March 22, 2016 | Written By: Tribune news services | Source: ChicagoTribune
Johnson & Johnson has ramped up its ambitious project to learn how to predict who will develop particular diseases and find therapies to prevent or stop the disease early, when it’s most treatable.
Since the health care giant announced its groundbreaking project in February 2015, it’s expanded to include two dozen research programs with partners — in government, universities, patient advocacy groups and other drug and diagnostic test companies. Their expertise and resources should speed discoveries and allow Johnson & Johnson to spread its funding across more ventures.
On Tuesday, J&J gave an update and announced the latest two projects. They’re meant to identify which pregnant women will develop gestational diabetes, and to identify and treat people at risk of or in early stages of chronic obstructive pulmonary disease, the third-leading cause of death worldwide.
“We’ve really been trying to introduce a new paradigm,” the J&J project head, Ben Wiegand, told The Associated Press in an exclusive interview. “We’re moving from disease care to health care.”
Wiegand said the mapping of the human genome and other recent scientific advances have made that goal feasible. J&J’s “Disease Interception Accelerator” now is working on multiple studies in Type 1 and gestational diabetes, cataracts and vision-damaging presbyopia, depression in women during and after pregnancy, lung disorders and cancers of the cervix, mouth and throat caused by human papilloma virus.
The project is remarkable in an industry whose bread and butter is medicines that patients with chronic diseases take for years.
The idea is to first discover biomarkers — measurable biological and molecular signs in blood and other patient samples — indicating a disease will develop or is beginning. Next, scientists would develop affordable and easy-to-use diagnostic tests for those biomarkers.
Finally, researchers would develop new therapies, or determine which existing ones would work, to head off full-blown disease in those people. Those could include medicines, nutrition changes and physical or psychological therapy.
If successful, those strategies could be used much as cholesterol tests are given to patients, with those who have a problem being prescribed statin drugs to prevent a heart attack or stroke.
“This is the way to go,” said Dr. Robert Hardi, president of the Academy of Physicians in Clinical Research. “If anybody can pull it off, they can” — with help from partners.
He noted that researchers already are developing biomarker tests in areas such as cancer that help doctors pick the best treatment for each patient.
“It may well save a lot of money and a lot of suffering,” added Hardi, a gastroenterologist in Chevy Chase, Maryland.
One of the newest projects piggybacks on existing research at Boston University School of Medicine. It’s been working since 2011 under a Defense Department grant to identify which military members and veterans will develop lung cancer. That group has a high risk because many are heavy smokers and they’re exposed to fuel fumes and other dangerous substances while deployed, said Dr. Avrum Spira, a pulmonologist heading that study.
It’s been testing blood and skin cells and doing chest scans on hundreds of participants, aiming to link changes in those tests over time to which people later develop lung cancer. J&J has given Spira’s group $8 million to test 1,000 civilian smokers, to identify cell changes in the individuals who eventually develop chronic obstructive pulmonary disease, which includes emphysema and chronic bronchitis. They’ll then test therapies to stop further destruction of lung airways.
With another $2.1 million from J&J, Spira said, his team is studying how the immune system fails in the early development of lung cancer and whether new drugs that fight cancer by boosting the immune system could prevent it.
Another new collaboration is seeking biomarkers indicating which pregnant women likely will develop gestational diabetes, so they can be treated to prevent it. Half those women would otherwise develop Type 2 diabetes within 10 years, and their babies have an eightfold risk of developing it eventually, Wiegand said.
Preventing diseases or treating them early on is much cheaper than trying to save people diagnosed with advanced disease, so Wiegand believes that insurers will cover the diagnostic tests being developed and new, proven treatments.
Johnson & Johnson, based in New Brunswick, New Jersey, is a leading maker of diagnostic tests, as well as vaccines, surgical equipment and prescription medicines, putting it in a good position to offer products for many of the disorders being studied.
For the project to have a big impact, the U.S. must to address the shortage of primary care doctors, said Dr. Wanda Filer, president of the American Academy of Family Physicians. She said pediatricians, family doctors and internists, along with nurse practitioners, already focus on preventive care such as vaccines, so they’re best suited for identifying and helping at-risk patients.
With patients more focused on medical costs as they bear more of them now, Filer said, they’ll need to be convinced new diagnostic tests and pre-emptive treatment are worth the cost.
“This could be transformational,” she added.
