WIRED Health 2017 (London, England)

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ADDITION 10/3/2017 0915

I finished writing this blog post at some silly time in the early hours on the day after the conference. It was one of those jobs that simply needed to be done. I knew I wouldn’t be able to sleep if it wasn’t completed.

As it stands, I’m sat in a hotel waiting for a full-English, feeling like death. 4 hours sleep simply doesn’t agree with me and the hotel doesn’t do espresso!

After re-reading the piece it’s obvious I missed an incredibly important sentiment. Rather than sneakily jumping back in and editing seamlessly I want it to stand as it reads and bolt this on like an extra appendage.

The key to success for many of the projects we heard from yesterday depends on working collaboratively and sharing resources and funding. In a world that appears to be shrinking due to the cowardly fury of some sections of the population, it puts everything at risk. If we don’t work across borders, without restriction and we don’t pool finances to be better as one, then we risk everything. Everything.

Take the genome project for example. We know that the key lies in sharing and cooperation. Isolationism risks this. The Concordia research base is used and funded by countries across Europe and is part of the European Space Agency. Where does the future of Britain lie in these types of project? Worryingly, we don’t have answers and, even worse, the underlying sentiment from a Government without opposition appears to be that we’ll be just fine on our own.

Whilst we should be celebrating great minds we find ourselves worrying about the actions of the stupid ones. History tells us they can’t and won’t win but the stakes are high. When the world should be pulling together and giving us our Star Trek moment, it feels fractured and broken.

But, rather than shedding liberal tears, I’ll raise my middle finger to the situation and put a boot through it. It won’t stop me and it won’t stop the people in the room yesterday. Character IS destiny and I’ll raise a glass to the crazy ones. The ones that bring the world together through science. The ones that disrupt. The ones driven by compassion and love. The ones who believe in changing the world for the better. To the main event…

Cheers, Kris.

 

The #WIREDHealth conference is sold out again this year, so to be in a room with so many brilliant influencers, movers and shakers, I feel incredibly privileged.

But, why is a blood cancer patient at a conference widely regarded as a showcase for healthcare innovation, not necessarily medical breakthrough? Patient power means that we have to consider the bigger picture and when I attended two years ago and made contact with Oxford Nanopore it made me realise how isolated we can be.

One day, the MinION from Oxford Nanopore will allow blood cancer patients the opportunity to home test and send results to their consultant. A breakthrough for anyone who’s had a bone marrow biopsy. And take it from me, I’ve had 14 and this would be a welcome relief!

Today is all about looking at the health sector and seeing how we can apply technology and breakthrough advances to blood cancer. I’m incredibly grateful to Leukaemia Care, who I serve as a trustee, for funding my attendance and having the foresight to look at the bigger picture and for truly caring.

400 eager delegates packed the auditorium at 30 Euston Square in London to listen to speakers from across the planet. After the formalities from the incredible team at WIRED who put the conference together we moved straight to our first speaker: Peter Piot from the London School of Hygiene & Tropical Medicine. Peter spoke at length about the threat of epidemics, the reality of HIV and the danger of reliance on antiretrovirals. The messages were particularly hard-hitting, as they should be, and focused on better communications (especially on social) and ensuring funding is secured in this worrying isolationist time. In other words, if we don’t rebrand AIDS then we’re in danger of it getting out of control again.

Straight to Helmy Eltoukhy, the CEO of Guardant Health, to talk about cancer and genomes. The Guardant360 blood test ensures that cancer patients can be matched to specific therapies and in 2017 it is the fastest growing test for advanced cancer patients. It will also play a part in early detection. Their LUNAR test which is under $1,000, will test for five of the main cancer types (sadly not blood cancer at this point). 

Imagine fighting an infection without knowing the associated virus.” – Helmy Eltoukhy, the CEO of Guardant Health

The Chief Medical Officer for England, Professor Dame Sally Davies followed up on the topic of genomes and cancer and presented an incredible introduction to genomics. The UK is leading the world in genomics and it is proving to be the key to unlocking the deadly secrets of cancer. She spoke about the 100,000 genome project that 85 hospitals across the country are involved in, 1,500 NHS staff and 2,500 researchers and trainees from across the world. They are looking for faulty genes and the reasons they become faulty.

