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1013–1014, 2012), recently licensed Google’s ‘smart lens’ technology (Nat. Biotechnol. 32, 856, 2014) for ocular medical applications. Merck, of Whitehouse Station, New Jersey, is also investing in digital health, through its $500-million Global Health Innovation Fund, which has made more than 20 investments in four years. Shire and Pfizer are also collaborating in studies using gaming products as markers of cognitive ability. Wearables and devices that collect information are creating new opportunities to improve medical delivery and treatment while cutting down on costs. Even so, digital health remains at a relatively early stage of development, and the sector has yet to deliver a killer app—or, indeed, a silver bullet. ‘Digital health’ encompasses a multitude of approaches. At the Digital Health Forum meeting in London in June, Jack Young, of San Diego–based Qualcomm Ventures, identified categories that range from applications for sensor-enabled smartphones through data management, analytics and changes in healthcare delivery. All imply massive data capture and analyses that extend far beyond existing patient treatment and management paradigms. “Your body is basically giving tweets all the time about your vitals. What do we do with all those data?” Young asks. Apple, of Cupertino, California, on September 9, released an app that takes a stab at centralizing all those data. The HealthKit body-monitoring system, pulls together health and fitness information— blood pressure readings, weight, body fat, calorie intake, existing medical conditions and sleep patterns—under one framework. Can Geppetto’s Sophie persuade a middle-aged man with asthma to stay indoors when pollen counts are high? Avatars could also track a patient’s But despite this and daily changes in emotions, speech and facial expressions. other smartphone, With Apple’s smartwatch unveiled on September 9, the company takes aim at a digital lifestyle. The Apple Watch may have just tied health and communications into one device, but digital sensors have been booming for some time. As smart devices spill into drug development, investors are piling cash into the sector. In the first half of 2014, the sector attracted $2.3 billion in venture capital, more than the $2 billion it raised in all of 2013, according to Rock Health, a S. San Francisco, California–based seed fund. In July, Proteus Digital Health, a Redwood City, California–based firm, which two years ago gained US Food and Drug Administration (FDA) approval for its ‘smart pill’ ingestible, wireless sensor, raised over $172 million in a series G financing round. Large pharma is also ramping up its interest in digital technologies as applied to healthcare. Novartis, of Basel, already a Proteus investor (Nat. Biotechnol. 30,

Geppetto Avatars

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© 2014 Nature America, Inc. All rights reserved.

Apple moves on health, drug developers shift into smart gear

nature biotechnology volume 32 NUMBER 10 OCTOBER 2014

Electric Grand Prix cars to be powered by algae-based generators Formula E, the world’s first electric Grand Prix series, is powering race cars with electricity derived from algae. Designed to showcase and inspire developments in electric car technology, race organizers have partnered with UK startup Aquafuel to supply generators powered by glycerine, a biodiesel by-product that also can be produced from saltwater algae. However, with the technology still at an early stage, the algaebased generators will need to be transported to race locations around the world. The ten-stop circuit kicked off September 13 with the Beijing ePrix, attended by 75,000 spectators.

Student-led startup Covagen snapped up by J&J Cilag, an affiliate of Johnson & Johnson–owned Janssen Pharmaceuticals, has acquired Covagen, launched by two postdocs at ETH Zurich in 2007. Covagen is developing multispecific protein therapeutics through its FynomAb technology platform. Covagen’s technology fuses together antibodies and Fynomers, small binding proteins engineered to bind target molecules with the same affinity and specificity as antibodies. Its lead compound, COVA322, is in phase 1b/2a testing for psoriasis. Financial terms were not disclosed, but Covagen had previously raised $56.6 million. See CEO’s story here http://bit.ly/1tGaine.

Actionable Genome Consortium to guide NGS in cancer Four major cancer institutes have joined Illumina to set up a program that helps oncologists diagnose, classify and treat cancer using next-generation sequencing. The Actionable Genome Consortium (AGC) brings together the San Diego–based sequencing giant with the Dana-Farber Cancer Institute, Memorial Sloan-Kettering Cancer Center, MD Anderson Cancer Center and Fred Hutchinson Cancer Research Center. The aim is to define genomic changes in patients’ tumors that will allow oncologists to choose optimal therapies and testing strategies. The hope is that defining an ‘actionable tumor’ will support new diagnostics development and regulatory oversight for genomic testing in cancer. 

“This should be the last Ebola epidemic without a cure,” said Ahmed Tejan-Sie, a Burlington, North Carolina physician, who started a petition drive on Change.org to fast track drug and vaccine research for Ebola. Under pressure from physicians, FDA announced in August that it would consider providing treatments under special emergency conditions. (Reuters, 3 August 2014)

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NEWS NIH issues genomic data sharing policy The US National Institutes of Health (NIH)’s new data sharing policy, issued in August, hopes to speed the translation of genomic data into knowledge, products and procedures that improve health while protecting the privacy of research participants. The policy will apply to all NIH-funded, large-scale human and non-human projects that generate genomic data beginning with funding applications submitted by January 25, 2015. The GDS policy traces its roots to the Human Genome Project completed in 2003, which required rapid and broad data release. It replaces the previous Genome-Wide Association Studies (GWAS) data sharing policy, issued in 2007. 

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© 2014 Nature America, Inc. All rights reserved.

Vertex buries Incivek Boston-based Vertex will discontinue sales of its hepatitis C virus treatment Incivek (telaprevir) barely three years since its approval in May 2011 (Nat. Biotechnol. 29, 553, 2011). Incivek was one of the first antiviral treatments to double cure rates compared to standard treatment. It was approved for use in combination with pegylated interferon alpha and ribavirin to treat HCV genotype 1. But its dominance didn’t last. The launch of the first all-oral, interferon-free regimen, active against all genotypes, Gilead’s Sovaldi (sofosbuvir), in 2013 (Nat. Biotechnol. 32, 3–5, 2014), quickly eroded Incivek’s market share.

