Drug developers have been improving the efficacy and safety of cancer therapies for more than 50 years. Over time, we have moved increasingly from nonspecific, generally toxic molecules to more targeted approaches, improving the beneficial nature of drugs, and reducing side effects for patients.
But biomedicine also holds surprising lessons for global security. Our experiences in developing improved cancer therapies may have applicability to another unimaginably complex challenge: the fight against terrorism.
Yes, you read that right. Although the fields of biomedicine and counterterrorism may seem far apart and unrelated, there are striking parallels. In the wake of the horrific attacks in Belgium, they are important to consider as experts weigh new strategies.
For example, some of the current approaches to terrorism, such as large-scale military action, stigmatize large populations of innocent civilians in order to target terrorists harbored in their midst. This kind of broad-based attack often harms both the terrorists and the innocent civilians who surround them.
So it was with the first effective chemotherapeutics used to attack cancer: The toxic drugs did not discriminate, but killed both normal and cancerous cells alike. In essence, these drugs targeted rapidly proliferating cells, and that meant they also killed normal, fast-dividing cells throughout the body. The result was modestly improved patient survival, at the cost of terrible side effects.
Even worse, original chemotherapeutic drugs often induced secondary cancers because of the very nature of their toxic effects on normal cells. Similar broad-based responses to terrorism have in some cases led to radicalization of small subsets of local populations exposed to systemic retribution.
Several decades ago, the picture began to change in cancer treatment when a set of rare blood cancers was cured for the first time by researchers who were able to tease apart the types of cells being attacked with chemotherapeutics. Recently, we’ve been able to fine-tune cancer treatment even further, moving from a focus on nonspecific, toxic therapies to more targeted approaches in order to kill cancer cells. These approaches include monoclonal antibodies and small molecule drugs specifically targeted to the mutations that distinguish certain cancer cells from normal cells.
The same precision approach could inform the global fight against terrorism. Using fine-grained analysis of big data, governments could develop algorithms to identify clear markers that distinguish terrorists from the general population. Targeted approaches could be developed to combat online and offline recruitment of young, disaffected people in regions that seem to be incubators for terrorists.
One of the most exciting advances in cancer therapies during the last few years has been the burgeoning field of immuno-oncology, based on increasing the ability of the patient’s own immune system to identify and destroy cancer cells. Again, there may be an analogous opportunity as we confront terrorism: harnessing the natural “immune system” of the general population and the wider social structure.
Countries could activate their natural “immune system” by developing support for those prone to terrorism by tackling chronic unemployment and providing educational opportunities for the most disaffected. The ultimate goal: to constructively integrate marginalized populations into wider society in order to help them develop a stake in personal and community success.
Given the arc of progress in cancer therapeutics, there is reason for optimism in the fight against a daunting disease. And this battle makes it clear that while the diffuse nature of modern terrorism is lethal and frightening, it might not be insurmountable if we dissect the unique characteristics of each threat and focus on more precise and targeted approaches for “treatment.”
Dr. Christoph Westphal is a partner of Longwood Fund and is a biotech entrepreneur, having cofounded as CEO several Boston biotechs: Momenta, Alnylam, Acceleron, Sirtris, Verastem, and Flex. Follow him at @drcwestphal.