Asian patients finally have medicines designed for them

Mumbai

FOR decades, much of the pipeline of medical innovation has flowed from West to East. Now a string of companies are attempting to upend that trend with new drugs and products tailored to Asian bodies and lifestyles.

There's the Singapore-based drugmaker tackling an obscure cancer that's rare in the West but common in Asia, where it's been linked to a popular fish dish. Med-tech startups are preparing to sell tests to detect tumours more accurately in Asian women with denser breast tissue. Even Big Pharma firms like AstraZeneca plc and Roche Holding AG now have drugs targeting a lung cancer-causing mutation most often found in women from East Asia.

This simple yet radical departure comes as Asia's booming economies and rising incomes enable higher spending on health care. That's providing incentive for more pharmaceutical companies to set up shop in the region, whether it's Western firms creating R&D centres to develop drugs for local populations, or new Asian drugmakers springing up.

Consultancy Frost & Sullivan predicts that total revenue for the Asian health-care industry will jump 11 per cent this year to US$517 billion. Many of the researchers focusing on Asia have a simple starting point: diseases and their cures can sometimes work differently in different populations, and a one-size-fits-all regimen tailored to the West isn't sufficient.

The approach is cropping up most often in cancer care in Asia, home to tumours that are rare in the West. "The patients are here, the tumour samples are here, and also the basic know-how," said Brigette Ma, a professor at the Chinese University of Hong Kong who specialises in new drug development.

"By acknowledging diversity, not just in cultural and economic needs - by acknowledging diversity in terms of cancer care - we are getting the drugs to where they are needed."

The shift is part of a broader trend sweeping through the global health-care industry called precision medicine, which seeks to tailor treatment to a person's specific genetic make-up and circumstances, including ethnicity or culture.

In Asia, Japan has long been an important market for the health-care industry, and a site of new discoveries. But the rapid growth of the rest of the region is heightening its importance as a whole, and diversifying the industry's focus in it.

Singapore-based biotech company Aslan Pharmaceuticals Ltd is now conducting late-stage human tests for a drug targeting bile duct and gastric cancers. The prevalence in Asia of a stomach-infecting bacteria which can lead to cancer-causing inflammation is one factor that makes gastric cancer more common in the region.

But research suggests it usually takes even more culturally specific traits, like the aggravating diet of salty and fermented foods common in Northern China, Korea and Japan, to turn that inflammation cancerous.

North-eastern Thailand, meanwhile, is the global centre for an obscure disease called bile duct cancer. Rare in the West, researchers have traced its prevalence in certain parts of South-east Asia to a fermented fish dish called koi pla beloved by the area's Lao people. The cooking process for the dish often fails to kill an inflammation-causing parasite called the liver fluke, and the infection can eventually lead to bile-duct cancer.

Carl Firth, Aslan's chief executive officer, said: "There are very few effective treatment options for these patients. The focus is very much on cancers common in the West."

Aslan has received orphan drug status for its lead molecule in the US as a potential treatment for biliary tract and gastric cancers, and is seeking approval to sell it both there and in China. He said his company could look for ways to help the Thai patients access the drug after it completes its clinical trials.

Meanwhile, by controlling for both ethnicity and gender, researchers over the last decade have established that a particular cell mutation which causes lung cancer even in non-smokers is much more common in Asian women than anyone else.

Two multinational pharma companies, AstraZeneca and Roche, have since made tracks to develop and market therapies that specifically target these parts of the cell, and so have proved to be particularly effective in Asian patients.

And when it comes to breast cancer, just diagnosing it can be harder because research shows Asian women are more likely to have denser breasts than Caucasians. This can obscure a tumour on a mammogram, leading doctors to issue false negatives or even false positives.

Startups that have sprung up to tackle the problem include MiRXES in Singapore, which plans to launch a test that will examine patients' blood for microscopic particles that are byproducts of tumour growth.

Where traditionally the health-care industry would seek approval for new products in the West before bringing them to Asia, now more firms are planning to go the other way for some diseases. "These patients really need the drugs in Asia," said Vishal Doshi, whose drug development startup AUM Biosciences is focusing on therapies for Asia-prevalent cancers. "This is what I term an East to West philosophy, from a West to East philosophy. BLOOMBERG