A recent publication by the American Society of Clinical Oncology (ASCO) emphasized the traditional key role of US investment in cancer research. However, they also noted both a 75-percent drop in the number of fully-funded National Institutes of Health (NIH) studies presented at the ASCO Annual Meetings from 2008 to 2017, and a serious drop in the number of new NIH proposals funded—from 27 percent in 2001 to just 12 percent in 2015.
As someone who has had my myeloma research funded by NIH for over two decades, I personally understand the crucial impact of these large grants. A report published this week by the National Academy of Sciences underscores that impact. It shows that NIH funding contributed to published research associated with every one of the 210 new drugs approved by the Food and Drug Administration between 2010 and 2016. But without seed funding, and later, expanded funding, these types of important ideas remain unexplored.
While US government-funded research decreased, a race for new cancer therapies has led to a 500 percent surge in biotech investment in China, where a big focus is on CAR T-cell therapies. There are 153 ongoing Chinese studies of CAR T, second only to the 186 studies in the US.
In 1992, I earned my certificate for climbing the Great Wall of China, and I've been returning to the country for research projects, trials, and medical meetings ever since. During these many visits, I have witnessed a dramatic shift in China’s home-grown research efforts, which are culminating now in the issuance of the 2018 China FDA legislative road map. The plan includes many new guidelines and reforms to modernize rules governing multicenter clinical trials, as well as the drug registration and approval process. In our official meetings with the Chinese FDA, the IMF team members have noted this major change in emphasis and priorities.
The bottom line is that China wants to develop and commercialize new drugs in China, rather than license or import them from outside entities. This effort is supported by the Chinese government's massive investment in the biotech sector. As a result, new and creative research in China is moving ahead aggressively. Witness a recent paper about a DNA nanorobot (a tumor-attacking bot), which can be injected intravenously and delivered to selective target cancer cells.
Although the US is by no means fully eclipsed by China’s research push, the dominance of US biomedical research is definitely under threat!
A silver lining
Before you descend into irreversible depression about the state of American research, let me say a couple of things. First, a 500-percent surge in biotech investment is great for patients, wherever it is occurring! And second, through our Black Swan Research Initiative, the IMF continues to focus on innovative research around the globe in the search for a cure. Our wonderful collaborators in Iceland, Spain, Germany, and Australia, as well as in the Asia-Pacific region, are making major contributions in the areas of imaging, familial myeloma, CAR T and other new agents, early disease, prevention, and resistant disease, among others.
In the coming months I will report back from the IMF’s return visits to China, where we will focus on CAR T-cell studies (an obvious priority in China), as well as MRD-testing, which is essential for appropriate monitoring.
Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.