If you haven’t heard that Google is now funding research into human aging and lifespan, they’ll be very disappointed. There’s been plenty of publicity, which I find sort of interesting, considering that there’s not too much to announce:
The Time article—and a Google blog post released at the same time—provided scant detail about what the new company, called Calico, will actually do. According to Time, the company, to be based somewhere in the Bay Area, will place long-term bets on unspecified technologies that could help fight the diseases of aging.
Page did tell Time he thinks biomedical researchers may have focused on the wrong problems and that health-care companies don’t think long-term enough. “In some industries it takes 10 or 20 years to go from an idea to something being real. Health care is certainly one of those areas,” Page told Time. “We should shoot for the things that are really, really important, so 10 or 20 years from now we have those things done.”
The company’s initial investors are Google and Arthur Levinson, also chairman of Apple’s board and that of biotech company Genentech. Levinson, a trained biochemist, will be the CEO of Calico, which the The New York Times reported is short for California Life Company.
I’m fine with this. Actually, I’m more than fine – I think it’s a good idea, and I also think that it’s a good idea for the money coming into it to be long-term, patient money, because it’s going to have to be. I think that human life span can probably be extended, although no one’s ready to say if that’s going to mean thirty extra years of being 40, or thirty extra years of being 90. If you know what Trimalchio says about seeing the Cumaean Sybil in the Satyricon, you’ll have come across the problem before. (Trimalchio’s an unlikely fount of wisdom, but he seems pretty much on target with that one).
Patience will be needed on several fronts. Biochemically, there are actually a number of ideas to follow up on, and while that’s good news in general, it also means that there’s a lot of work ahead. Not all of these are going to actually extend lifespan, I think it’s safe to say, and sorting them out will be a real job. But that’s the sort of problem that a lot of therapeutic areas have. Aging research has several others piled on top of it.
One of them it shares with areas like diabetes and cardiovascular disease: you’re looking for a drug or therapy that the patient will be taking for the rest of their lives – their extended lives, if all goes well – so toxicology becomes a huge concern. Tiny safety concerns can become big ones over the decades. And that leads into another big issue, the regulatory one. How would one set up a clinical trial for an anti-aging therapy? How long would it run? How long would you have to work with the FDA to get something together? Keep in mind that the agency doesn’t have any framework for making people better than normal. You’ll note that despite the possible lifespan enhancement with the sirtuin compounds, GSK never really mentioned this possibility in their takeover of Sirtris. It was all about diabetes and other conditions that have defined clinical endpoints and a regulatory environment already in place.
The answer to that problem, then, is surely to pick some disease of aging and see if you can ameliorate it by attacking the aging process in general. It’s a bit like a second derivative: in other therapeutic areas, you pick a biomarker, and you try to get approval based on an effect against it as a surrogate for the long-term benefits against the actual disease. In this case, though, you’d pick an actual medical condition, and hope to get approval using it as a surrogate against the meta-disease of aging itself. Those will not be short trials, nor easy to run, nor will it be easy to obtain statistical significance in them.
And I don’t think we’ll be seeing one of those for quite some time. Larry Page himself is 40, I believe, so if he’s looking for a benefit that he might realize, he’s almost certainly out of luck. As am I at 51. Page’s ten or twenty year timeline seems very short indeed. If I find a wonder drug in my lab this afternoon, it won’t be hitting the pharmacy shelves for about fifteen years itself. I hope I’m wrong about this, but I doubt if anything will be worked out enough to try before either of us are much further into old age, at which point you start to run into that Cumaean Sibyl problem. Unless, of course, you are fortunate enough to come up with something that actually turns the clock back a bit, but that’s much less likely. Just slowing it down is enough of a feat already. I realize that this is more of my patented brand of “pessimistic optimism”, but I can’t make myself come up with any other opinion yet.
I thought seriously about titling this post “Gegen Den Tod Ist Kein Kräutlein Gewachsen”, but I figured that would drive my traffic into the basement. That is, I’m told, one of the mottos of the old German herbalists, translating as “Against death does no simple grow”. It’s safe to assume, though, that anything that really does usefully treat aging will not be simple, so the Germans are probably still in the right.
Update: a reader has sent along more information on that quotation. It actually goes back to Latin (cue various readers holding their heads and moaning). It goes “. . .contra vim mortis non est medicamen in hortis”, and is part of the declamations that are more or less Quintilian’s work on Roman court cases and rhetoric (thus often ascribed to “pseudo-Quintilian”).