Human Practice

Overview

Team NJU-China believes there are two main aspects of Human Practices: public outreach to the non-technical communities as well as education engagement; and collaboration within the academic and iGEM community. For both sides, we participated in a series of engagement exercises, including consulting with patients and doctors about potential application spaces for our research technology, educational and investigating outreach to the local Nanjing community, and collaborating with fellow iGEM teams to share information and improve the projects.

1. Public outreach

1.1 Questionnaire and Propagation online

We believe science is everywhere and it is a part of each person’s everyday life. For most people without science background, synthetic biology and targeting therapy seems to be a very far-off topic. In order to offer better understanding about synthetic biology and the targeting therapy applied in our project, we did a grand scaled questionnaire on social network and then gathered data for a thorough analogy.

Conclusion of normal group questionnaire

• A basic situation of the investigation group

1. Effective investigation number: 780.
2. Age distribution: 18~50 years of age accounted for the dominant.
3. Education level: 66.67% for bachelor degree, the survey group basically has the education background of high school or above.
4. Family economic conditions: the vast majority of respondents are of well-off level.

• The respondents’ understanding of cancer is relatively simple, one-sided and inadequate.

• The way of understanding cancer is limited. Most people learn about it from media reports, even though they are uneven in quality.

Rumor of Tumors

• While the respondents generally recognize that if detected early, cancer can be treated and cured in time, the data notes that there are still nearly 15% of respondents identifying cancer as a terminal and incurable disease.

• The majority of respondents still have a fear of malignancy cancer, which is believed to be their nightmare scenario. Notably, among the 780 valid surveys, only 39.1% are aware of that, during the last decade in China, LUNG cancer made the highest mortality rates amid all types of cancers; 30.9% chose liver cancer, which is of the same high degree of malignancy with Lung cancer; the remaining 30% people choose other types of cancer.

This result demonstrates that people in China still hold a superficial and inadequate perception in the cognition of the malignant degree and the death rate of cancer.

• The attitude towards cancer treatment and new therapies

• Of the 780 respondents, curative efficacy and side effects were their top priority concern if selecting cancer treatment.

• Under the influence of "Wei Zexi incident" (a malpractice due to deceptive advertising of immune therapy), 40.86% of the respondents worried about the curative effect and side effect of immune therapy as a new therapy for cancer, and 31.04% said they are afraid to be cheated and take advantage of by criminals when try a new therapy. 24.75% said they would believe the latest research achievements, while only 3.34% expressed entrust or even rejection of immune therapy.

• With a brief introduction of the background of molecular targeted drugs (e.g. Iressa), 64.87% of respondents were open to molecular targeting drugs and consider it acceptable, while 18.27% respondents were worried about the high expense, which they may be unable to afford. It should be noted that there are still 16.92% of the objects consider the immunotherapy as immature and are unwilling to take any risk.

• Attitude & Suggestions

1.2 Interview with doctor

To better understand the current situation of cancer treatment and further shape our project direction, we interviewed a doctor from Affiliated Hospital of Nanjing University Medical School (also known as ‘Drum-tower Hospital’) for a broad view of therapeutic concern from professional perspective. There are many teams focusing on technical problems on the interaction between targeting drugs and their models, but the acceptance and trust issues from patients are less discussed. In our project, attitudes of patients is correspondingly valued, so we interviewed doctors from Drum-tower Hospital (Its oncology department is the National Key Clinical Specialist) for their opinions on patients’ acceptance and our project. The suggestion would not only be used for the further improvement of our project, but also provide a general concept of the safety issue that must be dealt with when synthetic biology encounters clinical medicine. Their professional experience and advices are valuable if we want to apply synthetic biology to a broader clinical field in the near future.

Current Situation

• Lung Cancer

• Early diagnosis is vital for lung cancer patients as only detection and surgery in the early stage can hold the possibility of cure. However, 2/3 of the patients are diagnosed too late and have already lost the chance of being cured. These un-surgery cases can be called as advanced lung cancer.

• Now numerous people blame the cause of lung cancer on environmental problems, but even in a good environment condition, the incidence of lung cancer is equally high. To some extent, it can be said that the leading cause of lung cancer is smoking.

• According to statistics of 2012, incidence of lung cancer has now made top of all cancer incidence in China, especially for male. Obvious correlation can be observed between smoking and lung cancer. And terribly, lung cancer maintains high mortality rate. The five-year survival rate of clinical lung cancer (i.e., the probability of the patients who still alive five years after diagnosis.) is approximately zero.

• Lung cancer patients stand for unbearable and excruciating pressure both physically and psychologically. There are also some severe complications along with lung cancer, resulting in plummeted life quality after the illness. For example, advanced patients may experience struggle when breathing, chest tightness, persistent cough, and that lung cancer can also be transferred to all other parts of the body, such as brain, bones, causing severe pain, intracranial hypertension, weakness and other symptoms.

• Current Treating Situation

• There are 3 main treatments for advanced lung cancer: chemotherapy, radiotherapy and targeted therapy.

