Precision medicine, an emerging toolkit of ways to better understand the complex mechanisms underlying a patient’s health, disease, or condition, and to better predict which treatments will be most effective, has grown unevenly outside the United States and Western Europe. The vast pools of genomic data on which its precision relies are scarce outside of Western populations. And even when drugs have been found to be good matches for certain genetic mutations, they don’t always work.
Now in China, Singapore and elsewhere across the Asian continent, the promise of precision medicine appears to be taking hold. Recent advances in genetics and emerging methods of analyzing large data sets mean information once scarce is now increasingly available, as new companies offer low-cost sequencing of the human genome. Asian governments and universities are directing resources into bettering the genetic understanding of diseases. And companies across Asia are making inroads into research with the goal of designing drugs and other products tailored to the bodies and lifestyles of individual Asian patients.
Precision medicine employs diagnostic testing to select optimal therapies based on the context of a patient’s genetic content or other molecular or cellular analysis. Tools employed in precision medicine can include molecular diagnostics, imaging and analytics.
Many diseases today are being treated with pharmaceuticals and products that do not work with equal effectiveness across populations. And many diseases and conditions that are prevalent in Asia are not in the West. Diabetes, for example, presents differently among the average Asian than among patients in Europe and North America. Allergies also present differently and at varying rates among different populations.
Why Has Precision Medicine Grown in the West But Not in Asia?
At the heart of the promise of precision medicine is data collected from large numbers of people. But until recently, such data pools were severely limited outside of the United States, Europe and, to some extent, Japan. Since 2003, when the landmark Human Genome Project published the full genome sequence, large DNA repositories have been created. But because the research first took hold in the United States, the information has largely been the province of researchers based in the United States and Western Europe, and the databases are overwhelmingly made up of Caucasian data. The research requires large numbers of volunteers willing to share their genetic and health data, along with biospecimens from blood, urine and saliva. Advanced tests rapidly sequence large segments of a person’s DNA, or even their entire genome. The dearth of advanced healthcare information systems incorporating electronic health records in countries like India and Indonesia make it difficult to effectively capture vital patients’ data on a large scale.
Indeed, even as evidence grows that different populations may manifest the same disease very differently, and respond with significant variety to the same drug, depending on their genetic makeup, the gap in genomic data persists. Indeed, genomic data collected from people of non-European ancestry represents less than 20 percent of genomic data employed in most studies. And genomic data from Asian populations represent only about 15 percent of genomic data available worldwide. The gap is even larger when it comes to South Asia. While 25 percent of the world’s population comes from South Asia, according to estimates from the U.N., only one percent of genetic data comes from that region.
What Is Changing
With Asia’s booming economies and rising incomes pushing increased spending on healthcare, the incentive is growing for research by Asian governments, along with local and Western companies, into precision medicine solutions to diseases and conditions found most often in Asia.
Major countries like China, India and Japan are rapidly adopting modern healthcare technologies. And Asian governments are leaping forward with their own precision medicine initiatives.
The GenomeAsia100K initiative, a non-profit consortium launched in 2018 to generate genomic information for Asian populations, seeks to sequence the DNA of 100,000 people in 28 countries in Asia. The nonprofit organization plans to make the collected data available to scientists at universities and private companies.
Two years earlier, China launched its own precision medicine initiative, saying it planned to invest about $9 billion in an effort to collect, store and analyze genetic data from its population by 2030. It has partnered with pharmaceutical and medical device company WuXi AppTec to design the research facilities, and with Chinese telecommunications giant Huawei Technologies Co., Ltd., to build the cloud-based platform to support the initiative.
Singapore has followed suit. SingHealth Duke-NUS Institute of Precision Medicine is developing a genome/phenome database. Also, at the National University of Singapore, the Cancer Institute Singapore (NCIS) is matching genetic profiles of cancer patients to early-phase clinical trials of new drugs.
In South Korea, the Cancer Precision Medicine Diagnosis and Treatment Enterprise (K-MASTER) joins Samsung Genome Institute, Macrogen and Korea University to study biological and genetic markers in cancers.
U.S. and Asian Companies Pioneer Precision Medicine in Asia
Bolstered by the government advances, U.S. and Asian companies are beginning to capitalize on the promise of precision medicine in the region.
In China, biopharma companies are gaining a toehold. In July, Chicago-based conglomerate GE Healthcare opened the GE Cell and Gene Therapy Asia Technology Center to train thousands of scientists in precision medicine-driven biopharma techniques. Eleven Chinese companies, among them Shanghai-based Cellular Biomedicine Group, Inc. (CBMG) and Xiangxue Pharmaceuticals co., Ltd. (XPH), in Guangzhou, are using its biopharma production process, FlexFactory.
A July 2018 joint venture paired U.S.-based DNA Chip maker Centrillion Biosciences with WeDoctor, a Chinese firm, to provide genomic analyses to patients. And in Hong Kong, both local firm Prenetics, and the U.S. company Advanced Genomic Solutions (AGS), offer genetic testing services to consumers.
In Singapore, a local pharmaceutical company, Aslan Pharmaceuticals, is using precision medicine techniques to research bile duct and gastric cancers, which are rare in the West but common in Asia.
AstraZeneca and Roche are using research that has established that a particular cell mutation that causes lung cancer in non-smokers is particularly common among Asian woman. They are developing and marketing therapies to target that mutation.
The evidence is building that such forays are just the beginning. Indeed, the precision medicine market in Asia is predicted to grow by more than 15% yearly through 2023. As the promise of precision medicine accelerates, companies that offer big data analytics, gene sequencing, pharmacogenomics and companion diagnostics are expected to be among the major players.