Integrated Human Practice
Overview
In order to confirm our project is responsible for the society and ensure that we are working on the correct
direction to push our project moving forward and contribute to the real world, we conducted different human practice
activities and communicated with different resources.
Overview of our integrated human practice
Online Questionnaire
We published an online questionnaire focused on how much the common knowledge about glioma, TMZ, and TMZ resistance
during the treatment of glioma. After we spread our questionnaire online, finally we received 432 completed
questionnaires.
Basic information analysis
Figure 1. Gender, age and monthly income statistics of the respondents
Among the 432 persons, 45% is women and 55% is men, and 33% of people's age is around 18~35, 30% of people is around
age 18 and under, 27% of people is around 35~65 years old, and 10% of people is 65 years old and above.
In term of the monthly income, 36% of people takes in 5000 RMB and under who might be students, 31% of people takes
in 5000 RMB~10000 RMB each month who might be graduates or undergraduates, 15% of people received 20000 RMB~50000
RMB who might work for years, 11% of people gained 10000 RMB~20000 RMB every month who might be the young workers,
and 7% of the people obtained 50000 RMB and above monthly who might be the senior workers.
Based on the analysis of the information above, it's
appropriate to indicate that people who filled up our questionnaire equipped certain level of knowledge but not
high-level intellectual persons, so the data of the questionnaire is able to reasonably show the knowledge level of
the common people about glioma, TMZ, and TMZ resistance.
Focus analysis
Figure 2. Survey results of the questions “how much do you know about Temozolomide” and “how do you know about
glioma?”
According to the survey result above, it's obvious to conclude that the knowledge level of the common about glioma,
TMZ, and TMZ resistance is relatively low, which only 6% of people knowing glioma mostly because of the spread of
network, new media, and introduction of popular science by friends and relatives. That means the social attention on
glioma is relatively low because the influence of magazines, radio and television, and classes or lectures that are
all formal is small, which also indicates the small number of articles, programs, channels, and classes published
and established in the society, so social exposure of glioma is not that high let alone knowing the TMZ drug
resistance.
Figure 3. Survey result of the question “do you think long-term use of temozolomide (TMZ) will lead to tumor
resistance?”
Unquestionably, 51% of people who know glioma don't know about Temozolomide like Temodal, Tiqing, and Jiangning, and
58% of people gained information about Temozolomide through the introduction and popular science from friends and
relatives. That indicates public traditional media including magazines and professional books don't pay much
attention to the treatment of glioma related to TMZ, so the influence of those traditional media is not enormous
enough to improve the knowledge level about TMZ of the common.
Above all, in one way we could create our own media channel and post related information for public education, in
the other way we can cooperate with some influential press or media to publish educational articles or videos so as
to increase the public attention or awareness of our concerned topic, glioma, and the TMZ drug resistance.
Field Trip
We took a field trip to patients who live in so-called "Cancer Village",actually some rental rooms for tumor
patients around the Fudan University Cancer Hospital. Since most cancer patients require timely treatment, they
usually choose to live near the hospital espectially those famous at cancer therapy which also results in the
"Cancer Village" such a social phenomenon. From the environment where they live, we know that their lives are very
tough. At the entrance of the hospital, there are also many people advertising related rental properties. Some
people are still handing out flyers for recycling targeted drugs.
We interviewed patients who got the glioma. Most patients were pessimistic about their illness. They thought they
might no live long after they develop drug resistance. Based on this concern, we realize that it is neccessary to
solve this drug resistance issue which matters a lot for these patients even like life matters. We felt the
responsibility that our project should take to help them.
Of course there are still a small number of patients who believe that their future is still bright and that they
believe they can recover from this again. We expressed our caring and support to them and wish they can recover
soon. Considering humanistic concern,we brought some fruits to the patients in Cancer Village to send our
condolences to them.
We took visits to those patients and conducted interviews
Expert Interview
Back to our research, we were looking forward to the insights from those experts in relative areas so that we could
review our topic and our project in a more objective way and further modify or improve our plans to proceed.
Therefore, we managed to contact 4 experts in different areas.
1. Interview with Zhang Liang,professor and a doctoral supervisor of Shanghai Jiaotong
Univeristy School of
Medicine, the group leader of tumor chemical biology research group.
We conducted a series of interviews with Professor Zhang Liang online, and gained a lot of professional knowledge,
which is of great help to our work.
Online meeting with Prof. Zhang Liang
First of all, our awareness of the causes of glioma, symptoms, and treatment, at present, the medicine does not know
what it is made of induced, there are two kinds of hypothesis, one is that the brain by radiation, another is human
body absorb pathogenic substances, If the cerebellar visual and primary nerves are compressed, their function may be
lost. If the brain stem is compressed, the symptoms of headache and dizziness may occur. The current treatment
options are drug chemotherapy, radiotherapy and surgical resection, but the recovery cycle of surgical resection is
long and the sequelae are obvious
Second, we know that Temozolomide therapy works by giving the body a compound that, when it gets into the cell,
inhibits the replication of the diseased cell and causes the diseased cell to die. In the medical community,
Temozolomide is an irreplaceable ace drug, but its disadvantages are also obvious, its mechanism leads to its
inability to recognize diseased cells and normal cells, has no targeting, and will destroy human healthy tissues
Third, we know that the principle of resistance is human body cell repair resistance, when it is damaged, can
secrete a kind of didn't fix it is just like the sunshine, died not bask in the sun, ultraviolet radiation damage to
the skin secrete repair, so as to timely repair, cancer cells have the same characteristics.
