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Friday, January 26, 2018

Precision Medicine panel at Davos

Reported by STATnews:

apropos, my current journal read of interest (given my daughter's ever-more-exigent plight) at

Probably paywalled. I didn't check. I'm an AAAS member. You should be as well.
Accumulating evidence indicates that dysregulation of microbiota-host interactions associates with various diseases, including inflammatory bowel diseases (IBDs), colorectal cancer, diabetes, and liver cirrhosis (1). Recently, research has generated paradigm shifts in concepts about the interactions between bacteria and cancer therapeutic drugs. For example, bacteria modulate the antitumor efficacy in preclinical models of various chemotherapies (2–4) and immunotherapeutic agents (5, 6). Conceptually, these findings suggest that bacteria-mediated interactions with the immune system are essential for optimal drug efficacy. However, there is limited information regarding the functional impact of the composition of the human microbiome and therapeutic outcomes in cancer patients. On pages 91, 97, and 104 of this issue, Routy et al. (7), Gopalakrishnan et al. (8), and Matson et al. (9), respectively, address this important issue and demonstrate that patients can be stratified into responders and nonresponders to immunotherapy on the basis of the composition of their intestinal microbiomes, suggesting that microbiota should be considered when assessing therapeutic intervention…
[Conclusion] The relationship between microbial communities and antitumor drug responses are complex. On the one hand, depletion of selective bacterial taxa by means of antibiotic exposure or other stressor conditions may diminish immunotherapy responses. On the other hand, the presence of specific microorganisms in local or distant sites may interfere with treatment through metabolic activities (14). For example, bacteria of the Enterobacteriaceae family, such as Escherichia coli strains, decrease efficacy of the chemotherapeutic agent gemcitabine by metabolizing and deactivating the active form of the drug, thereby negatively interfering with tumor response (15). Therefore, the presence of specific strains of bacteria may be able to modulate cancer progression and therapeutics, raising the possibility that precision medicine directed at the microbiota could inform physicians about prognosis and therapy. One could view the microbiota as a treasure trove for next-generation medicine, and tapping into this network may produce new therapeutic insights.
My daughter is now on a 3-weeks-on/1-week-off chemo regimen of Abraxane+Gemcitabine. I rather doubt they're assaying her gut microbiome. "Next generation medicine."


Given that Davos is about "economics" and the foregoing video focuses on innovations that will hopefully bring us effective "precision medicine," one of my new reads seems quite timely.

The Innovation Economy

The Innovation Economy begins with discovery and culminates in speculation. Over some 250 years, economic growth has been driven by successive processes of trial and error and error and error: upstream exercises in research and invention, and downstream experiments in exploiting the new economic space opened by innovation. Each of these activities necessarily generates much waste along the way: dead-end research programs, useless inventions and failed commercial ventures. In between, the innovations that have repeatedly transformed the architecture of the market economy, from canals to the internet, have required massive investments to construct networks whose value in use could not be imagined at the outset of deployment. And so at each stage the Innovation Economy depends on sources of funding that are decoupled from concern from economic return…

Janeway, William H., Doing Capitalism in the Innovation Economy (p. 1). Cambridge University Press. Kindle Edition.
Wonderfully written. Stay tuned, I'm early on in the book. Bill Janeway is a Sensei. You can freely avail yourselves of the extensive introduction in full here.

More to come...

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