Matthew Herper, Forbes Staff
Christopher Hitchens, quite famously, did not believe in miracles. His death is a reminder that we shouldn’t, either – even when they’re the scientific kind.
Hitchens, like Steve Jobs, was among the first patients to benefit from a very new technology: the use of DNA sequencing to pick cancer drugs that might have a better chance of slowing a tumor’s growth.
Cells become cancerous because of mutations in their DNA that make them stop behaving as discrete parts of the body and instead cause them to multiply like crazy and run amok. Once a cell is cancer, its genes get twisted and re-arranged even more. The idea is that by identifying some of these mutations, doctors can figure out which drugs are most likely to stop or slow tumor growth and prolong life.
Jobs was so excited by this idea that he told his biographer, Walter Isaacson, that he could be among the first to outrun cancer this way or be among the last to die from it. Both DNA from Jobs’ tumor and Jobs’ own cells was sequenced — the most expensive and exhaustive way to look for tumor-causing defects. (A cheaper way is to just look at genes known to correlate with effectiveness for existing drugs in some cancers.)
Characteristically, Hitchens did not get nearly as excited as Jobs did about the prospect, but he still seemed filled with hope. “At least it spares me some of the boredom of being a cancer patient because what I’m going through is very absorbing and positively inspiring,” he told the Daily Telegraph. “But if it doesn’t work, I don’t know what they could try next.”
Also characteristically, the story of sequencing Hitchens’ tumor is full of larger-than-life debates about belief and nonbelief, God and the absence thereof. He was approached by Francis Collins, a devout Christian and head of the National Institutes of Health. A decade ago, Collins led the government-funded Human Genome Project, and he became deeply involved in Hitchens’ care.
In this video, aside from responding to the question, “Well Christopher, how are you feeling,” with “Well, I’m dying, but so are you,” Hitchens talks movingly about Collins, who he calls a great American, “one of the devout human beings I’ve ever met.”
Hitchens did find a drug that seemed to address one of his tumor’s mutations – it was reportedly Novartis’ Gleevec, the first targeted cancer drug – and that may have spared him some rounds of chemotherapy. But the medicine did not, of course, save him. Nor did it save Jobs.
According to Hitchens, Collins told him that he’s never seen anything in his medical career that could be called a miracle. That’s probably worth remembering as we begin to move into an era where many patients’ tumors will be sequenced. M.D. Anderson, where Hitchens died, has been trying to use DNA sequencing as a standard step in picking experimental drugs for patients; so have other cancer centers. One company, Foundation Medicine, which counts Google Ventures among its investors, is trying to turn this into a business model. Makers of DNA sequencing technology, including Illumina, Life Technologies, and Pacific Biosciences have been talking about the business opportunity for years.
This make sense because caring for late-stage cancer patients is so expensive, and so often futile, that even a costly technology like DNA sequencing (the price is dropping at an amazing rate but it’s still $5,000 or so for a full genome) could easily lead to improvements. But this technology is still in its early days, and it is not saving many lives just yet.