Stuart K. Hayashi
The following is a section of the longer essay, “How Billionaires and Capitalism Save Billions of Lives — Including Yours.” That essay includes an index listing various case studies of a for-profit initiative saving lives. The blog post below is of at least one such case study. You can return to that index here.
To be used along with docetaxel or nab-paclitaxel, there is yet another drug that has been of assistance to patients undergoing chemotherapy, this one being the first employment of recombinant genetic engineering for use against cancer. That is trastuzumab, going by the brand name Herceptin. From 1969 to 1980, scientists came upon a series of clues concerning the manner in which some inheritable genes are especially vulnerable to mutations that lead to cancer. These mutated genes are known as oncogenes. In 1982, a German-born scientist employed by Genentech Corporation, Axel Ullrich, identified a particular oncogene that would later be named Human Epidermal growth factor Receptor 2 —“HER-2.”
Ullrich first found it in mice and was able to use the mouse’s own immune system to develop antibodies that attacked and eliminated the cancer. Methods by which an immune system is triggered to fight tumors as though they were viruses are known as immunotherapy. Coming upon HER-2 genes in humans as well, Ullrich wondered if what he did with the mice could be applied to other species.
When Ullrich presented his findings at a conference, one of the members of the audience was especially fascinated — UCLA oncologist Dennis Slamon. They struck up a conversation and ended up collaborating on a search for a treatment. Sadly, in this instance the executives at Genentech were resistant to funding their research. Slamon pestered Genentech’s executives until they finally gave in. This was fortuitous, as one-fifth of breast cancer patients are HER-2 positive.
Eventually receiving assistance from another Genentech scientist, H. Michael Shepard, the duo was able to find a solution. They took the antibodies from mice that fought of the tumors and “
humanized” them. That is, they genetically modified the mice’s antibodies to make them
similar enough to human genes that, upon their insertion into the human body, the human immune system accepted and incorporated them to destroy tumors.
This team introduced this treatment in
Science in 1987. As is typical, it would take the FDA
another 11 years to approve it.
According to UCLA’s website, “Between 2.7 million and 3 million women have been treated with Herceptin, and women with HER-2-positive breast cancer now have among the highest survival rates compared with all women with breast cancer.”
After three years, patients who received trastuzumab with their chemotherapy had a 33 percent lower risk of death than patients who received chemotherapy only, and a 50 percent lower risk altogether of cancer recurrence, a new cancer, or death.
Ten years after having received trastuzumab with their chemotherapy, patients have had a disease-free survival rate ranging from 70 to 75 percent. Seventy percent of the 2.7 million women treated with trastuzumab would be 1.89 million lives saved.
For these enterprises, Ullrich earned a net worth
exceeding $10 million.
Tying this back with the other cancer drug we discussed earlier, the two seem to be compatible. In the journal
OncoTargets Therapy, Giuseppina Rosaria Rita Ricciardi and associates
conclude that a “nab-paclitaxel and trastuzumab combination” shows to be “a promising approach for neoadjuvant treatment in HER-2-positive breast cancer.” Axel Ullrich’s wealth and Patrick Soon-Shiong’s complement one another.
And after leaving Genentech, Ullrich synthesized other drugs that direct the immune system to strike against cancer. One of them is sunitinib, brand name Sutent. Before sunitinib, the standard immunotherapy drug for metastatic renal cell carcinoma (RCC) was interferon alfa. In experiments comparing sunitinib against interferon alfa,
the former gave patients a longer median overall survival (26.4 versus 21.8 months) and a longer median progression-free survival (eleven months versus five months).
Return to index of case studies of lifesaving for-profit ventures.
