Scientific progress isn’t linear, it’s more of a parabolic curve. On the flatter part of the curve, the change is gradual … incremental. But as you reach the steep part of the curve, the pace of change accelerates incredibly rapidly. Here is where we are in biology, the start of the Biocentury.

The progress we’re starting to see in biology now is just as dramatic as the progress in physics and engineering that transformed life in the 20th Century. Today, the most explosive changes are taking place in the life sciences.

In the next 50 years, many diseases with few effective treatments will either be cured or controlled by medicines based on insights from human genetics…and our ability to leverage that knowledge to solve some of the toughest problems we face as a species. I know that it seems hard to imagine, but we’re doing things now in biology that were unimaginable just five or ten years ago.

So if we are doing so well, why is disease still so common?

In many ways, biology poses a tougher challenge than engineering-based disciplines. Biological systems and processes are incredibly complex, dynamic, and microscopic. To heal a disease, you need deep understanding of human biology. The challenge is that biology is incredibly complex. The smallest building blocks of the body are the proteins. There are 20 000 different types of molecules of proteins in our body.

Each single cell has more than 10,000 different types of proteins that work inside it and total no. of proteins per cell can range from 1 billion to 10 billion which resides in a space 10 000 times smaller than a grain of salt.

In engineering, you can use computer modeling to solve very intricate problems. Put enough computers together and almost anything is calculable. That’s harder to do in biology, since the systems themselves are analog, not digital. The one crucial exception is DNA, which is digital information that provides the code for making every protein and cell in the body.

Our challenge has been that the human genome is massive. In book form, the DNA letters that make up your genome would fill more than a million pages. However with today’s computers we can crunch genetic data and apply it to the challenge of figuring out how biology works and why disease happens. Fortunately, the fastest progress we’ve seen in any technology is occurring right now in the field of DNA sequencing. Moore’s Law says that computers double in speed about every two years, which is true for things like the laptop you use at home.

Our ability to read DNA is improving roughly a thousand times faster than Moore’s Law. In 2004, it cost 20 million dollars to fully sequence a human genome. Today, we can do it for about the price of an iPhone.

Even though we are just beginning to identify all the genes that can cause or prevent disease, we already have new medicines that are based entirely on recent genetic discoveries.

And now that we have the tools to discover every gene that impacts human disease, our ability to design effective treatments will accelerate dramatically.

Right now, we aren’t just reading the genome; we can actually edit the genes of living organisms. The robots we use to screen for drugs are faster and more productive. So are the computers and software that help us to visualize and design drug molecules. Biology is poised to change the world in the same way the Internet changed it. Perhaps even more so, because good health is the most fundamental need we have. Despite all the progress we’ve made with other technologies, we still accept the fact that any one of us could drop dead from a heart attack.

We accept that one in five of us will eventually succumb to cancer.

Precision medicine is the logical outcome of modern healthcare

Precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person.” This approach will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. If you think about your blood type, the first example of precision medicine, you already have an idea about its importance. Researchers discovered human blood groups in the early 1900s, and it is one of the most important medical information ever since.

As disruptive technologies such as cheap genome sequencing, big data analytics, deep learning appear on the stage of healthcare, it becomes possible to get down even more deeply to the roots of diseases and treatments. The “one-size-fits-all” strategy will definitely start to crumble. It is the logical result of hundreds of years of medical research and accumulated knowledge. Currently, we know that everyone has a different genetic code, may react differently to pharmaceutics or may have a completely opposite reaction to treatment as assumed. So why should we treat everyone with the same drugs or with the same method?

While there is a myriad of treatment options, patients have different genetic backgrounds, metabolize drugs differently, make different lifestyle choices and have distinct life goals. The more relevant information the patient can bring to the doctor’s attention, the more personalized they can make the treatment together.

Cancer is a brutal disease…

According to the statistics of the Cancer Research institute in the UK, in 2012, an estimated 14.1 million new cases of cancer occurred worldwide. It is an insanely huge number! As if the entire population of Guatemala got the disease at once! However, not only the figures of new cases look so gloomy. In 2012, an estimated 8.2 million people died from cancer worldwide – the entire population of Switzerland, if you like.

And while the four most common cancers – lung, breast, bowel and prostate cancer – account for around 4 in 10 of all cancers diagnosed worldwide, there are many cancer types, where the disease has so many variations as the number of patients themselves. As a consequence, it is extremely difficult to treat it with the old methods.

…but chemotherapy is no less disagreeable

As it is commonly known, cancer occurs when cells refuse to die and keep multiplying in various places in our bodies, while hiding from our immune systems. Currently, the most widely used  treatments against cancer comprise of various forms of radiation and chemotherapy, which stop the regeneration procedure for cells. The problem with chemotherapy and radiation is that it cannot be utilized in targeted ways. It means that they also affect the functioning of healthy cells, which has serious, sometimes even life-threatening side effects. The solution lies within the finding methods targeting only cancerous cells, this way reducing side effects as well as supporting longer survivals.

