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BIO 2019 in Philadelphia

Three takeaways from physician and author Siddhartha Mukherjee

Siddhartha Mukherjee, a keynote speaker at BIO 2019 in Philadelphia
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Thousands of BIO 2019 attendees lined up Tuesday morning to hear from cancer doctor, Pulitzer-Prize-winning author and biotech company founder Siddhartha Mukherjee. He won a Pulitzer Prize in 2011 for his book about cancer called “The Emperor of All Maladies.”His latest book is “The Gene: An Intimate History.”

The Columbia University assistant professor and "New Yorker" columnist was interviewed by BIO CEO James Greenwood. Here are a few highlights:

1. For Dr. Mukherjee, patients are the why.

Few other professions offer the “covalent molecular bond” that forms between physician and patient, Mukherjee said. The cancer he specializes in treating, which is rare enough to be considered an orphan disease, has a 60-70 percent mortality rate. Serving the patient also means heads-down research and forming “an immune-oncology company developing novel therapies with broad potential for treating cancer.”

 2. What causes cancer? That’s a deeply complicated question

Of course, some causes have been identified, but much less is known definitively about chemicals, agricultural pesticides and amorphous sources such as “stress.”

With chemical causes, the question always must be at what dose does the substance cause cancer, he said. Broad, government-sponsored research is needed to resolve those questions and determine if some of the chemicals identified in environmentally aware states, like California, deserve attention or not.

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As for “stress,” it means too many things to different people and varies person to person too much to isolate as a cause of cancer. He also rejects the notion because it is unfair to patients.

“Be careful not to blame the victim for a disease that’s genetic,” he said.

 3. Persistence and collaboration produce breakthroughs.

BIO, the world’s largest biotech conference, celebrates the life-saving therapies that have already reached patients but it remains restless and hopeful for what comes next. Mukherjee was quick to lay down a hard truth about cancer research: “For the last decade, we have not found preventable or removable human chemical carcinogens of substantial human impact.” After a few moments of discussion, he repeated the statement again.

Pushing through will mean fully tackling some daunting complexities. For instance, it’s not a slam-dunk that every gene mutation has a one-to-one connection to a disease. More exploration is needed to understand how many genes contribute to create genetic risk, Mukherjee said. A multifaceted cause could necessitate a more complicated treatment. Or not. Mukherjee also thinks it’s possible that researchers could find some commonality across many cancers, a key that’s been elusive for a long time.

Collaboration fuels the process, he said. Mukherjee described how the dawn of gene editing breathed new life into an area of research that had stalled. He recalled spending six hours with the older researchers, drawing on their acquired wisdom. He probed for anything he could learn – even a single, anecdotal finding about one patient – that could help take the science to the next step.

“It is, to me, one of the most exciting things that people do.”