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Is the communications guru, Maurice Saatchi right in thinking that the law is an obstacle to finding a cure for ovarian cancer?
 
There’s a bigger and more substantial obstacle: poor communications.
 
Saatchi might consider using his abilities, honed in building global advertising agencies, to improve ways scientists and doctors communicate and share clinical data and tumour samples in their endeavours to find a cure for ovarian cancer.  
 
Saatchi’s Medical Innovation Bill
In 2012 Saatchi introduced a private member’s bill to the UK’s Parliament, “to show that scientific progress has been stopped by law” and to encourage new therapies by legalizing the ability of doctors to use experimental treatments even if there is no proof they work. 
 
In 2011, Saatchi’s wife, the novelist Josephine Hart, died of ovarian cancer. He described her treatment as, "medieval, degrading and ineffective.” Doctors, he said, aren’t receptive to new and innovative therapies and don’t move away from the tried and tested, but unsuccessful treatments they know.
 
Speaking of his wife, he said, “She would have had the same procedure anywhere in the world: same drugs, same operation, same everything.” Saatchi’s Medical Innovation Bill is designed to change this by liberating doctors from generally accepted medical protocols and encouraging them to innovate.
 
Rarely in the UK does a private member’s bill become law, but Saatchi has triggered an important debate.  

Some Facts
Ovarian cancer is an age related silent killer of women. There is no effective early detection method for the disease and therefore it’s mostly diagnosed in advance stages. It accounts for five per cent of all cancer deaths among women. The average age for the onset of the disease is 63.
 
Each year, more than 204,000 women are diagnosed with ovarian cancer worldwide. About half die within three years of being diagnosed, partly because so few drugs exist to stop the cancer metastasising and no new treatment has been introduced for more than a decade.
 
Ovarian cancer and commercial interests
Despite being the most frequent cause of cancer related death from gynaecologic malignancies, ovarian cancer does not attract the same level of R&D interest from pharmaceutical companies as some other cancers. This is because pharmaceutical companies create value for their shareholders by concentrating their research resources on the discovery and development of patented blockbuster drugs that are expected to dominate the largest disease states for the duration of their patents.
 
As a result, smaller disease states, such as ovarian cancer, suffer from a relative lack of pharma-backed research resources. As a consequence, ovarian cancers’ mortality rates remain high, detection rates remain low and treatment options do not improve.
 
Obstacle to change
Saatchi has a point about English law. In 1957 an English High Court judge ruled that doctors must act in accordance with, “what the majority of doctors do, even if there are opposing medical views.” This ruling set a precedent for medical negligence cases and is reinforced by the world’s largest professional body for oncologists: the American Society of Clinical Oncology, which promotes evidence based treatment protocols for all cancers to its 30,000 plus members.   

Supporters & detractors
Saatchi’s Bill has its supporters. Lord Howe, the Minister of Health, believes that UK approvals for new treatments are “unacceptable” slow. "It takes an average of 17 years for only 14% of new scientific discoveries to enter day-to-day clinical practice," he said.
 
The Bill also has its detractors. Professor Karol Sikora, a leading authority on cancer and a director of CancerPartners UK, believes Saatchi’s proposal is unnecessary. "If a doctor wants to do something different and the patient consents, doctors can do wacky things," says Sikora, citing the alternative medicine industry, where there is little evidence to suggest that treatments work.

Targeted therapies
The science that underlies cancer therapies has changed from chemistry to genetics. Chemistry fuelled the growth of the pharmaceutical industry in the early to mid 20^th century, which has now matured. In the late 20^th century genetics gave birth to a new biopharmaceutical industry, which is growing rapidly.
 
Biopharmaceuticals, based on genetics and molecular science have given rise to targeted therapies and personalised medicine. This tailors medical decisions, practices and therapies to individual patients and corrects abnormalities at a molecular level. Such therapies offer the potential to reduce cancer’s unacceptably high mortality rates and raise its unacceptably low detection rates.
 
Several targeted therapies have been approved. The most well known is trastuzumab, which is marketed as Herceptin and used in early stage breast cancer patients with high levels of the HER2 protein.
 
Improved global communications and a cure for ovarian cancer
Targeted therapies require significant data flows between scientists and doctors: the bench-to-bedside approach.  Currently, at best, this is inefficient and at worse, it’s simply not done.
 
Breakthroughs in ovarian cancer research will not occur without significantly improving:

 

1. The collection and standardization of vast clinical data sets from different geographies
2. The creation and development of large-scale interconnected tumor banks with standardized tissue samples also from different geographies
3. The management and distribution of these vast clinical data sets and tumor samples to scientists able to combine genomic and clinical data, which is a necessary prerequisite for genetic, epigenetic and proteomic analysis.

 

Ovarian cancer breakthroughs will not come from professional cancer associations, nor from the endeavors of small charities and nor from doctors alone. All are inexperienced in global communications and big data management. Breakthroughs are more likely when well-resourced global organizations with highly developed big-data management skills get involved in medical research.

 
In September 2013 we came a step closer to this, when Google co-founder and CEO Larry Page announced that he is planning to launch Calico, a new company to use Google’s data-processing strength to shed new light on age-related maladies.
 
In a similar vein, Jonathan Milner the biotech millionaire and a founder of Abcam, one of the world’s largest retailers of research antibodies, is backing a venture to create a Wikipedia of genetic disease data to help diagnose an array of uncured conditions.   
 
Key takeaway
Maurice Saatchi should consider trading his ermine robes for shorts and T-shirt and head to Mountain View, California and combine his considerable communications skills and energies with those of Larry Page in an endeavour to, “change the ways medical scientist create, share, communicate, collaborate and do research.”