By Emily Senay

The ten year anniversary of the completion of the Human Genome Project reminded us that genetic and genomic research has yet to fulfill the promise of cures for devastating diseases such as Alzheimer's, Parkinson's and cancer. Those promises were wildly overblown, but nevertheless made it into the zeitgeist, leaving many discouraged. If the past is the best predictor of the future, what does this mean for genetic technology 20 years on? Will the big breakthroughs come? Will genetic technologies emerge that surprise us all? To help in making somewhat accurate predictions about the future I thought it might be wise to consult the Ouija board of new technologies: Gartner's Hype Cycle Graph.  

Developed to help investors understand how technology matures, Gartner's Hype Cycle begins with the emergence of an important new technology that captures popular imagination and promises to change everything. The new technology is then over-hyped by scientists, journalists and investors, creating the first phase: the peak of inflated expectations. When those expectations are not quickly met, disappointment sets in and the new technology is declared a bust-the trough of disillusionment phase. Then while nobody is paying attention anymore, the new technology begins to yield innovative and available products, most of them unanticipated in the initial hype phase. Everybody is surprised but pretty soon forgets their earlier skepticism and readily adopts the new products. The new thing becomes old hat and the technology enters the phase of the hype cycle know as the slope of enlightenment.

So where is genetic technology on the hype cycle graph? Plotting events since the completion of the Human Genome Map, it is clear we are currently in the trough of disillusionment. Bummer, I know. But if you trust the Hype Cycle Graph, this could actually be good news. If we are in the trough then there is nowhere to go but up. It is during this phase that the few stalwart innovators toil away in obscurity creating early versions of what will eventually be the next big thing that really will deliver. So before too long we could be experiencing an explosion of innovation in genetics and genomics.

But will this explosion include a cure for big problems like cancer? Two great minds think so: Jim Watson, co-discoverer of DNA, and Albert Brooks, comedian and author. Writing in Cancer Discovery in November 2011, Watson prophesies that with hard work scientists will be able to use RNAi to selectively block cancer genes leading to a cure for many cancers within the next 5 to 10 years. Brooks also predicts a cure in his new novel 2030-all cancers, all comers, 100% cured. Unfortunately the resulting dystopia is not so appealing. Old people don't die, debt balloons, and a generational war breaks out when the "olds" suck all the resources. Personally, I don't think either scenario is likely. For starters, this isn't the first time Watson has predicted a cancer cure and Brooks is famous for his overly negative outlook. Secondly, a cure for cancer would be the most obvious thing to predict, and according to the hype cycle it's usually stuff nobody sees coming that emerges first and takes off. So I expect that curing cancer, Parkinson's or Alzheimer's is going to be tougher, more incremental, and slower than we all want.

So what will emerge? Going out on a limb, I predict "social genetics" will take off much sooner and in a bigger way than currently anticipated and will be driven not by scientists but average folks. I base this prediction on nothing more than recent random conversations with two friends: both educated and savvy. For no particular reason each had their genes mapped by one of those new personal genetic companies. They weren't worried about Parkinson's or breast cancer. In fact they couldn't really articulate why they spent a couple hundred bucks and sent their spit to California. Maybe they're weird or just early adopters. No matter, though they learned nothing of real medical utility they couldn't have been more thrilled to share with me their risk of restless leg syndrome, excessive earwax, abdominal aortic aneurysm, etc. It all seemed like TMI, even a little creepy; at best, a novelty. Then it hit me: that's just what I thought when I first heard about a lot of things like the Internet, email, Google, and Facebook. The genetic genie is out of the bottle! Everybody is going to want their codes cracked-and they then are going to want to share that info with you. Imagine a website called Upload your code, find long-lost relatives, make common variant friends, or find your perfect genetic mate! Nah. Forget it. It'll never work. I'm sure I'm wrong and Jim Watson is right. I really hope so ... even if Albert Brooks is right too!


Dr. Emily Senay, MD, MPH, is currently the medical correspondent for PBS Need to Know. She is also an Assistant Professor of Preventive Medicine and a course instructor in the Masters of Public Health Program at Mount Sinai School of Medicine.  Prior to joining PBS she was a medical correspondent for CBS News for 15 years.

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