In case of cancer, timing is everything. If the disease is discovered in its early stages, the chance for survival is significantly higher as later. Every day counts.

However, technology has changed the equation. As it becomes more and more disruptive and accessible for people worldwide and patients are actively seeking help against this ugly disease, solutions beyond the framework of healthcare systems have piled up.

In oncology, there are various trends in fighting against cancer with more precise methods as before. On the one hand, researchers experiment with drugs that directly attack cancer cells without damaging other tissues.

Medical experts try to incorporate genetics into the fight against cancer to be able to offer the most personalized treatment ever. It is mind-blowing that you already have the possibility to send your biopsy sample from the primer tumour tissue to a company for analysis. They extract the DNA of cancer cells, sequence its code and try to find mutations for which there are available clinical trials and treatments. Another trail of research concentrates on the so-called liquid biopsy. It is basically a blood test, which is able to detect all types of cancer from a very early stage.

Tech giants, such as IBM, Google and Microsoft as well as a series of start-up, represent yet another direction in cancer research. They are building artificial intelligence solutions to design personalized treatments for any cancer type or patient faster than any traditional healthcare service. In case of IBM, they launched Watson for Oncology to help cancer research; Google has its Deepmind Health project; while Microsoft’s research machine-learning project, dubbed Hanover, aims to ingest all the papers and help predict which drugs and which combinations are the most effective.

What used to be a brave statement before about the future of medicine has become technically possible with new technologies. Genome sequencing costs hundreds of dollars instead of millions. Cancer cells can be extracted from the patient’s blood instead of the need for a tissue biopsy. Deep learning algorithms can look for associations between mutations and treatments faster than what the entire medical community could find together.

As long as someone is not involved either as a patient or a family member in the devastating battle against cancer, it’s hard to appreciate what precision medicine can bring to us (earlier diagnosis, better treatments, less side effects, longer survival or even the cure). In order to spare people from going through what cancer patients and their families are going through, precision medicine is the way to go.

Inside Amgen human genome experiment

Few companies are mentally and technically prepared for all these changes. Amgen is more than ready. Our company was built by people who saw the incredible promise of biotechnology, and the people who work here today understand the historic opportunity that’s in front of us.

No company has made a larger bet on using human genetics to drive R&D than Amgen.

It was roughly five years ago that Amgen first announced its plans to aggressively leverage human genetics in its research. At that point, Amgen’s belief that genetics could transform the search for new medicines had already led to several major decisions and investments. They included the acquisition of deCODE Genetics, an Iceland-based company with an unrivaled gene discovery platform. Amgen had also revised its R&D strategy to focus on drug targets validated by genetic or other compelling human evidence.

In the intervening years, Amgen has been conducting what amounts to one of the largest and most ambitious research experiments in the history of the industry. The goal is to show that human genetic validation of drug targets, applied as a forward-looking strategy, can help to cut the high failure rate that has plagued drug development programs for decades. The brutal attrition underscores the huge gaps that remain in our knowledge of human biology. Amgen believes human genetics offers a key approach to addressing both the complexity of biology and the industry’s R&D productivity problem.

No company was better positioned to leverage this technological breakthrough than deCODE. The support of the Icelandic nation and deCODE’s own unique capabilities have enabled it to assemble two massive data sets. One set contains genetic data provided by more than half the adults in Iceland, augmented by deCODE’s prowess in using genealogical records to predict genotypes. The other set, derived from Iceland’s universal health care system, contains phenotypic data on disease and other physical traits. By searching for non-random associations in these huge data sets, deCODE has found a wealth of rare and common genetic variants linked to disease risk.

In cancer research, the tools of human genetics have long been employed to identify tumor-suppressor genes and other targets useful in pinpointing tumor cells. Ouyang’s group is pioneering new ways to leverage sequence data through an approach called hypothesis-driven genetic research. Drug discovery scientists develop ideas for genes that might provide attractive targets, and data from deCODE is used to assess these hypotheses. Examples include an effort to find new cancer immunotherapies by identifying genes involved in autoimmune disorders.

Advances like CRISPR have made gene editing faster and easier, accelerating research needed to probe the function of newly discovered genes. Induced pluripotent stem cells (iPSCs) can theoretically be transformed into any cell type, including the cells that are most directly affected by key mutations. Major strides have also been made in constructing organoids, or miniature organs, which are useful in elucidating gene function at the level of human tissue. These and other emerging tools are helping Amgen build a more systematic approach to deciphering the biology resulting from gene variants. Newer technologies like RNA interference can address some hard-to-hit proteins by intercepting the RNA used to make the proteins.

We’re excited to be in the right place, at the right time, and with the right talent and technologies to not only work in the Biocentury, but to lead it.

Presentation of Dr. Krassimira Chemishanska’s at Webit, Digital Festival Europe, June 26-27, 2018, Sofia, Bulgaria.