2015 in Biomedicine: Baby Engineering, Spray-On GMOs, and Cancer Cures

During 2015, the combination of potent biotechnologies solved problems and created new ones.

Biologists often emphasize how little anyone really knows about the brain, the genome, and the mechanisms behind effective drugs. But this year their tune changed as diverse technologies–gene editing, stem cells, cloning, and DNA databases–coalesced into an immensely powerful toolkit for manipulating life. The message in 2015 seemed to be: “We can do anything.”

The technology that stole the headlines was CRISPR, the versatile genetic scissors that make it easy to cut and edit DNA of living cells. For the year, the number of scientific publications involving the technique doubled to more than 1,200, as scientists use gene editing to engineer extra-muscular dogs, create mosquitoes that can’t spread malaria, and alter plants so easily that companies predict it’s just a matter of years before gene-edited foods hit our dinner plates.

We can do these things, but should we? Social and ethical questions began dogging the CRISPR breakthrough early in the year, when MIT Technology Review toured readers through one emerging debate: the possibility of genetically modifying human embryos in IVF clinics to spare children from inherited disease. With an April publication from China disclosing the first edited human embryos, the debate over whether the technology is a slippery slope to eugenics exploded, and by December many of the world’s top gene-editing scientists had gathered in Washington for a will-we-or-won’t-we debate.

They concluded that we shouldn’t, not yet. It would be “irresponsible” to use CRISPR to make customized babies, the experts declared. In fact, one participant felt that our power to engineer life had outstripped our wisdom. “We are becoming masters of manipulating genes, but our understanding of their function is very limited,” said Klaus Rajewsky of the Max Delbrück Center for Molecular Medicine, in Berlin.

Yet we might know enough to cure some cancers, or solve the shortage of organs for transplant. Companies including Juno Therapeutics this year raised billions to start treating patients with genetically engineered immune cells that they have crafted into a lifesaving new treatment for leukemia. Surgeons in the U.S. smashed records for so-called “xenotransplantation” (transplants between species) by keeping a monkey alive nearly six months with a gene-modified pig kidney.

Gene technology isn’t just more powerful. It’s easier to access. Entrepreneurs started selling do-it-yourself DNA engineering kits to modify bacteria, and in October we told the story of a startup founder, Elizabeth Parrish, who claimed to be the first person to thumb her nose at the U.S. Food and Drug Administration and treat herself with anti-aging genes. “I am patient zero,” she declared.

It’s a sign that we are deep into the second generation of biotechnology. That also means some pioneering inventions are being retired. This year, Monsanto’s patents on its original herbicide-resistant soybeans expired (pound for pound, the beans are easily the most important product of the biotech era), allowing farmers to plant “generic GMOs” for the first time. But  Monsanto has new ideas in its pipeline, like genetic sprays that can kill bugs or even change the behavior of plants on contact. Those products rely on RNA interference, which was also used to create the world’s first biotech apple.

A different trend that gained traction was the use of electricity to heal the mind or treat the body. Some call these therapies “electroceuticals.” Doctors began using brain stimulation to treat cocaine addiction, obsessive-compulsive disorder, and other problems once “considered too complex and mysterious” to cure with a simple jolt of electricity. In Cleveland, meanwhile, specialists at Case Western ran wires between the brain of a paralyzed man and the muscles of his arm, allowing him to move the arm with his thoughts. We didn’t forget to check in with the brave volunteers who got us here. We learned how patients who received a previous generation of implants at Case were left without tech support, rendering the devices useless inside their bodies. One far-out scientific pioneer even decided to put an implant in his own brain.

That role Silicon Valley might play in biotechnology is also worth watching. For that, we checked in several times this year with famed Facebook investor Peter Thiel to learn about a cancer-fighting startup he funded and get his views on how drug development could be more efficient if only biotech companies acted a little more like computer startups. Thiel, who thinks there shouldn’t be so much trial and error going on, told us his goal is to “get rid of randomness.”

We also tracked tech companies attempting to disrupt the huge, unhealthy U.S. health-care system. It’s not going too well: consumers don’t trust tech companies with their health data, and wrist-worn devices aren’t too accurate. But tech companies won’t be dissuaded. This year we learned that Apple was in discussions with researchers to collect people’s DNA data, and a San Francisco startup called Helix, bankrolled with $100 million, said it would launch the first DNA app store for consumers in 2016.

These ideas were part of an emerging boom in consumer use of genomics, which drew in figures like J. Craig Venter. Yet the economics of consumer DNA services remain unclear, partly because DNA predictions aren’t always foolproof or useful. This year, a $699 direct-to-consumer blood test for cancer got a very chilly reception, while pregnancy tests expanded into uncharted territory and sometimes found cancer by accident. Even better-established cancer tests aren’t proven to really help patients. The leader in tumor DNA testing in the U.S., Foundation Medicine, sold a majority of its shares to Roche, a sign that its future was uncertain.

Making DNA data more useful is the goal of President Obama’s “precision medicine initiative,” a $215 million effort that includes a planned study of the health records and DNA of one million people. Only with big numbers, the government says, will the next wave of links between genes and disease be discovered. Yet big studies could cause big, unexpected problems. In March, the CEO of DeCode Genetics, a subsidiary of Amgen that runs a nationwide gene bank in Iceland, said its database was now so big that it could pinpoint each and every Icelandic woman with a dangerous breast cancer mutation. Yet because of privacy laws, DeCode complained, it is unable to tell them. 

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