Gene therapy tourists
How a German-born businessman turned to China and a controversial gene treatment to tackle his cance
Desperation drove Richard Weissenborn to China. Last July, doctors back home in Houston gave him two months to live. The cancer on his tongue had spread to his lymph nodes - the only option, they said, was drastic surgery to remove part of his neck and face.
Weissenborn, a retired German-born businessman, went on the internet. There, he stumbled across something that surprised him. While US hospitals are reputed to be the most advanced in the world, only in China can patients receive gene therapy, widely believed to be the most promising innovation in cancer treatment. He rang Dr Li Dinggang at Haidian Hospital in Beijing, who told him there was no time to lose - so he got on a plane. Six months later, his life has been transformed.
"I was dying and I had no hope," he said, the day before he was due to return to the United States. "You look at me now, but you have no idea how I looked then. I was spitting blood, everything was swollen. But last Friday I got the results from the PET scan and I'm totally cancer-free."
Dr Li, who was trained at the Johns Hopkins University in the US, describes Gendicine, the gene therapy with which he treated Weissenborn and several hundred other patients, as "a milestone on the order of penicillin". But he does not tout it as a miracle cure.
"Richard is a lucky man and he made the right decision to come to our hospital," he said. "But only after five years, if we see Richard has survived, can we say this is really good. Right now we go case by case."
Gendicine is manufactured in Shenzhen, in southern China, by SiBiono, a Chinese company. It works by reactivating the p53 gene, which acts as a tumour suppressor. The drug is injected directly into the tumour, using a virus as a medium to carry the p53 gene into the cancerous cells. Once the p53 has been reactivated, it causes the cancerous cells to commit suicide and the tumour to shrink. Research shows the treatment to be most effective when it is used in conjunction with either chemotherapy or radiotherapy.
Dr Peng Zhaohui - who returned from the University of California in San Diego to found SiBonio - dismisses criticism of the Chinese authorities for approving the treatment precipitously. "When Gendicine was approved in 2003, we'd only had just over a hundred cases and it wasn't a very long observation period before that. It was licensed based on short-term effectiveness," he admits. "But today we've had more than 4,500 cases and have followed up our patients for six years."
None of this is by accident: the Chinese government backs companies such as SiBiono because the long-term plan is to base the Chinese economy on innovation, not manufacturing. Moreover, they see science as a way of reasserting what they regard as China's rightful place in the world. Hundreds of highly skilled doctors and biochemists like Dr Li and Dr Peng are returning from the US because research possibilities are opening up in China. Trials are much cheaper, and there's little chance of patients suing.
Some US researchers say Dr Peng hasn't been transparent about his research because he has published in Chinese-language and not English-language medical journals. SiBiono continued to develop Gendicine after a patient in an American trial of a similar drug died, possibly in reaction to the virus used as the medium. His family sued, and the US Federal Drug Administration put trials for such therapies on hold for three years. A similar problem occurred in France. China was able to take advantage of the slowdown.
This has caused some resentment. A press release from the British-based company Ark Therapeutics, which is developing a gene therapy for brain tumours, states that - if approved - its drug Cerepro "will be the world's first gene therapy product". It adds as a footnote, "outside China", as if China were not part of the world.
But for foreigners like Weissenborn and 200 others who have received treatment here, China is very much part of the world. He paid about £20,000, a fraction of what cancer treatments cost in the US. Such is the demand from foreigners, the Haidian Hospital is opening a new 50-bed international centre next month, with translators to help patients communicate.
China is also pressing ahead with stem-cell research, including the use of embryonic stem cells, whereas American research is handicapped by opposition from the Christian right.
Weissenborn has no doubts about Chinese ethics. "In the US they take five or six years. They want all the facts and the data, but in those years thousands die because they don't get the drug," he said.
Lindsey Hilsum is the Channel 4 News China correspondent