“If I had asked people what they wanted, they would have said faster horses.” — Henry Ford
As we know, Henry Ford did not make faster horses, and instead paved the way to be one of the key players in building the car industry.
To go from faster horses to cars, he made a tremendous leap by changing perspective. And changing perspective is everything when you want to build new, transformative products that revolutionize an industry.
So I asked myself: “In healthcare, do we need faster horses?” Do we only need better, less toxic drugs that are more efficient and more precise? The healthcare industry has gone through major changes in recent decades, with advances in biology that brought about many of the current innovative treatments we have today.
However, if you only look at the world with one reality, the reality that you have today, you are shaping the results of your question. The way you ask yourself a question will shape the results you get.
Can we change our perspective and build a new industry? What if we were to examine the problem from a different angle, and re-invent the concept of drugs?Rethinking the definition of a cell because cell is not just biology
Let us look at what we know today about cellular biology, and consider the example of a cancer cell that we want to destroy..
Killing a cancer cell typically involves the targeting of one molecule that is implicated in the disease. When you develop a drug, you examine a molecule that can interact with a single molecule or molecular pathway that affects the generation, existence, destruction or spread of the cancer cell. By targeting this molecule, you enter a complex system where your drug may interact with many other molecules linked to this cancer cell, as well as other pathways. And in reality, this cancer cell is surrounded by numerous other cells with complex interactions to form a tumor, which is itself within a human body made of billions of cells having their own interactions and biological behaviors. All together, this is a very intricate system where it is difficult to predict how a drug will behave and provide its benefit or risk.
Here you see a video where the cell can be perceived differently. You are not viewing chemical or biological interactions; you are viewing objects that display physical behaviors: membranes of varying fluidity, bags that are moving, pods that are dragging bags, pillars that sustain the global structure of the cell; there is motion, electrical conductivity in neurons, and so on.
You are viewing the physics within a cell. We know that changing one of these physical parameters (e.g. temperature, PH, membrane fluidity, or structure) will change the cell and have an impact on its behavior.
Doing so, you can redefine the cell in terms of physics and not biological interaction, and also target physical properties instead of targeting a molecule to treat disease.
You can rethink the entire way we invent a drug by targeting the physics of a cell. To influence the physics at this scale, you need something that is small enough to enter the cell, but can be developed with specific properties to influence its environment.
That is the definition of a nanoparticle: A nanoparticle is a small enough object at the nanometer scale (small enough to interact with the cell at a subcellular level) and also has very specific and tunable properties.
Indeed, nanoparticles can be developed to have various tunable physical properties because of their size. For example, changing the size of the particle can alter the physical properties of matter. In this picture, the varying colors are actually coming from the same material (they contain the same atoms organized in the same way), but with different sizes. Thus, physical properties can be altered by changing the size of the matter. Beyond changing colors, for the past decade we have made tremendous advances in designing and building nanoparticles that have very specific and useful properties.
Today we can manufacture nano-objects that will cut, spin, glue, absorb or deliver energy. This is an entirely new toolbox for developing treatments for patients.
The treatment of cancer using chemotherapy is a well-known approach. Let us assume that we take 1,000 cells originating from different cancers sourced from a number of patients. If you apply one type of chemotherapy to the cancer cells, some of these cells will die (because they are sensitive), other cancer cells will start dying but then recur (because they have adapted and developed resistance) and some cancer cells will not be impacted at all (because they are not sensitive). That is the reality of biological variation—cancer cells vary within the human body and also between patients.
Now if you take the same 1,000 cells sourced from multiple patients, and treat them with particles that can deliver energy (heat or radiotherapy absorption), you will kill all the cancer cells with no exception. This is the reality of physics, where cells are not equipped to resist this high dose of energy.
Purely physics-based treatments could re-open the door of Mass Medicine, in contrast to most of the drug industry that is focused on multiplying personalized medicine. Treatments that utilize these physical approaches are already in clinical development or on the market, and are helping patients everyday.
New therapeutics are not discovered — they are designed
When developing a nanoparticle to make a new therapeutic tool, you start by deciding to work on a specific function. For example, you can develop a nanoparticle that will heat a cell to 40°C under a certain excitation of a magnetic field. Over time, you can develop different versions of this nanoparticle that will heat the cell to 60°C, 80°C, etc. You can improve the function and develop versions of your product, much like an iPhone.Consider the comparison an iPhone, which has several different functions (e.g. the phone, an mp3 player, a camera): likewise, you can develop new versions of your nano product with additional functions, such as visualization of the object by MRI.