Fast failure is a term rooted in the startup world.
On the contrary, the terms “medical research” and “scientific inquiry” conjure up images of slow, deliberate, painstaking clinical validation.
If the American Heart Association, Verily (formerly Google Life Sciences) and AstraZeneca get their way, they will not only figure out a cure for coronary heart disease, but also set a whole new paradigm for how medical research is done. This unlikely trio announced Wednesday that it is awarding a cardiologist at Brigham and Women’s Hospital $75 million over at least five years to gain a new understanding of coronary heart disease to find a way to cure the largest killer of human beings.
“Part of it was taking on something like coronary heart disease which is a major killer, but also transforming how science is done,” said Jessica Mega, chief medical officer of Verily, in a phone interview on Wednesday, explaining the motivation behind the company’s participation in sponsoring the award.
The award to Dr. Calrum MacRae, chief of cardiovascular medicine at Brigham and Women’s Hospital in Boston, was the culmination of the One Brave Idea competition by which a global search for a winning idea began in January. MacRae won out among 300 ideas submitted, and his focus will be on identifying how, why and when people go from being healthy to developing heart disease.
Dr. MacRae explained that current treatment of coronary heart disease has focused on the last 20 to 30 years of a patients’ life thereby “lumping together lots of different things that look similar.” His goal, with a multidisciplinary team, is to create a rich tapestry of the disease — looking at cell biology, environmental factors, behavioral effects and other factors — to understand the disease when it first strikes an otherwise healthy person.
“What this amazing award … lets us do is to move way back into the very earliest stages of disease at the very first transition from wellness really,” MacRae said by phone Wednesday. “By moving earlier we can potentially understand exactly how behavior, the basic biology, the environmental exposures, the different types of exercise that you might undertake, different ways in which you can use your nutrition, the different symptoms and even the different feelings about their health may all be an important part of what’s actually driving the disorder.”
The 8-member team that MacRae will lead brings together people from different institutions such as Stanford University Data Science Initiative; Center for Complex Network Research, Northeastern University; Atlas Ventures; and Donnelly Centre for Cellullar and Biomolecular Research, University of Toronto among others.
The award – $25 million each from AstraZeneca, AHA and Verily — is as much financial as it is resource based, a fact that was repeated by representatives of all three organizations.
“This partnership goes beyond financial resources so there may come a time where there might be certain resources or projects or assets or things that each of us can bring to the initiative,” Mega of Verily said.
Verily’s strength of course is in data analytics, engineering as well as software. The AHA brings decades worth of experience in the field of coronary heart disease and AstraZeneca can bring clinical experience to the table for instance, said Dr. Gregory Keenan, vice president & head of U.S. Medical Affairs at London-based AstraZeneca.
But the similarities to the startup world is that the medical research team that MacRae will lead will have milestones and deadlines in place that will help to determine which project or idea should win financial and expert resources.
“Instead of having a set of aims that you specify at the start of a five-year award and then moving through those aims, what we are actually going to be able to do is to move nimbly, understand what works and what doesn’t work, with hard milestones, with early failure and then divert resources and reallocate them to the projects that are working,” he said. “From the investigator’s standpoint I think the exciting thing is actually operating along exactly these new strategies.”
Keenan echoed Dr. MacRae saying that this new approach to medical research is what attracted the drugmaker’s participation.
“One of the things that was compelling to me and I think to the committee looking at this was the concept of fast failure,” he said.
Dr. MacRae said that there are some “shovel ready” projects that his teams can explore with the funds available now. For instance, using wearables to measure risk in young relatives of people who have coronary artery disease.
“For four decades it’s been known … that the disease is present in significant number of individuals as teenagers. And then there were very inventive studies on vascular biology done about 25 years ago that show there is abnormality in teenage relatives of people who have premature coronary disease. The advances in modern technology now allow us to measure those types of physiologies with wearables at the wrist….”
One Brave Idea’s website shows that the project intends to kick off with a study to collect genomic information, lifestyle data (sleep, activity, stress), public health data (environmental and economic factors) and responses from people who have coronary heart disease in their families.
So what happens if some valuable (read commercially viable) idea emerges from the project?
Based upon its $25 million investment, the single largest ever research award in its history, AHA will have a share of any IP that emerges, but Verily and AstraZeneca won’t, explained Nancy Brown, president of AHA. But the goal is not necessarily financial given that if the IP results in a financial gain for AHA, the money will simply go right back into financing more research.
“So in essence, we are helping to create an evergreen fund,” Brown said.
Keenan, whose firm is also contributing $25 million is similarly interested in how the trio and MacRae’s team could be instrumental in changing the very definition of medical research
“The way science is done has to change. Science moves too slowly with conventions that have been developed over the decades of the last millennium.” he declared. “It’s time for science to move into the new millennium and I think that this is the evidence of it.”
Photo: Danil Melekhin, Getty Images