Returning from Working2Walk 2011, if you are currently sitting in your wheelchair and ‘’waiting’’ for the cure, you could be disappointed by the absence of a fantastic scientific breakthrough. Even though some interesting and encouraging results were presented, the long awaited cure is not there yet…
However, we should definitely stress many positive outcomes from the presentations and discussions that were held in Rockville, Maryland. On the translation front, besides some update on a few clinical trials already ongoing or expected to start soon (eg the Geron trials and Miami Project on acute, Wise Young clinical trial network in China, working on chronic SCI), we got confirmation that NeuralStem, yet another important player, has already applied for IND for trials on chronic SCI patients. They expect to be able to start it off as soon as their ALS safety trials are ratified. There was some good news from the labs as well: we heard and saw the remarkable results recently obtained by Jerry Silver in chronic rats (1 year post) with chondroitinase. And we also got a glimpse of Stephen Davies line of research and will be looking forward to his publication (currently under peer review). Working2walk also delivered to promises when it comes to bringing various stakeholders together and paving the way for further collaboration and cross-learning. InVivo Therapeutics, for instance, clearly showed their willingness to collaborate with various players in the field as they consider their biocompatible polymer scaffolding device as an instrument to bring the right drug or cell to the lesion in the most effective way.
Coming back from Maryland, you might however have seen your enthusiasm tempered when you realized that the problem is by far not just scientific but also systemic! As it is, collaboration, however greatly improved over the past decades, should be enhanced further. Also, the discussions again pointed out the need for a system/ framework that would be better geared towards a faster cure. There are currently all kinds of reasons why promising therapies do not go through swift translation. An example is the earlier mentioned Chondroitinase. This is an enzyme that was successfully tested on rats by Dr. Jerry Silver, but the human application depends on a decision by Acorda Therapeutics and a Japanese patent owner, besides remaining important scientific challenges. Like for so many other therapies, the human application depends on a number of factors. The path from the lab to the bedside must first cross what is commonly referred to as the “ Valley of Death”. The hurdles are many and include patent considerations, financial investment, scientific challenges and important regulatory hurdles which strive to guarantee optimal safety. It is more critical than ever, for legislators, regulators, researchers and advocates to work together to navigate the “Valley of Death” and enable a swift and safe translation of combination therapies. Also the imbalance between clinical trials on chronic and acute injuries should be corrected (acute injuries being current focus of clinical trials and studies, though the number of chronic cases is about 20 times bigger, not to mention easier logistics and more robust outcome measurement).
So the sky is not totally blue… But the good news is: we can do something to brighten it up! And this is the view that we should keep from W2W2011: that of the exponential progress accomplished over the past few decades by dedicated researchers and that of the fantastic potential for action by the sci community and related organizations. They can foster collaboration between researchers, dialogue with regulators and support creative solutions to the challenges of translational and clinical studies. The attending SCI representatives, coming from all over the world, have indeed not only shown their realistic commitment to a cure, but also their deep and integral knowledge of the subject. The voice of the community was clearly heard by the research community, and in most cases, well received.
Opinions will differ as to how far we still are from a cure or even from significant functional returns, but one fact is not questioned at all: we have never been so close! In other words, it is time to act, time to join forces, think out of the box and apply new ways and strategies towards functional returns. All in all, a more cohesive and aggressive target-driven approach (comparable to the ‘’moon shot approach’’) seems to be of essence. Settling for a cure as the medium term target and deriving strategies from there would naturally lead to a more integral (from bench to bed), collaborative and innovative approach, and to more timely and effective outcomes. Simple? Of course, not. Yet time for hope alone is over. It is now time for action. (W2W - Document)
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