So, analysing a whole genome sequence will allow us to have that comprehensive view and give us the power to make decisions and diagnosis with a higher success rate. We were shown a case study where a partial sequence didn’t help, only the comprehensive approach provided the answers needed. The 100,000 genome sequence is patient focused and Dame Sally really believes that the one-size-fits-all approach DOESN’T work. Her approach is steeped in science-fact. What an inspiring talk, Dame Sally is to be applauded and supported for all she is doing. 

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(l-r) Kris Griffin and Waseem Qasim

Hot on her heels, Waseem Qasim from the Institute of Child Health. This conference was non-stop, amazing stuff! Waseem presented his work on engineered cell therapies, something that blood cancer patients may be aware of; it could be a considered a future treatment instead of a bone marrow transplant!

He’s involved in some incredible work on immunotherapy and the use of T-cells has been called a breakthrough in science (and leukaemia treatments) by publications and the industry alike. There’s lots of work to be done but this is an area we should be very aware of as we search for that elusive cure. In 2015 a high risk ALL patient aged 11 months was treated using a special therapy licence. UCART (UCART22 is an allogeneic engineered T-cell product candidate designed for the treatment of acute lymphoblastic leukaemia) cells were introduced to eliminate the leukaemia cells, these UCART cells were then deleted. 18 months on and the disease is undetectable. A formal phase-one trial is underway for children and adults with ALL. It’s an incredible breakthrough and the term molecular-scissors is one I feel could be a gateway to a brighter future.

You can find the story of Layla here: www.newscientist.com/article/dn28454-gene-editing-saves-life-of-girl-dying-from-leukaemia-in-world-first

Jurgi Camblong, the CEO from Sophia Genetics spoke about data-driven medicines and gave us an overview of collective intelligence through interconnectedness. This interconnectedness involves people and organisations working together all over the world. It was good to see privacy issues addressed but they continue to be the biggest obstacles. It seems, that we have no choice but to find a productive, safe solution. If we don’t, then we risk our future. Sophia has hit the 100,000 genome sequence target and they continue to build. We need more data because data means treatment becomes more successful. We’re back to patient power and personalised treatment once again. It’s a constant theme.

IMG_4109After a short break, we moved to section called ‘the data will see you now’ and to Jessica Mega representing Google’s medical arm, Verily. She spoke about collecting info, organising it and activating people to promote healthier lives. It was interesting to look at the advent of new, connected devices. Whilst we’re beginning to get comfortable with wearable devices, how about a spoon that detects a tremor or a phone that detects changes in voice and language patterns? We need to move from a system of individual productivity and IT silos to a system of collective intelligence and distributed computing. In other words, sharing is good. It’s that theme again. She talked about designing with the user in mind and ensuring that the patients get the tools and solutions that they need rather than the ones that they are given.

Straight on from Jessica,  Jasmin Fisher from Microsoft Research Cambridge spoke about decoding cancer. She started by talking about cancer being a personalised disease. Some of her work includes modelling leukaemia cells so we are able to look at different states and make better predictions in order to reduce the effectiveness of the diseases. This means new biological insights, the ability to identify new therapies and help against resistance, which will all lead to better personalised treatments. This was an exciting blend of science and data.

WIRED have the ability to change gear very quickly and Marko Ahtisaari from Sync Project waxed lyrical about self-medicating with music! He took us through the scientific stimulation that listening to music gives us; the brain fires in different ways when we listen to different types of music. In several studies, music has had pain reducing effects. It’s hard not to be sceptical but in an era when music is so readily available and I know that I have playlists I put on to focus, inspire and cheer me up – then why not have a playlist that helps with pain. The work that Marko is doing starts to turn this into a science; the research he is doing into relaxation before sleep is particularly interesting and the Unwind.ai website is fascinating; please check it out on your mobile device.

Khaliya, a mental health strategist tried to push the envelope. Khaliya told a very personal story about her connection to the mental health agenda and the issues that come with it. Unfortunately, her scripted approach didn’t make it easy to connect with her. The concept of mental injury is an excellent one but when she spoke about the usage of psychedelic drugs on brain injuries, my scepticism kicked in. I was tempted to switch off but I’m glad that I didn’t. On reflection, this provocative section really challenged my thinking and Khaliya’s standing applause from some members of the audience really stopped me in my tracks.

BhBI-acCcAEUvqYKris Famm from Galvani Bioelectronics ended the morning session with a focus on bioelectronic medicines. This felt like future-gazing at its very best. I don’t profess to understand this area at all but it’s clear that it could offer good outcomes for many diseases. The electric stimulation of a nerve (vagus) by an implant has had incredible effects in trials for rheumatoid arthritis. There was similar evidence for type two diabetes patients after nerve stimulation. It presents an incredible opportunity for a large number of future treatments and it’s a system that provides high efficacy, low side effects and broad access.

