Nobody has cured cancer. That needs to be made clear from the beginning, because what Herve Hoppenot is talking about sounds very optimistic. It’s the kind of thing that in careless hands could be made to sound more definitive than it really is. And false hope is a dangerous thing.
That said, progress on cancer treatments is moving briskly forward all the time, as are treatments for infectious diseases, says Hoppenot, chairman and CEO of Delaware-based pharmaceutical company Incyte. Researchers have found ways to manage diseases like hepatitis C and HIV, and that wasn’t true just a few years ago. Now cancer is — maybe — on the ropes, thanks to science. If only people would recognize that science is not actually the Devil.
Hoppenot will present “Scientific Innovation is Transforming the World” at the Princeton Chamber’s July Monthly Membership Luncheon on Thursday, July 13, at 11:30 a.m., at the Princeton Marriott Hotel & Conference Center. Cost: $75. Visit www.princetonchamber.org.
Hoppenot was born and raised in France, where his father was an officer in the army. He attended ESSEC Business School (Ecole Superieure des Sciences Economiques et Commerciales), where he earned his MBA in science in 1983 as part of an integrated degree program.
Hoppenot began his career at Rhone-Poulenc Rorer and first visited the United States in 1978, when he did a summer abroad program in Pittsburgh. He moved to the Philadelphia area permanently in the late 1990s to serve as the head of the U.S. oncology business unit at Aventis. In 2003 Hoppenot joined Novartis, becoming president of Novartis Oncology in 2010. In 2014 he was named chairman and CEO of Incyte. He lives in Princeton with his wife, Anne de Broca-Hoppenot, the honorary French consul for New Jersey (U.S. 1, September 21, 2016).
To understand where cancer treatments are headed, it might help to reflect for a moment on where HIV treatments were a few decades ago. HIV, which targets the immune system, was a major problem in the 1980s and 1990s. But the effort to get it under control forced scientists to look deeply into how the immune system works.
Fast forward to the past few years and the knowledge of the immune system gained by studying infectious diseases like HIV has given cancer researchers new ways of looking at treating the C-word, Hoppenot says. That’s a huge shift in perspective, but clearly a vital one, because the truth is:
Everybody has thousands of cancers every day. The normal cycle of the body making and remaking itself constantly, Hoppenot says, means that we all produce abnormal cells every minute of every day. Those defect cells are eliminated immediately, before they can replicate, and this happens thousands of times a day.
Until, of course, it doesn’t. When the system for eliminating defect cells breaks down, defect cells replicate and disease spreads. Part of what Incyte is focused on, Hoppenot says, is reigniting the immune system to keep killing off the bad cells. (The other part is targeted genetic therapies.) The shift in approach, however, has been to realize that the reason bad cells survive is that they are protected. So it’s not just a matter of killing the bad guy, it’s a matter of destroying its veil of protection. “The shell” of the tumor, Hoppenot says.
This revelation, he says, began with, of all things, pregnancy. Scientists realized that when pregnant women have diseases in their systems, their babies are often protected from pathogens. The shift from thinking of the womb as a cocoon to thinking of it as more of a shield has led scientists down new avenues of research. Consequently, research has advanced immensely.
“We’re about to be able to treat cancer non-toxically in maybe the next 10 years,” Hoppenot says. And the approach will change families and the very business of treatment. Speaking of which:
The economics of cancer treatment is … complicated. Let’s revisit our brief look at HIV 30 years ago. In the late ’80s treating HIV was still expensive. Patients needed to be hospitalized. Life expectancy was dismal. But as progress was made in HIV treatment, more than quality of patient life improved. So did treatment costs.
The hangup is, HIV drugs are pricey, just like drugs for all kinds of serious conditions. And as cancer drug improve, they will also likely be expensive. Hoppenot points to the single-provider-billing solution found in some European countries and in Taiwan as a way to keep access to money from becoming something that limits access to cancer care.
Under single-provider billing, patient care is billed as more of a collective cost; under dual-provider billing, as we have in the United States, patients are billed for medical care by one entity and for drugs by another. Thus, the price of drugs can be prohibitive for many people because drug companies and prescription benefits providers need to make their money independently.
Looking at care end to end, though, Hoppenot says, palliative care costs will go down as drugs for cancer improve. If there’s no need for all-day hospital visits and elaborate treatment procedures, healthcare systems will save a lot of money. Were there a single provider sending out bills, he says, the savings to hospitals could easily be passed on to patients, so that even if drugs were pricey, the overall price of care would not run away.
First, however, people need to see science as a friend. Hoppenot is, to say the least, dismayed by how science is increasingly vilified in the United States.
“We live in a society with a growing amount of skepticism about science,” he says. “People in Princeton are saying that children should not be vaccinated. How is that possible?”
The paradox is not lost on Hoppenot: We live in a world that operates the way it does because of science, and yet Americans increasingly distrust it. American parents take their kids to doctors, American business runs on mobile and wireless technology, and recovery rates from treatments for diseases and injuries have shrunk to the same degree that travel time across the ocean shrunk from months to hours once we started flying. And, oh yeah, people are flying and safely landing thousands of miles away, hours later. All that happens because of science. And yet people increasingly squint their eyes at what evils science is producing.
Objectively, Hoppenot says, the numbers for things like poverty, death in war, and hunger are all diminishing and constantly improving. But for some reason, he says, people have this nostalgia for how great things were yesterday.
Hoppenot’s suggestion? Stop using science as a political tool and look at objective results. In other words, maybe it’s time for a perspective shift. Remember, it worked when someone changed the definition of womb from cocoon to shell. And look at how fast cancer treatment improved once that happened.