The Most Studied Diseases in a Post-Covid World: Q&A with Gen Li

Gen Li
Founder and CEO
Phesi

Each year, Phesi releases an analysis of the world’s most studied diseases. The survey includes data from the 67,569 recruiting trials conducted in 2024. Phesi founder and CEO Gen Li spoke with Pharmaceutical Executive about this year’s results and what he believes it shows for the industry.

Pharmaceutical Executive: Can you explain what the results of the survey showed this year?
Gen Li: We have been doing this for several years, and this one shows that we are getting out of the COVID-era fluctuations of several diseases. It appears like we're going back to normal (the pre-COVID status). The striking thing to me is that it's still the non-small cell lung cancer coming back to the top of the list. We're getting more and more understanding of the different biomarkers associated with different subtypes underneath of non-small cell lung cancer. If you're looking at the pharmaceutical industry, the main driver is, of course, the dire needs from the patients. Another key driver are new innovative understandings of the diseases. Not surprisingly non-small cell lung cancer has the combination of both.

The other aspect was stimulated by COVID. We were trying to understand how this pandemic is going to impact the pharmaceutical pipeline. In previous years, it wasn't a surprise at all. We saw high attrition rates during the pandemic. However, I was expecting that as the pandemic moved behind us, the previous state of things would come back very quickly. That's not the case. My thinking is that it looks like we are being hit by something rather serious which exposed some already existing problems in the industry. The site, performance, and the design of the protocols are problematic. Those are the things that seem to be hit very hard by COVID. The pandemic exposed those weakness and caused us to have an ongoing problem seems to be lasting longer. I hope it's not too much longer, but we will see.

PE: The survey revealed that there's still a high rate of clinical trial attritions, could you discuss the potential causes?
Li: When the COVID hit, we were totally unprepared. We were not able to visit the sites or do many of the routine things we had been doing for decades. The situation put a lot of restrictions on us, and some countries have much more strict restrictions on conducting clinical trials. It’s not particularly surprising that we saw a rising attrition rate in phase two trials (we just use phase two as an example because that's the core of the clinical development in the process).

After the pandemic, we thought that things would go back to normal and the attrition rate would be a thing of the past very quickly, which wasn't the case. It's because, fundamentally, we had problems in selecting better sites and designing better protocols. Those are the things that are not coming back as quickly.

For example, there's a percentage of investigators impacted by COVID, and they basically had to back out from doing clinical trials altogether. Just because we put the pandemic behind us, that doesn’t mean we solved the problems that the industry already had. Those problem had been intensified by the pandemic. That's our view of why this situation is lasting so long, and unfortunately, could actually last even longer still.

PE:According to the results, breast cancer continues to be the most researched cancer. Can you speak to why that is?
Li: Breast cancer is the number one among all of the cancers, not only among women, but also among the whole humankind. It's the number one cancer. It is not surprising that once COVID passed by, breast cancer returned to number one.

Compounding to the fact is that we are still improving our understanding of breast cancer at the molecular level with different biomarkers. While we are making very good progresses in some of those different subtypes of biomarkers, some of the other ones are still much more complicated. We still have a very strong desire to look for better treatment. It's a very tough knot to untie.

PE: What other major trends are you watching?
LI: One of the things we continue to be amazed by is big data and artificial intelligence impacting our ability to understand more data and identify different patterns coming out from the data, and how the data can be utilized in cognitive development setting.

Also, the political headwind says that the DEI is an issue to be discussed in a social setting. But for pharmaceutical industry, DEI is not a political issue. It's a realistic issue. If we're developing a drug for humankind to use, we have to take care of different populations regardless of their racial or ethnic composition. Those are things that are now becoming much easier to define with the help of artificial intelligence. I just want to make sure the industry is aware of those improved capabilities.