Hype surrounding new genome-based medical technologies is unrealistic

July 18 2006 : A medical revolution using advances in genetic science will not materialise in the way it has been promised, a University of Nottingham expert warns in a new report.

Dr Paul Martin cautions that the high hopes for the transformation of medicine — through genetic testing, gene-based drugs, stem cells, gene therapy and other new developments — are the result of hype rather than realistic expectations.

Dr Martin argues that many of these techniques, which come collectively under the umbrella term of genomic medicine, will only come to fruition very gradually.

Rather than a revolution in medical treatment, he argues that it is much more likely to be a slow evolution. His report focuses on which new therapies and diagnostics are likely to be available for the treatment of patients in the near future, ie. the next three to five years.

Since the sequencing of the first draft of the human genome in 2000, there has been huge interest in the diagnosis and treatment of diseases using genomic medicine.

Some treatments, such as the leukaemia drug Glivec — marketed as Gleevac in the USA — have shown encouraging results. Glivec is a pharmacogenomic drug, approved in 2001 as the first product of its type, and now has global sales of more than £2 billion a year.

Testing for the BRCA genes, whose presence is linked to a higher risk of breast cancer, is also held up as a success story of genomic medicine.

But many other potential treatments — including gene therapy, cancer vaccines and embryonic stem cell therapies — are not likely to see significant advances in the next five years and perhaps even beyond that, the report claims.

Dr Martin said: “Progress in translating these inventions from science into the clinic has been much slower than people expected. So we need to have a different model in terms of timeframe — it is going to be an evolution, rather than a revolution. It’s not going to transform medicine overnight.

“I’m not saying these things are not going to happen: some of them will, but it will take much longer than initially thought.

“It’s important to be realistic — otherwise there are dangers of public disillusionment. In recent years the public has been misled to a certain extent, with the expectation that we are going to see dramatic changes in healthcare as a result of this technology. The evidence doesn’t support those claims.”

The report, ‘Realising the Potential of Genomic Medicine’, was commissioned by the Pharmacy Practice Research Trust and funded by the Royal Pharmaceutical Society of Great Britain. Its authors are Dr Martin and Michael Morrison, of the Institute for the Study of Genetics, Biorisks and Society (IGBiS) at The University of Nottingham.

Among the report’s conclusions, the authors write: “The field of genomic medicine is marked by high hopes for its future. These expectations have been created to a greater or lesser extent by all the key stakeholder groups involved in biomedicine, including scientists, entrepreneurs, investors, clinicians, industry, policy makers, the media and patient groups.

“Significantly, it appears that there will be a continuing, but modest, stream of new medicines and diagnostics reaching the market, in particular, therapeutic protein drugs and genetic tests for monogenic disorders. There may also be a small number of new pharmacogenetic drugs/tests, genetic and biomarker based diagnostics for common conditions, adult stem cell therapies based on Haematopoietic Stem Cells and pharmacogenomic drugs, such as Glivec.

“However the medium term prospects for gene therapy, cancer vaccines and embryonic stem cell therapies are relatively poor and few new products are likely to be launched in the next three to five years. The only exception to this overall picture is monoclonal antibodies, which look set to undergo a period of sustained expansion.

“Taken together it is clear that this level of progress, whilst welcome, falls a long way short of the high expectations that many people associate with these technologies. Does this mean that genetics has ‘failed to deliver’? Or have expectations been unrealistic?

“The latter appears to be a more compelling explanation.”

Dr Sue Ambler, Director of the Pharmacy Practice Research Trust, said: "This report makes a unique contribution to our understanding of an important scientific and technological area. The Trustees look forward to working with other stakeholders to fund further work in this important area."

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PDF copies of the report are available from The University of Nottingham’s Public Affairs Office, tel +44 (0)115 951 5765.

Notes to editors: The University of Nottingham undertakes world-changing research and provides teaching of the highest quality. Ranked in the THES World Top 100 Universities, its academics have won two Nobel Prizes since 2003. An international institution, the University has campuses in the United Kingdom, Malaysia and China.

The Pharmacy Practice Trust was established in July 1999 as an independent research charity, with a broad objective to promote and develop the field of pharmacy practice research. Its trustees are drawn from among senior health policy makers, leading academics, industrialists and retailers.

The Medicines and People programme is a major initiative by the Trust. As an independent research charity, the Trust aims to promote research that will enable policy makers, manufacturers, prescribers and others to better understand the people and the contexts in which they use and take medicines.

More information is available from Dr Paul Martin, Institute for the Study of Genetics, Biorisks and Society (IGBiS), University of Nottingham, on +44 (0)115 951 5419, paul.martin@nottingham.ac.uk; or Media Relations Manager Tim Utton in the University’s Public Affairs Office on +44 (0)115 846 8092, tim.utton@nottingham.ac.uk

For information about the Pharmacy Practice Research Trust contact Beth Allen on +44 (0)20 7572 2466, or email beth.allen@rpsgb.org