A Spoonful of Sugar? - A Case for Customized Cancer Treatment

The remarkable recent advances in genomic technologies may represent medical science's best chances for fighting many forms of cancer. Philip M. Parker, the Eli Lilly Chaired Professor of Business, Innovation and Society, presents a clear, concise and comprehensive overview of the scientific, political, ethical and commercial issues surrounding recent developments in genomic technology as it is being used to fight one of the world's most dreaded and prolific diseases.

by Philip Parker
Last Updated: 23 Jul 2013

The remarkable recent advances in genomic technologies may represent medical science's best chances for fighting many forms of cancer. With the World Health Organisation warning that global cancer rates might quite possibly increase by 50% by 2020, enormous resources are now being devoted to genetic therapy research worldwide.

Philip M. Parker, the Eli Lilly Chaired Professor of Business, Innovation and Society, presents a clear, concise and comprehensive overview of the scientific, political, ethical and commercial issues surrounding recent developments in genomic technology as it is being used to fight one of the world's most dreaded and prolific diseases. The case describes the great expectations associated with findings based on the Human Genome Project, a massive genome mapping and sequencing study completed in 2003 that will allow researchers to produce DNA sequence chips, enabling them to identify various types of cancer cells in their earlier reproductive stages. Such breakthroughs in gene decoding may provide much more than revolutionary advances in curing genetic-related diseases. They may even change much of the fundamental nature of medicine, from the current role of being essentially reactive to disease, to being inherently more predictive and preventative.

Most experts predict that there will be a massive breakthrough in cancer-related genetic diagnosis and therapy in the near future, largely made possible by an almost 1000% drop in the costs of DNA sequencing since the early 80s. The study discusses the three potential product areas in genetic-based oncological research: detection, treatment and prevention, stating that "genetic therapy [may soon be] almost substitutable for traditional therapy", and may soon dominate the market in all three areas. This will almost certainly happen by 2020, when customised treatments are generally expected to be available.

The case details major developments anticipated in the next few decades, stressing that the timeline may well be shorter, given the strength of the current combines forces of technological progress and massive investments in biotechnologies globally. It also highlights recent innovations in the field of detection, including various methodological improvements and a global genetic database for cancer that will soon be made available.

Despite customised genetic cancer medications being the result of new technologies that have not yet matured, the author sees the market's value chain as being very similar to that of the traditional pharmaceutical industry. This is presently based on five major forces: equipment manufacturers and chemical substance suppliers; various barriers to entry (which are currently quite high); potential buyers; the entry-stage status of all traditional drugs makers, and the relatively poor performance of almost all currently available non-gene-based medicines.

The study concludes with a discussion of regulatory and governmental issues involving the most influential organisations affecting the future of customised gene medicines in the US government and the World Health Organization. It also briefly considers various commercial liabilities that may be associated with R&D, as well as wider ethical and legal issues at the heart of the ongoing controversies that currently surround so many areas of genetic engineering.

INSEAD 2003

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