• Before targeted drug therapy, advanced lung cancer patients have an average survival period that is no more than one year, and that with other means of therapy (e.g. Radiotherapy), the period can be extended for only 2 to 3 months. Chemotherapy certainly lead to a plummet of life quality of patients. Finally, most patients lose confidence and Survival consciousness during their cure.

Interview with doctor

Doctor’s view of the 4 treatments

• In the past few decades, molecular targeting drugs visibly elongated the patient's survival periods and improve the disease control. Recently, the so-called "four carriages" of cancer treatment are surgery, chemotherapy, radiotherapy and molecular targeting drugs.

• Among the treatments of lung cancer, surgery is generally practiced on early patients. The early diagnosis rate of lung cancer, however, is relatively limited because all tumors had no specific symptoms at early stage. Therefore, rate of patients who are able to be performed surgery also take a minor part. To make matters worse, cancer generally has a risk of recurrence and metastasis.
The most commonly used two means, radiotherapy and chemotherapy, were developed only after World War II.
Chemotherapy is to use cytotoxic drugs to kill cancer cells, and inhibit the growth of tumor cells. To some extent, chemotherapy is of certain specificity, but it still terribly influence normal cells;
Now there are some drugs for chemotherapy with less side effects.

• In 2004 after the listing of the molecular targeted drugs iressa (also known as Gefitnib), situation has been greatly changed.
Targeting drugs have a lot of advantages:
Firstly, targeted drugs can be taken orally, removing troublesomeness of hospitalization, providing more convenience;
Secondly, the side effects are relatively small;
Thirdly, it concerned with genes associated with the disease, offering efficacy for specific populations.

• Most of our chemotherapy drugs perform by intravenous infusion, so patients need to be hospitalized. Yet lots of molecular targeted drugs are kinase inhibitors of small molecules, which can be made into oral dosage, providing patients with great convenience. Also, compared to radiotherapy and chemotherapy, molecular targeted drugs with more specifically design, cause far less side effects. Life quality during treatment can be greatly improved from the patient's perspective.

• An important significance of molecular targeted drugs is that, in the past, most drugs are searched and then acquired by human from the nature, but the molecular targeted drugs is a re-creation of human with certain purposes, thus a great revolutionary breakthrough.

• The emergence of targeted drugs allow the basic research apply into clinical cases, leading a revolution in the field of oncology.

• Now, for those who can take targeted drugs, that is patients with sensitive mutations, we can practice molecular targeted drugs combined with radiotherapy and chemotherapy at the same time, enabling patients to survive up to three years --- such a survival period is pretty remarkable. (In fact, clinically 2 to 3 months of survival extension could be viewed as miracle.) The emergence of molecular targeted drugs, combined with a reasonable quantity of radiotherapy and chemotherapy, has promoted a huge progress compared to a dozen years ago.

• One or two decades ago, doctors would thought it irrelevant to his treatment if they heard about a mutation in a patient's genetic site. With the emergence of targeted drugs, the clinical treatment of tumors upswing to a molecular level.

Interview with doctor

1.3 Interview with patients

N/A (To do)

2. Education and school workshop

Team NJU-China tried to introduce synthetic biology to people through various ways. This year, NJU-China planned to arouse adolescents’ interest towards this new field of science by organizing lectures for high school students. After the discussion, the students were taken on a tour to visit the laboratory. Through these activities, we successfully presented the basic information about iGEM and synthetic biology to the youth.

visiting M3 lab

On Aug 20th, we held a lecture to the participants of a biology summer camp held by Nanjing University, who were high school students from all over China. The presentation consisted of an introduction of iGEM, synthetic biology and our project. Most students showed strong interests in our project and iGEM. The aim of the lecture was to let students have better understanding of the applications and benefits of synthetic biology. We believe that giving presentation about iGEM to high school students, we, college students as well as iGEMers, can inspire them to think deeper about how synthetic biology can change our lives. After the talk, the students were taken on a tour to visit the laboratory where our experiments were taken.

Presented the basic information

3. Conference and Communication

3.1 CCiC

Central China iGEM Consortium (CCiC) is a national iGEM communication summit hosted by Chinese universities, It was founded with the aim of idea-sharing, communication and cooperation among iGEM teams, and promoting high-level discussion of advanced issues pertaining to the promotion of international Biosynthesis issues. CCiC schedule simulates that of iGEM Giant Jamboree, with each undergraduate team presenting their project and display posters, seeking out to be an academic conversation and experience sharing conference, while providing an interactive platform for training teams at the same time.

The CCiC was held at Hedanqing Hall of Sun Yat-sen University in Guangzhou, with 28 teams from all over China participated. Our presentation won unanimous praise from the judges and audience, as well as attracted many spectators to interact with us in the Q&A section. Also, while displaying our poster, we had close talks with numerous teams, introducing the project design and progress, and shared our achievements and experience when working on the project.

Communication at CCIC

Our poster at CCIC