Exelixis slashes 70% of staff Exelixis announced in September that it will cut 160 jobs after disappointing results for its lead drug Cometriq (cabozantinib) in prostate cancer. Cometriq is already approved to treat metastatic medullary thyroid cancer. But in a phase 3 comparison study of Cometriq, in men with castration-resistant prostate cancer, the small molecule failed to show a significant increase in overall survival compared with prednisone. Cometriz inhibits multiple tyrosine kinases including MET, VEGFRs and RET.

“We’re not trying to create some characteristic that makes this person a stronger person or [someone who] will have blonde hair. We’re trying to prevent disease and I think that is the only justification for doing this.” Doug Turnbull, from the University of Newcastle, UK, commenting on cytoplasmic transfer technique that he helped popularize in Europe. Some object to it on the grounds that it amounts to germ-line engineering. (BBC News Magazine, 31 August 2014) “This is a big leap into the unknown for AbbVie. Google is used to leaping into the unknown but AbbVie is not.” Aubrey de Grey, CSO at SENS Research Foundation, comments on the $1.5-billion partnership between AbbVie and Calico, Google’s answer to aging. (The Wall Street Journal, 4 September 2014)

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iPad, video-based technologies, adoption so far has been slow. For new companies braving the market, “The biggest strategic challenge here is focus,” says Arthur Hiller, chief business officer at Geppetto Avatars, a Mequon, Wisconsin– based startup, which aims to improve patient management and patient monitoring through the use of digital avatars powered by artificial intelligence. “The reality is we could do a thousand different things,” he says. Geppetto has developed a platform that integrates myriad technologies, including natural language processing, facial recognition, voice-to-text recognition and biometric data analysis, as well as insights from social psychology and behavioral science, into a ‘digital doctor’, which can interact with patients through ordinary speech and video. Two beta customers are already using the technology in undisclosed settings, and a first commercial version is due to ship this fall. Such digital information could also be exploited for drug development. In difficultto-diagnose degenerative conditions, such as Parkinson’s disease or Alzheimer’s disease, the Geppetto’s face-recognition technology might monitor speech patterns or microfacial tremors. Although the company has not yet initiated such studies, “We have the potential to establish clinical endpoints that never existed before,” says Hiller. Intel and the Michael J. Fox Foundation are testing smartwatches to follow symptom progression in patients with Parkinson’s disease. The Intel Basis smartwatches and a specially developed app track body movements, rhythms and function, to produce information that could aid understanding of the disease and inform drug development. Other trials in patients with Parkinson’s disease are testing whether Google Glass can help them retain their independence for longer. The device reminds people to take their medicine and attend medical appointments, and provides discreet prompts to speak louder and swallow. Beyond tracking and monitoring, devices could be therapeutic. Adam Gazzaley, founding director of the Neuroscience Imaging Center at the University of California, San Francisco, and colleagues are testing whether a three-dimensional training video game, called NeuroRacer, can improve multitasking performance in older adults—assessed by their performance in playing the game—compared with two different control groups. “We were pretty excited by the strength of the signal we saw even though it was a very small population,” says Gazzaley, who reported the results last year. The performance improvements

lasted at least six months and also translated to improvements in working memory and sustained attention, which were assessed using different tests (Nature 501, 97–101, 2013). “One of the biggest challenges is developing approaches that strengthen not only the individual ability to do that task but that also have a more generalized impact,” he says. Gazzaley is a cofounder of Akili Interactive Labs, a Boston-based company, which is developing a commercial version of the game. Shire, of Dublin (soon to become part of AbbVie, of North Chicago, Illinois), is an investor and is collaborating with the company on a clinical trial in 80 children with attention deficit hyperactivity disorder. Pfizer is assessing its potential as a diagnostic aid in Alzheimer’s disease. “Pfizer’s interest is, can game play over time be used as a more sensitive marker of cognitive ability than we have achieved with more standard neuropsychological testing?” says Gazzaley. The end goal is to help the brain “train its way out” of a problem, to use gaming to harness the innate plasticity of the human brain. But contrary to Gazzaley’s finding, other studies claim to have found no transfer effects from brain training programs (PLOS One 8, e59982, 2013; Nature 465, 775–778, 2010). Michael Merzenich, professor emeritus at the University of California, San Francisco, and cofounder of Posit Science, a brain training firm, also based in San Francisco, is critical of their findings. “It’s not so easy to create a study that corrects a brain that’s complexly distorted,” he says. “Most people operating in this realm are not neurologically informed.” But Posit and a sister firm, Brain Plasticity, also have several trials of cognitive training programs ongoing, in military veterans with traumatic brain injury and in schizophrenia patients, for example. “I consider this is going to be the dominant therapeutic approach in the not-too-distant future,” says Merzenich. The field is still waiting on what Merzenich calls a “linchpin moment.” The pharma industry’s present level of engagement has yet to move beyond the experimental stage. The digital health sector has yet to reach that point when clinical—or market—validation aligns with a sustainable business model. In the long run, the companies that succeed in this space may be those that best integrate the brash, consumeroriented culture of the technology sector with the more conservative, regulation-bound ethos of drug and device development. No FDA label has ever included the word ‘awesome’. Cormac Sheridan Dublin

volume 32 NUMBER 10 OCTOBER 2014 nature biotechnology

Apple moves on health, drug developers shift into smart gear.

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