The answer is the same for every cell in the body: each cell has a mechanism for remembering what it's supposed to be, so heart cells keep on growing as heart cells, and skin cells, and fat cells, and so on. So Dr. Bradner's team acquired a batch of midline carcinoma cells to experiment on. Midline cancer is rare enough that it's not an attractive target as a moneymaker. They figured out how to give the cancer cells amnesia by inserting a new molecule they had developed called JQ1, and the cancer cells forgot they were cancer and became normal cells.
Naturally this was very exciting, but it was just the beginning. Following the open source principal of "release early, release often" they mailed samples of compounds based on JQ1 and other compounds to other labs, published a detailed paper, and now 70+ labs and pharmaceutical companies worldwide are working on this. These are not silver bullets for all cancers, but they are promising for an entire category of cancers that includes midline carcinoma, acute myeloid leukemias, and multiple myeloma.
From research to a pill for people is always a long process. Some researchers just want to do research. Dr. Bradner is working with Tensha Therapeutics to bring new cancer treatments to market. Tensha already has two drugs in clinical trials from this new research, a topical drug for lymphoma of the skin and an oral medication for multiple myeloma. Dr. Bradner gives credit to open source methods in this inspiring Ted talk.
"This string of letters and numbers and symbols and parentheses that can be texted, I suppose, or Twittered worldwide, is the chemical identity of our pro compound. It's the information that we most need from pharmaceutical companies, the information on how these early prototype drugs might work. Yet this information is largely a secret. And so we seek really to download from the amazing successes of the computer science industry two principles: that of open source and that of crowdsourcing to quickly, responsibly accelerate the delivery of targeted therapeutics to patients with cancer."
Covering open source medicine would fill a book, so here are some references to a few more worthy projects.
- Trisano helps the Centers for Disease Control monitor outbreaks of infectious disease, environmental hazards, and bioterrorism attacks.
- Dr. Insup Lee of the University of Pennsylvania is working with the FDA on the development of a reference model-based approach to software conformance checking for producing highly-reliable software for medical devices, using a drug infusion pump for the prototype.
- Medsphere gives healthcare administrators, clinicians, and developers a place to meet and collaborate on the administrative side of medicine.
- The OpenEMR electronic health records and medical practice management software is a fully integrated electronic health, records, practice management, scheduling, and electronic billing application.
- PLoS Medicine is a peer-reviewed, international, open-access journal that publishes original content and analysis.
- Brainstorm is a free, open source cross-platform Matlab toolkit for Magnetoencephalography (MEG) and Electroencephalography (EEG) data visualization and processing.
- The Veterans Administration is the largest healthcare organization in the US, and it runs on a single medical records network powered by the open source Veterans Health Information Systems and Technology Architecture (VistA). Over 300,000 medical staff use VistA every day while treating over 6 million patients.
- Midland Memorial Hospital in Midland, Texas is one example of a successful VistA implementation. They spent $6.3 million, which included 680 workstations, plus bar code scanners and printers, and Red Hat Linux. If they had gone with proprietary software it would have cost $18-$20 million just for the software.
- The Indian Health Service (IHS) uses a fork of VistA called Resource and Patient Management System (RPMS), which is deployed at more than 600 medical facilities. The main difference is the VA treats military veterans in hospitals, while IHS treats all people of all ages in small clinics.