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March 7, 2016 | Written By: Upal Basu Roy, MPH, PhD | Source: LUNGevity
“The LUNGevity award provided me the resources to study premalignant lung cells—a stage in which normal lung cells have changed, but not yet completely into cancer cells. This is an extremely important area of cancer research for lung cancer as well as for other types of cancers. Studying premalignant cells provides us a unique window to understand the early stages of lung cancer—before the lung cells acquire the mutations in DNA that allow them to become cancer cells. Such studies allow us not only to develop biomarkers for early disease detection, but also to identify new targets for cancer treatment and prevention.” —Jennifer Beane, PhD
Cancer develops in a sequenced manner. Patches of lung cells gain the ability to multiply faster than their neighboring normal cells by acquiring mutations. These patches of cells are called “premalignant lesions” (PMLs). Some of these lesions may eventually become cancer. LUNGevity Career Development Awardee Dr. Jennifer Beane from Boston University has been studying the differences between PMLs and normal lung cells in order to develop predictive biomarkers to determine who might be at high risk for developing lung cancer and thus need further screening. I sat down with her to discuss her work.
LUNGevity: What is the focus of your LUNGevity award?
Jennifer Beane: I was always interested in developing tools to catch lung cancer early. As a PhD student, I studied how a special type of cell that lines the respiratory tract, also known as a respiratory epithelial cell, reacts to cancer-causing substances, or carcinogens. As you know, exposure to cigarette smoke is a known risk factor for lung cancer. My project focused on understanding how smoking injures respiratory epithelial cells. I helped develop a biomarker that could identify whether or not epithelial cells were from a person with lung cancer. While this was exciting, I became interested in understanding earlier stages of the disease—what are the changes that are happening in normal lung cells before they become cancerous? I wanted to learn more about this stage because it represents a unique opportunity for therapeutic intervention. That’s how I got interested in the study of premalignant lesions, or PMLs. These patches of cells in the respiratory tract are not like normal lung cells. They have a life of their own. They can progress quickly to become cancer, go away, or stay stable for years without causing any trouble. What determines whether these lesions become cancerous? Does how the cells respond to injury from carcinogens decide whether a PML becomes cancerous? These questions keep me awake at night and are the focus of my LUNGevity grant. With this grant, I am studying RNA molecules from normal lung cells and PML cells to understand how they work and then develop a biomarker that can identify the presence of PML cells and predict which PMLs will progress to full-blown cancer.
L: What are some of the major findings of your project?
JB: Cells in our body use different metabolic pathways to make energy. While studying PMLs, we stumbled upon something unusual: PMLs and normal lung cells use different pathways to produce energy and survive. We can capture this difference and other changes in a biomarker signature that I developed. This is helpful because our technology is easily adaptable to a clinical setting. In the clinic, respiratory cells are collected during a procedure called bronchoscopy. These cells can then be tested for the presence of a precancer signature. Veracyte, a biotechnology company, has already developed a test known as PerceptaTM to decide whether a person needs further invasive tests to diagnose lung cancer. The idea behind the research on PMLs is to develop similar such tests that can identify people with PMLs that will progress to cancer. People with these types of PMLs would need more aggressive screening or may benefit from cancer prevention drugs. This is a very exciting time in early detection research because there are so many new technologies.
L: How is your project changing our understanding of chemoprevention for lung cancer?
JB: Our research has opened up the exciting possibility of developing drugs that stop lesions from progressing to full-blown lung cancer, a concept known as chemoprevention. For example, taking an aspirin can protect you from developing colon cancer if you belong to the high-risk group. However, we have not had much success with chemoprevention in lung cancer. This might have been because we were not selecting the right group of patients. Now that we have a biomarker signature for PML, we can use it to select patients who might benefit from chemoprevention and treat them with a drug that stops cancer from developing. We are not there yet, but I cannot help but feel excited—we might someday have drugs that stop lung cancer from developing altogether.
(This is the first blog in a two-blog series of interviews with our amazing women scientists, who are contributing to major progress in lung cancer research. Stay tuned for the next blog, which will be focused on Targeted Therapy.)
We are leading a $13.6 million study aimed at developing novel technologies for the early detection of lung cancer. The five-year multi-site, multi-phase study that will focus on active military personnel and veterans is funded by the United States Department of Defense (DOD) Lung Cancer Research Program. We are collaborating with military hospitals and Veteran’s Affairs medical centers across the country that collectively have the ability to investigate a large number of patients and gain access to a diverse variety of researchers and tools. The Detecting Early Lung Cancer Among Military Personnel (DECAMP) Consortium represents the largest consortium of researchers dedicated to identifying non-invasive ways to detect lung cancer early.
Watch the video of Dr. Spira describing this project.