Aug 2016

Dr. Shinya Yamanaka

Are we there yet?

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(This post is one of several addressing a single subject today in a blog carnival to mark the 10th anniversary of the discovery of induced pluripotent stem cells. Please click here to read what other bloggers have to say.)

As summer holidays wind down, most parents are now too familiar with the following question: Are we there yet?

Any family trip to a campground, cottage or Nana’s house in Northport starts off with excitement for all concerned, what with getting up early, packing the car and hitting the road. For kids, though, it’s magical. Then, after about an hour of travelling, regardless what onboard entertainment you’ve arranged, boredom sets in. Two hours into the trip, they’re sure you’re never going to get them there.

Waiting for stem cell discoveries to turn into actual treatments is a lot like that, except that instead of hours, it’s decades. Instead of frustration, the feeling is desperation.

Consider the remarkable discovery, by Japan’s Dr. Shinya Yamanaka, that adult cells extracted from skin can be reprogrammed to an embryonic stem-cell-like state to reproduce any cell required for transplant or to repair organs and tissue. We first heard about these induced pluripotent stem cells (iPS cells) on August 25, 2006. A decade later, we’re still waiting for the Nobel Prize-winning work to turn into treatments.

People, especially those suffering from life-threatening diseases, want to know why we’re still waiting. Unlike bored children, they have far more riding on the answer to the Are we there yet? question. For them, it’s life and death.

At the Canadian Stem Cell Foundation hardly a day goes by that someone doesn’t contact us seeking a stem cell treatment for themselves or a loved one. Today, it was a 48-year-old Toronto man whose doctor had told him his ALS will kill him. At least we could point him in the direction of Dr. Eva Feldman at the University of Michigan, who is trying to get a Phase 2 clinical trial going on a stem cell treatment for ALS.

In all areas of medical research, the wheel turns slowly. It can take decades of lab work and clinical trials and hundreds of millions of dollars to bring new treatments to patients. Consider cervical cancer, the second most common cancer among women. In 1972, Germany’s Dr. Harald zur Hausen started working on the notion that the disease is caused by a virus. It took about 35 years — most of his career — for HPV vaccines to make it to market.

It’s even more complicated for stem cells, a relative newcomer to the scene. While their existence was proven in Canada by Drs. James Till and Ernest McCulloch in the early 1960s, the focus afterwards was on bone marrow stem cells for treating leukemia. Embryonic stem cells have only been in play since 1998. Realistically, iPS cells are still the new cells on the block.

Cell-based therapies represent a whole new way of thinking about treating diseases, and regenerative medicine is a disruptive technology. Unlike a vaccine or a drug, the actual therapy isn’t an easy thing to grasp for industry, whose commitment is crucial in moving things from the lab bench to the hospital bed.

What’s needed, then, is an innovative approach. We need to think bigger. That’s why our Foundation is championing the Canadian Stem Cell Strategy, a private/public partnership to deliver up to 10 new curative therapies to the clinic within 10 years. Crafted in consultation with 150 scientists, doctors, leaders from health charities, industry experts and philanthropists, it is backed by an in-depth KPMG study and endorsed by an international panel of experts.

The private sector is already at the table, pledging more than $350 million toward R&D — almost one-quarter of the $1.5-billion Strategy. Other industry partners, health charities and leading Canadian philanthropists are prepared to make major contributions upon demonstration of a federal commitment to the plan. We’re asking the Government of Canada, as part of its Innovation Agenda, to provide one-third, about $50 million annually over 10 years.

Are we there yet? Clearly not. But a coordinated national road map can get us there.

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