Healthcare in 2100

31 July 2018

Interview with

Catherine Priestley, AstraZeneca

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There is no doubt innovation is going to revolutionise healthcare in the future. The Internet of Things and wearable technologies will allow us to get health monitoring from anywhere in the world: perhaps your pillow, for instance, will read your brain activity while you sleep and then it could adjust the environment to ensure you get the best night’s rest. Or, when you sit on the loo, a so called “com-poo-ter” will analyse what goes down the drain and then monitor your health that way. A breath sample could flag up impending ill-health for example, and artificial intelligence can then help us to develop individually tailored drug and treatment protocols. Chris Smith got the story from Catherine Priestley is the Director of Science Engagement, Innovative Medicines and Early Development at the pharmaceutical company AstraZeneca.

Catherine - You only need to look at the way that we’ve turned science fiction into science fact in the past 80 years. 1953 was our first open heart surgery and yet today greater than 8,000 patients, just in the UK, receive new heart valves. Then the improved technologies that we’ve had, therapies, vaccinations eradicating these killer diseases - we’re really moving in the right direction for patient survival rate there.

I think, as you heard from the other speakers, healthcare is also on that paradigm shift and this is a result of this data connectivity, this machine intelligence. And that coupled with automation is going to change the way that we’re going to develop and design medicines of the future. Therapies that are going to not just manage and cure, but actually the way that we’re even going to run our daily lives to, hopefully, prevent and even delay the onset of disease.

Chris - This is more of an all round package that you’re proposing then. So rather than I go to a chemist and I pick up a packet of pills that have been made by your company and take them, you’re saying that you would also provide people with an app to make sure I take them on time, or an app that will guide my lifestyle changes that will mean that drug will work optimally in me, for example?

Catherine - Correct. You can sort of think about this as the pill is the therapy, and that might not be a pill in the future - who knows. But also around that pill the apps that are going to make sure that we’re compliant, that it’s going to actually inform you that you that you’ve got the right dose. And even then beyond the pill, you can see how apps and technologies and wearable devices - biosensors etc., can not only inform with it where the medicine that you’re taking is actually going to be impactful and improve the patient outcome and lead to a healthier lifestyle, but also might suggest lifestyle changes. Divert you from going to the fridge, or that you’re contact lens might actually inform you whether your glucose levels are changing. And what’s going to be so clever about the machine intelligence, plus the human interrelationship, that diversions away from that fridge. How it’s going to change the way our lifestyle, should be healthier in the future.

Chris - One of the things that’s challenged your industry for many years is the whole question of clinical trials. It’s doing big trials with large enough numbers of people to get statistically meaningful data and often, it ends up being a bit artificial because you end up putting people into quite artificial situations to make sure that it’s statistically rigorous but actually that’s not how people behave and so it ends up biased anyway. So with all of this information gathering is this a new opportunity to do clinical trials a whole new way?

Catherine - Yes. There’s two aspects to think about this. Actually what’s fueling into the clinical trial will be different, so not only will the drug itself - the chemistry of the drug be different. We have small molecules, monoclonal antibodies, peptides today as routine. Now even within AstraZeneca we’ve got 13 different types of chemistry going in that’s going to go after new disease biology because, actually, we’re informing back all the way from the clinic to the discovery angle to inform that better practice. We’re also going to have very different pre-clinical datasets; ones that are more predictive using organ chips. Those are little microchips, where you take all the different cells in the tissue or organ and populate them together, so you the interplay. Therefore all the different experiments you’ve run on those chips are better informed, more predictive for what’s going to happen in the clinic.

Chris - Ah right. So you could even, potentially, model say, you wanted to give me a drug for a liver complaint, you could actually model my own liver on a chip and test your drug on that before you’ve got it anywhere near me?

Catherine - Potentially. Although I think at that stage, doing it so tailored at the preclinical stage I think is more that you can use stem cells at that stage rather than your own patient. But then if you couple that with all the imagery advances we are in the hope of creating a google map of cancer. And the way that all of those cells interact with the imagery, the compute power that we then have means that what we’re fuelling into those clinical trials are much more predictive and more likely to succeed.

So those clinical trials then, you could forsee with all the wearable technology, and all the different data that’s been collected in real time, those patients don’t need to be in a clinical trial centre, they could be in their own home. And, therefore, more patients are going to have access to more innovations that are happening in real time as well. And hopefully as patients - all of us in the future - are going to end up with healthier lifestyles and better outcomes if we do have to manage disease.

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