China Turns to Precision Medicine in Fight Against Cancerby
Push is part of a broader effort to dominate biotech globally
Genetic technologies attract funding from Chinese investors
When Nisa Leung was pregnant with her first child in 2012, her doctor in Hong Kong offered her a choice. She could take a prenatal test that would require inserting a needle into her uterus, or pay $130 more for an exam that would draw a little blood from her arm.
Leung opted for the simpler and less risky test, which analyzed bits of the baby’s DNA that had made its way into her bloodstream. Then, Leung went on to do what she often does when she recognizes a good product: look around for companies to invest in.
The managing partner at Qiming Venture Partners decided to put money into Chinese genetic testing firm Berry Genomics, which eventually entered into a partnership with the Hong Kong-based inventor of the blood test. Over the next few months, Berry is expected to be absorbed into a Chinese developer in a 4.3 billion yuan ($625 million) reverse merger. And Leung’s venture capital firm would be the latest to benefit from a boom in so-called precision medicine, an emerging field that includes everything from genetic prenatal tests to customizing treatments for cancer patients.
China has made the precision medicine field a focus of its 13th five-year plan, and its companies have been embarking on ambitious efforts to collect a vast trove of genetic and health data, researching how to identify cancer markers in blood, and launching consumer technologies that aim to tap potentially life-saving information. The push offers insight into China’s growing ambitions in science and biotechnology, areas where it has traditionally lagged developed nations like the U.S.
“Investing in precision medicine is definitely the trend,’’ said Leung, who’s led investments in more than 60 Chinese health-care companies in the past decade. “As China eyes becoming a biotechnology powerhouse globally, this is an area we will venture into for sure and hopefully be at the forefront globally.’’
New Chinese firms like iCarbonX and WuXi NextCode that offer consumers ways to learn more about their bodies through clues from their genetic make up are gaining popularity. Chinese entrepreneurs and scientists are also aiming to dominate the market for complex new procedures like liquid biopsy tests, which would allow for cancer testing through key indicators in the blood.
Such research efforts are still in early stages worldwide. But doctors see a future beyond basic commercial applications, aiming instead for drugs and treatment plans tailored to a person’s unique genetic code and environmental exposure, such as diet and infections.
Isaac Kohane, a bioinformatics professor at Harvard University, says when it comes to precision medicine, the science community has “Google maps envy.” Just as the search engine has transformed the notion of geography by adding restaurants, weather and other locators, more details on patients can give doctors a better picture on how to treat diseases.
For cancer patients, for example, precision medicine might allow oncologists to spot specific mutations in a tumor. For many people with rare ailments like muscle diseases or those that cause seizures, it allows for earlier diagnosis. Pregnant women, using the kind of tests that Leung used, could also learn more about the potential for a child to inherit a genetic disease.
The global interest in the field comes as the cost of sequencing DNA, or analyzing genetic information, is falling sharply. But a number of hurdles remain. Relying on just genes isn’t enough, and there must also be background information on a patient’s lifestyle and medication history.
Precision medicine applications also require heavy investment to store large amounts of information. A whole genome is over 100 gigabytes, according to an e-mailed response to questions from Edward Farmer, WuXi NextCode’s vice-president of communications and new ventures. “So you can imagine that analyzing thousands or hundreds of thousands of genomes is a true big data challenge."
WuXi NextCode was formed after Shanghai-based contract research giant WuXi AppTec Inc. acquired genomic analysis firm NextCode Health, a spin-off from Reykjavik, Iceland-based Decode Genetics, which has databases on the island’s population. Wuxi NextCode continues to have an office in Iceland, where the population is relatively homogenous and therefore good for gene discovery.
"Genomics today is like the computer industry in the ’70s," said Hannes Smarason, WuXi NextCode’s co-founder and chief operating officer. "We’ve made great progress but there’s still a long way to go.’’
In China, Wuxi NextCode now offers consumers genetic tests that cost between about 2,500 yuan and 8,000 yuan, providing more details on rare conditions a child might be suffering from or even the risk of passing on an inherited disease.
China is diverse and with 1.4 billion people, the planet’s most populous nation. WuXi NextCode announced a partnership with Huawei Technologies Co., China’s largest telecommunications equipment maker, in May to enable different institutions and researchers to store their data.
The goal is to use that deep pool of information -- which ranges from genome sequences to treatment regimens -- to find more clues on tackling diseases. WuXi says that “this will in many instances enable the largest studies ever undertaken in many diseases.”
Another Chinese player, iCarbonX, which received a $200 million investment from Tencent Holdings Ltd. and other investors in April, is valued at more than $1 billion. It announced last month that it had invested $400 million in several health data companies to enable the use of algorithms to analyze reams of genomic, physiological and behavioral data to provide customized medical advice directly to consumers through an app.
The global precision medicine market was estimated to be worth $56 billion in revenue at the end of 2016, with China holding about 4 to 8 percent of the global market, according to a December report from Persistence Market Research.
Encouraging interventions for some patients too early, even before they have life-threatening diseases, comes with risks and ethical questions, Laura Nelson Carney, an analyst at Sanford C Bernstein, wrote in a Jan. 6 note. Still, precision medicine research has many benefits, and some in China see the country’s push as a significant opportunity "to scientifically leapfrog the West,” she said.
In the U.S., universities, the National Institutes of Health and American drugmakers are part of a broad march into precision medicine.
Amgen Inc. bought Icelandic biotechnology company DeCode Genetics for $415 million in 2012, to acquire its massive database on Iceland’s population. U.S.-based Genentech Inc. is collaborating with Silicon Valley startup 23andMe to study the genetic underpinnings of Parkinson’s disease.
“Humans are computable," said Wang Jun, the chief executive officer of China’s iCarbonX. "So we need a computable model that we can use to intervene and change people’s status, that’s the whole point.’’