bug in the dish,
that we should be able to translate that into the clinic.
You know, if you get the right concentration in the blood that you should kill the bugs in patients, etcetera.
But clearly, it's not the case so that we run into mechanisms or rather resistance, et cetera, et cetera.
So you're right. And the.
If I thought that I've done this without my thank you so much right now,
you are set to make space for a more risky environment where science is a minefield, getting back on a journey together.
And I would like to thank you for being here and to all members of the cabinet who took part in tonight's discussion.
I just want to remind you that our next meeting will be on Monday, the 17th of seven next Monday week.
Five. It always it, and I'm happy you anticipated that the topic of Professor Green has to be the crucifixion of rather
peter more planes and religious imagery in two competing narratives about the Cochrane collaboration.
So thank you for being here. Thank you.
I know.