For more information, I’d recommend reading this article: www.newscientist.com/article/2099472-google-firm-hopes-to-control-organs-with-electrical-signals

After lunch, we went straight into a section on the end of ageing which was curated by Dr Jack Kreindler.

The section started with Matt Eagles who has had Parkinson’s since the age of eight, 41 years. He’s a patient advocate and speaker and I applaud the conference organisers for including him on the agenda. He weaved an incredible life story around his use of implant technology (deep brain stimulation) and traditional treatment. Matt’s desire to stay young for as long as he can and his fight against a degenerative neurological disorder is one of courage and the love of life itself. Plenty of life-affirming moments from an inspiring individual.

F1.mediumThrough to Daisy Robinton from Harvard University who provided an in-depth presentation about CRISPR, the Science magazine discovery of the year in 2015. She provided insights how we are using this to move forward with actual gene editing of humans. There is already a trial happening in China at the moment.

For more information on CRISPR and a more detailed discussion, this article provides an excellent read: www.sciencemag.org/news/2015/12/and-science-s-breakthrough-year

In the future will a visit to the doctor result in a referral to the gene surgeon? At childhood, will all children be screened and edited against diseases? Can this be abused to ensure a child has 20/20 vision or the attributes of a great sprinter? Ethically, it’s a challenging time but the opportunity to eradicate a number of diseases is too good to lose sight of.

Just when you are getting comfortable in your seat, WIRED pokes you in the ribs, we end the session with Elizabeth Parrish. She’s the CEO of BioViva Science and has undergone two rounds of gene therapy to reverse the symptoms of ageing. With photos of old people on the screens behind her, she spoke about the inevitability of ageing and clearly sees the consequence as the end of civilisation as we know it. She spoke about ageing as if it were a disease and treating the effects of it with gene therapy. This talk raised plenty of issues with me, mainly one of the ethics in experimenting on yourself but conversely isn’t this the ultimate in disruptive behaviour? The charismatic Parrish polarises the healthcare community and offers a useful insight of what could be.

It was refreshing to see Beth Healey from the European Space Agency to talk about life at the extreme. Concordia Research Station, which opened in 2005, is a French-Italian research facility that was built 3,233m above sea level at a location called Dome C on the Antarctic Plateau, Antarctica. Beth spent over 12 months at Concordia and spoke of days without the sun, sensory deprivation and living with, and on top of, a small crew. Beth was part of, and led on, a number of experiments and research during her stay including MRI, cognition, movement analysis and searching for extremophile bacteria. The preparation for manned deep space exploration is key but the knock-on effect for life on earth is equally important. It was a fascinating insight into this research platform and the work that goes on behind the scenes.

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After another short break, David Halpern from the Behavioural Insights Team talks about disputing heath. I really enjoyed his analysis of the variety of outcomes that comes from behaviour in health. Using the basics of long waiting times, missed appointments and the over-prescription of antibiotics he provided some alternatives to current solutions based on behaviour. For example, if you tell the patient that a missed appointment costs the NHS £160, this has proved to reduce the amount of missed appointments – get the messaging right! By making high-calorie drinks a little harder to reach in a hospital canteen meant they reduced the amount sold whilst keeping sales stable because healthy drinks were purchased instead. He advocated that healthcare should go EAST when it comes to behaviour: Easy, Attractive, Social, Timely. An outstanding presentation, I immediately went to Amazon and purchased David’s book!

Eren Bali, from Carbon Health, followed up by looking at creating the world’s largest healthcare network, essentially redesigning the current model. It would be a technology platform that would connect hundreds of thousands of doctors. This is a system where you hold all of your own medical records, electronically.


I’m sold! In San Francisco, there are 100,000 patients already on the platform with 20 practices dealing with primary care, urgent care and specialist care. His virtual bot approach isn’t that different to the scripted NHS service we currently get on dialling 111. Using big data means that users of the platform can take advantage of a more personalised approach and much better outcomes. A brilliant approach!

IMG_4128The (Pricilla) Chan (Mark) Zuckerberg Initiative has £3bn to spend to eradicate all diseases, Jeremy Freeman joins us to tell us how. One of the issues with science and collating data is knowing what to do with the raw data; clearly getting results from raw data is key to making progress. How do we make ALL of the science more efficient, more effective and more collaborative? Their aim is to support basic science and technology that will make it possible to cure, prevent or manage all diseases by the end of the century. By combing technology and science, experts from both fields collaborating, means that this can become a possibility as the data will not become an obstacle. It’s hard not to fall in love with such a bold, brilliant idea and I’ll be following their work with great interest.

