Leaders in Pharmaceutical Business Intelligence (LPBI) Group

Global Cancer Markets

Cancer causes 1 in 7 deaths worldwide and is rapidly becoming a global epidemic. If rates don’t change, the global cancer burden is expected to increase from 14 million new cases and 8 million cancer-related deaths worldwide to 22 million cases and 13 million deaths by 2030. The panel will discuss how approaches to deliver innovative technologies differ in different international markets, what the respective drivers are, requirements and challenges. Expert panelists from leading international companies and key governmental entities, including the famed NICE from the UK NHS, will consider key strategies and trends.

• How prioritization happens in global care
• Incremental innovations
• reimburement of oncology drugs
• Should Pharma fund DIagnostics development
• Cancer: Terminal or Chronic
• Future in Underdeveloped Countries is?
• Collaborations: 1 to 5 scale

• Patients in Global markets wants new medicines and innovations
• US can learn from other markets
• Innovating Pricing
• UK and Cancer, restrictions to access
• Speeding drugs to market: Japan GI drugs are most important in Japan
• 5 1/2 years drug launch in Japan for GI
• Breakthrough vs successful drugs like the one for testicular cancers
• MediCare, MedicAid — drugs, surgery, diagnostics
• Early scrreening are reimbursed by Gov’t, happy for that even if less drugs will be used if early detection is successful
• Pharma understand diagnostics, symbiosis between targeted therapy and development of companion diagnostics
• FDA very progressive, needs to open up diagnosis for approval by other entities
• Support Patient beyond the treatment, quality of life during disease progression
• Distribution of medicines in Africa

• US is the center of Innovations per GDP the strongest
• Europe has a process similar for approval but different on access and on reimbursement
• China and Russia Trips last week, Priority is related to available infrastructure
• price and cost of R&D is increasing
• China and drug discovery in HIV and Cancer: Government recognize the need to accelerate 1.3 Billion people
• creative for reward between development and delivery
• track value of combination therapy to Patients
• Best in class diagnosis a company was acquired for tracking the tumor – value in synergies between drugs and diagnosis
• Hope that measurement technologies will assist globally

• Regulatory concerns
• Companion Diagnosis is straight forward vs drug approval more complex a process
• In UK – ambition the ability to cure
• thresholds drops: early detection of small tumors
• Adoption of innovaton has a Curve for innovation adoption

• Investment in Diagnostics: is there a Marker to guide drug development
• Cancer is today chronic condition – stimulate innovations and paid for
• wrap around services needed for chronic diseases
• collaborations are needed to impact Underdeveloped countries
• Ultimate Cure is the goal

• Prioratization – Trials parallel in the World, big center in China
• Value to Patients, impact on healthcare cost
• Companion Diagnosis – assures the right drug for the right Patient, Partnership or internal development
• co-financing: agreeement with Patient association or Goven’t — sharing the cost of care
• 40% of ALL R&D in Pharma — is for Oncology

Epigenetics and Novel Cancer Targets

The initiation and progression of cancer is controlled by both genetic and epigenetic events. Epigenetics, the study of changes that influence how DNA does its job, is one of the fastest-moving fields in cancer research. Panel members will discuss the promise of epigenetics and how it can improve human health. They describe ongoing efforts at translating basic epigenetic research into cancer diagnostics and therapies, providingmembers of the audience with a better understanding of the market opportunities and competitive advantages.

• Microscopic Views of Cancer: therapies coming
• Epigenetics is different: less structure than other related disciplines in Life Sciences
• Ten years ago Nature, defined 24 milestones: Oncogens, epigenetics, tumor suppression
• Cromatin – large molecule put in a small cell – 20% of Cancers are common
• How transcription occurs??
• LONG non-coding RNA
• Process been developed in relations with SWITCHES SUper enhancers
• Enzype HNTs drugability

• Publicly traded based in Cambridge, MA
• Histome methylation and transcription control – transition to clinic
• go after an Enzyme structure for modulation
• enzyme create opportunities for binding modality for inhibiting them
• Biochemistry and structural biology – 800 crystal structure
• genetic lesion at a related pathway mechanism for large indexing  – loss of function create addiction of the cancer on another

• Epigenetics in conversation with Eric lander ten years ago: Complexity comes from tagging proteins, translate me twice – which genes are translated and active and which one are not
• CBP – stop translation of
• Single cell plating – 45% in every plate developed resistence against stress
• epigenetics – control immune system, dnt inhibitors, checkpoint inhibitors block T checkpoints
• Utilization of drugs
• turn on and off genes – program the gene
• can we drug these target, bioavailability, selectivity
• Readers, riders, structural biology – libraries of targets and selectivity
• noval biological targets are drugable

• 3D architecture of the gene – sequencing studies, mutations frequently
• structure and function of gene
• large machines cromatins – powered by ATP Hyrolisis
• combinatorial assembly – different function to each, thus, sequencing enable – Cromatin remodelling as drivers in Cancer was revealed
• mutations approches on nodes of Cromatin, unique synthetic  to activate genes or turn off is kept
• change of function

• Epigenetics and expression on X chromosomes
• RNA – specificity used to design a drug to impede RNA coding genes – x10 long codings RNA
• 90% of Junk is long coding RNA with function
• 200 RNA thus, long RNA
• 99% is non coding – long non-coging RNA: ONE PROPERTY: can target protein to a specific point in the genome one location only
• BAR CODES sorting proteins – for cancer development and NOR-AD upregulated during stress
• ciRNA – Cancer Progression – delete hematologic

• drugs for pathways — find the right Patients for it
• What is fundamental od disease
• non-coding regions of the genomes – have function
•  tools are ripes to deliver
• developmental biology: Enhancers – mesure them, expresse 12,000 measure by novel seq. SUper enhancers in eahc cell
• In cancer MEK core of  — targeting Super enhancers, regulatory proteind – target components of enhancers
• Super enhancer control a gene thus, target transcition kinease oncogenic, lower level of expression, super enhancer identidy noval dependencies – novally defined set of patients by the genome and super enhancers structures

• Epigenetics microenvironment affect  resistance
• identify combination new and old to suppress resistance to drugs
• copy variation, resistance clones of cancer
• chromosone 1: 20% of Cancer, regions epigenomic going in and cancer hijacks processes
• Hypoxia 1% in fetus triggers demythilase, cancer
• copy controls in cells and copies works across the types of cancer
• epigenetics drive metabolic states, DNA dosage change,placticity – in epigenetic — re-state the genome
• protein enzyme, 2006  vs 2016 – in ten years