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Brainstorm Health: Elephant Gene and Cancer, Drug Overdose Deaths, Glaxo HIV Injection

August 15, 2018, 7:22 PM UTC

Hello and happy hump day, readers. This is Sy.

An elephant never forgets, the saying goes. Or, at least, as Cliff explained a few weeks ago, it doesn’t experience nearly the same level of brain deterioration that humans do as it ages despite having way more neurons. But the massive creatures—which have lifespans that can reach up to 70 years (and in some cases, beyond)—have another advantage over mammals like us lowly humans: They seem to be strikingly resistant to cancer. And new research suggests that a certain “zombie gene” reactivated over the course of elephants’ evolutionary process may be the reason why.

The study published in the journal Cell Reports starts off by tackling what some might consider a common-sense hypothesis about cancer and the organisms that it affects: “Large-bodied organisms have more cells that can potentially turn cancerous than small-bodied organisms, imposing an increased risk of developing cancer. This expectation predicts a positive correlation between body size and cancer risk.”

Makes sense, right? Cancer is the uninhibited multiplication of cells. The larger a species, the more cells that can fall prey to this bioligical malfunction. But here’s the thing—”there is no correlation between body size and cancer risk across species (“Peto’s paradox”),” the researchers note.

So what’s going on here? Why are elephants, and a number of other mammals like bats and naked mole rats, seemingly resistant to cancer in a way that other humans aren’t?

Scientist Vincent J. Lynch of the University of Chicago, a lead author of the study, explained some of the nuances to the Los Angeles Times. A version of the “Leukemia Inhibiting Factor” (LIF) genes that can hit the biological brakes on rapidly-growing malignant cells in animals were both present and active in certain modern elephants, even though they’d been turned inactive over evolution’s course in multiple other animals. This LIF6 “zombie gene” as the authors dubbed it, once activated, went on to lead damaged, future-cancerous tissue to self destruct in a process called “apoptosis.”

The researchers had a slightly, uh, nerdier way of putting things: “These results suggest that refunctionalizing of a pro-apoptotic LIF pseudogene may have been permissive (although not sufficient) for the evolution of large body sizes in proboscideans.”

Whether or not such discoveries can eventually bolster human drug development is an open question. Fundamental differences in biology, as the researchers note, are millions of years in the making and can have unexpected effects. But our trunk-bearing cohabitants certainly offer plenty of food for thought in the life sciences.

Read on for the day’s news.

Sy Mukherjee


Express Scripts in talks to distribute pricey new gene therapies. Pharmacy benefits giant Express Scripts is reportedly in talks with a number of biotechs, including Spark Therapeutics, Bluebird Bio, and Biomarin Pharmaceuticals, to exclusively distribute their upcoming (and groundbreaking) gene therapies, according to Reuters. These treatments may wind up with list prices as high as $1 million to $1.5 million, but also could potentially cure conditions that would otherwise require continuous lifelong treatment. The reported discussions underscore the complexities of the U.S. drug supply chain; PBMs regularly criticize the pharmaceutical industry over high prices, yet also reap financial benefits from those prices by forcing rebates via their bargaining power and taking a big cut of those discounts (a practice for which benefits managers are increasingly facing scrutiny). Scripts argues that it can help the companies maximize their markets for expensive but important new gene therapies. (Reuters)


Glaxo gets a jolt with new HIV injection data. U.K. pharma giant GlaxoSmithKline saw shares rise 1.7% in Wednesday trading following promising results from a late-stage trial of a monthly HIV drug injection from its HIV arm ViiV Healthcare that involves just two treatments (as opposed to a current regimen of three drugs every day). As the field of HIV therapeutics evolves, companies are seeking ways to reduce dosing and side effects for patients. Glaxo's main competitor is Gilead, which has about 53% of the HIV treatment market share compared with GSK's 22%. According to the trial results, patients taking the two-drug monthly injection had about the same response as those taking three therapies orally every day. (Financial Times)

A new China biopharma index. Biotech investor Brad Loncar (whose pioneering Cancer Immunotherapy Index we've previously covered) has launched a new industry tracker—this time, specifically focused on "a basket of companies that are leading China’s biotech revolution," as Loncar puts it. The decision was inspired by new listing rules under the Hong Kong Exchange (HKEX) that would early-stage biotechs that haven't actually made any revenues to list publicly (as I recently noted, an expected boom in IPOs seems to have temporarily been stymied by China's ongoing fake vaccine scandal, which has rocked health care markets). 


A record number of Americans died of drug overdoses last year. A new Centers for Disease Control (CDC) report suggests that the number of Americans who died of drug overdoses spiked to a record number in 2017. All told, nearly 72,000 people may have died from overdoses—driven by opioids like fentanyl and heroin—over the 12 month period, representing a 6.6% national rise in deaths over 2016. (New York Times)


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Produced by Sy Mukherjee

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