To continue unlocking the brain, Aldo Faisal from Imperial College London takes up the baton by capturing the perception-action loop. That is, over 80% of the movement of parts of the body that flow in and out of the brain. He created the human ethome database and can tell us, using science, what the two most important movements of the hand are; not the presumed answers of pincer grip and power grasp. This science means that we can provide better functioning robotic limbs. We were also shown fascinating videos about human augmentation using this new understanding of the brain. It was refreshing to see him advocate an approach that meant the science has to be married up by behaviour in order for things to work.

A hop, skip and jump across to exponential medicine with Daniel Kraft from Exponential Medicine. Ten years ago the first iPhone launched and look how far we’ve come. This fast-moving talk moved at the pace of recent technology advancements. The initial conclusion was based upon joining the dots.

Daniel ran us through how everything is connected, especially with the advent of 5G but how do we make sense of all this data? Sock’ables, sweat’ables, breath’ables, voice tracking that detects mental health, sensors in a baby’s nappy, urinalysis are all becoming part of our healthcare system. Will Facebook, Twitter, Amazon, Echo and things like the Apple Health Kit be the thing that binds it all? It’s clear that we need integration. More is going to happen in the next 10 years than in the last 100 and we need to boldly create together.

This year the content on the main stage was of such high quality I didn’t get to visit the start-up stage. But the winner this year, Give Vision, was given the opportunity at the end of the day to present on the main stage. Stan Karpenko did a superb job in telling us about his revolutionary electronic goggles that allow visually impaired to see again. It was a special moment to watch a video of a young boy given the device that enabled him to see properly again. Because, ultimately, that’s what we’re all in this for. To make a difference. To make things better.

The WIRED team hit the highs of two years ago when I last attended, and then smashed through them. The conference was provocative, inspirational and fundamentally important in equal measure. I tell colleagues that this conference puts you one step ahead of everyone else in the healthcare sector, it feels like the beating heart of innovation. From the perspective of a patient with a chronic illness it gives you hope. Hope in that there are LOTS of people who care and hope beyond the system. Because this is what disruption is all about and we’re a better society for it.

Thanks to Leukaemia Care who funded my attendance at this conference. Please visit their website and find out a little more about them.

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(l-r) Kris Griffin, Greg Williams (Editor of WIRED), João Medeiros (curator of WIRED Heath)

Self-monitoring of CML Gene Fusion

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That’s a pretty heavy blog title, it’s the shortened version! Just wait until you open up the image below. Don’t worry I haven’t gone all ‘sciencey’ on you; I just want to share the amazing progress that Oxford Nanopore are making with the MinIOn and VolTRAX.

I’ve written about this before, quite a lot as it happens. I’m not obsessed yet but i do find the development of a piece of hardware that measure our DNA at home pretty incredible. This information shows that Oxford Nanopore really believe that this could be a reality and I applaud their vision.

People are starting to sit up and notice, I’ve had quite a few emails from clinicians and pharmacists around the world who are showing interest. The interest comes with slight reservation, this is disruptive technology and a huge step away from the safety net that we are all accustomed to.

Safety, that’s the key word isn’t it! As long as it’s safe; I agree, of course. But in the process I hope we’re going to break and bend a few rules, make the process feel a little uncomfortable. Find a better end result. That’s what disruptive technology is all about.

Think about the current process. We visit the hospital, wait, have blood taken. Come back a few weeks later, months in some cases, wait, see a consultant to be told that all is well (hopefully) and start the process again a few months later. It’s an uneconomical process on many levels. For many, who are several years into remission, it’s the constant reminder that they are sick.

It’s not a process that will work for everyone and it won’t work all of the time, but if we make the device safe to use it becomes a management tool for a chronic condition.

Whilst we’re getting our head around personalised treatment, we also need to manage patient expectations and the psychological impact of diagnosis and a lifetime of treatment. It isn’t a conversation that is happening enough and the NHS doesn’t have the funds to even consider it.

In this new world of taking tablets to treat cancer, the biggest cause of drug failure is compliance, people not taking their drugs. Would this new process, where the patient starts to take responsibility for the management of their disease, in a similar way that diabetics do, help or hinder compliance?

If the current system isn’t working, should we be even more disruptive when looking at compliance? When you ask why someone isn’t taking a tablet, it starts to become a very deep and psychological process; it’s personal. In order to save more lives we have to ask if hardware, software or a human touch is needed to solve the problem. The treatment is personal therefore the solution to any problems have to be personal too.

When I think of MinION or VolTRAX I can think of 20 different ways it could revolutionise treatment and diagnosis for CML: domestically and globally. That’s why I’m passionate about it and it’s why I don’t accept excuses and reasons not to do it.

If we’re fully committed to patient power, and that means accessing the right drugs as well as the right technology, we’re going to have to fight for it. Patient power means something might not fit into the already established status quo, there’s the fight.

It’s a fight worth having because it’s about us…

Kris

 

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Visiting Oxford Nanopore Technologies

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In April 2015 I visited the Wired Health conference in London, I write the following about a product I saw called the MinION:

Clive G Brown, CTO of Nanopore Technologies, spoke about how his company’s USB stick-sized DNA sequencer will enable an “internet of living things”. He spoke of how he could see consumers using this medical device and having results go to the cloud for diagnosis. Old DNA sequencing machines cost hundreds of thousands of pounds and are huge, this device costs just £650. Clive has a vision for immediate results on a device that can be run anywhere, he used an analogy of building it into a toothbrush so your biology can be sequenced every morning and monitored for changes.

A device like this could be revolutionary in the field of testing epidemics, environmental monitoring and infectious disease control. It’s predictive and preemptive. It could allow general self quantification in the same way diabetes patients track their blood sugar. For any leukaemia patient, like me, who has to have regular blood tests or bone marrow biopsies, several narratives converged for me at this particular moment in time.

Imagine a device that meant we wouldn’t have to visit our consultant regularly but still allowed us to do regular blood tests. It would pick issues up sooner, share results, save the NHS lots of money and do away with bone marrow biopsies. Imagine a device that could track chromosome abnormalities and check immediately for the philadelphia chromosome. The device you see me holding in my hand could be the key to unlocking all of that. This could also be the key to mass screening and therefore the saving of many lives. No pressure there then.

Clive is clearly a man who wants to keep expectations in check but I can’t help but get excited. I spoke to the team during one of the breaks and we are going to talk. This is one to watch!

Last week I was invited to the Nanpore offices in Oxford to give a talk to their staff about self-quantification. The talk ultimately ended up being about the life of a CML patient and the things we go through on a daily basis. It was an emotional rollercoaster and I felt the 150-strong audience were with me every single step. My talks are hard work, I don’t spare any detail but I try and look at things in a light-hearted way. I’m happy to share in order to get people to understand. Understand the patient and the process becomes simple.

After the talk I was given a tour of the offices and laboratories. It’s an incredible organisation with a talented staff who care deeply about their work. It was very humbling to meet so many good people. The CEO, Dr Gordon Sanghera, is driven, intense and inspirational and made me feel very welcome.

This won’t be last you’ll hear from me about Nanopore, I have high hopes from them in 2016. No one ever does something that changes the World because it is easy……they do it to make a difference. I hope I was able to show them enough to see what that difference will make.    Kris Griffin

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CML Advocates launch Leukaemia App

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CML Advocates Network has launched its new mobile Chronic Myeloid Leukaemia (CML) adherence app called CML Today. It’s for CML patients to help them support adherence to tyrosine kinase inhibitors (TKIs) as well as to track their polymerase chain reaction (PCR) results.

The mobile app is available for FREE in English, French, Spanish, German, Portuguese, Arabic and Hebrew. More languages will follow soon.

The App will allow patients to:

  • track the regular intake of their medicine
  • remind them to take their prescribed medication
  • track their PCR test results and other laboratory parameters
  • facilitate patients connect with local support groups in their country.

I’ve downloaded the App for my iPhone and have found it easy to use and very clear; the reminder function is excellent. Whilst there are several Apps that support CML patients this is the only one, to my knowledge, developed by a patient advocacy network. I know the people who have developed it and I trust them, very important with medical data of this nature. This App gets my seal of approval and a big thumbs-up from me. Well done CML Advocates Network.

Find CML Today in the Apple App Store (iphone) and in the Google PlayChronic (Android).

https://itunes.apple.com/de/app/cml-today/id1038000286?l=en&mt=8
https://play.google.com/store/apps/details?id=com.appropo.cml_adherence_app&hl=de

Thanks, Kris

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