Fourth, introduced to professor sleeve cap, Temozolomide produced by major pharmaceutical companies at home and
abroad has no obvious difference in drug resistance, because its chemical formula products are identical and its
compound products have the same degree of metabolism. Patients will have drug resistance after taking the drug for a
long time, but the effect is different
Fifth, Liang zhang, a professor at the research of new cancer drugs now have this view, drug research should be
according to the pathological mechanism, explore the targeting property, find the reasons of normal cells into
cancer cells, the first six, we asked, if our team created a kind of brand-new for Temozolomide amine resistance
cell line, the scientific research team will buy, professor Liang zhang said, If the clinical use is consistent with
the experimental results and the results are close to the clinical cases, it will be very marketable
Seventh, we asked how to successfully commercialize technology patents. The professor explained that it depends on
the value of our products. Will customers buy our products? Whether our product can meet the market demand, the
second is the uniqueness of the product, is not others unable to rule by law? Number eight, we also asked if cell
lines could be patented and concluded that by applying through the Patent Office and getting a lawyer to write the
application, we just provide the data and wait for a response. If successful you can seek a transfer to negotiate a
price for selling this technology
Finally, we asked the professor now for Temozolomide drugs instead of amine, the professor said, now the world's
major pharmaceutical companies are frantically for the development of new drugs, believe that will soon be listed in
the future, people have been studying the mechanism of crack resistance, the first nine o 'clock, the professor
explained the country and the government support to reduce tumor drug resistance study related policy, The state has
special funds for national scientific research institutions and private research and development institutions to
develop targeted drugs. Secondly, the state and enterprises can jointly establish projects to fund scientific
research institutions. Actually in recent years, tens of billions of yuan has been allocated.
Above all, through this conversation with Prof. Zhang, we not only had a deeper understanding about glioma and
Temozolomide therapy but also gained a clearer picture about the market.
2. Interview with Ye Mao, the production manager of an innovative public pharmaceutical company in Guangzhou
We interviewed Mr. Ye Mao, who graduated from Wuhan University of Technology with a degree in Pharmaceutical
Engineering in 2008, worked for Fosun Pharmaceutical Group in Shanghai, and now works as a production manager for an
innovative listed pharmaceutical company in Guangzhou. He specializes in the development and production of various
dosage forms of pharmaceutical formulations, such as solid dosage forms, lyophilized dosage forms, liquid dosage
forms, herbal extracts and APIs.
Online meeting with Mr. Ye
This interview brought us a lot of valuable information on drug production and its market. During the interview, Mr.
Ye Mao mentioned a little special requirement in the development and production related to oncology drugs. In
response to our questions regarding the position of TMZ in the market, and the gap between domestic and foreign TMZ
brands, Mr. Ye gave the following answers.
"The products of tumor related drugs in China are very popular, one of the big reasons is its high death rate and
low cure rate of tumors. And the side effects of common chemotherapy drugs will make us kill the cancer cells and
normal cells at the same time. At this point in time, targeted drugs are important and very demanded."
He added, nowayds the most mainstream treatment method in the market now is gene therapy and the most popular drug
used in gene therapy is Temozolomide (TMZ). Before the one-time evaluation of the drug in the last decade, the gap
between domestic and foreign drugs was relatively large, but after the one-time evaluation of the drug, the efficacy
of all drugs is similar. Although the efficacy is the same, these two models are used by different populations.
Because of the complications of TMZ, some patients who have taken TMZ may develop symptoms of epilepsy, and such
patients would not be suitable for the capsule and would use the injectable model of TMZ.
Professor Ye also answered questions related to the market value of our technology and the demand for it. He
believes that the method of knocking down PGRG-1 used in our experiment is a relatively cutting-edge method in
China. There are two methods of culturing cell lines that are routinely used now, the first is gradient culture and
the second is high concentration pulse culture. The advantage of the first kind is that the drug resistance is
stable but the process time is longer. The second type is more consistent with the in vivo drug uptake model, but at
the same time, the stability of drug resistance is not as good as the first method. Nowadays, the oncology drugs
developed in China mainly use large molecules and small molecules as raw materials, and the production purposes
corresponding to these two raw materials are different.
For the more important cost aspect which is exactly where we were stuck in our business plan, Mr. Ye also provided
us his opinion which inspired us a lot. He thought that most of the cost we should consider will be the spencing on
R&D. And there is a scarcity of products on the market with the same positioning as our products, he suggested our
future promotion shall focus on this selling point. After this conversation, we had more faith on our solution and
its business value in the future market.
3、Interview with Zhu Yufang,the chief physician of neurosurgery at Shandong Cancer Hospital
On July 24, we conducted a telephone interview with Doctor Zhu Yufang who is the chief physician of neurosurgery at
Shandong Cancer Hospital. This interview mainly focused on the pathological etiology, symptom classification,
prognosis, survival period of glioma, existing clinical treatment plans, and the Chinese government's subsidy policy
for related patients.
Photo of Doctor. Zhu Yufang
Regarding the cause of gliomas, Doctor Zhu mentioned there are mainly classified into genetic factors and
environmental factors. If you have some genetic diseases, such as neurofibromas (type 1), tuberculous sclerosis, and
so, it is easy to cause gliomas. Environmental factors are mainly related to electromagnetic radiation, such as
long-term mobile phone use and working and living in a high radiation environment that may lead to gliomas. Gliomas
can be classified into four grades according to their severity. In terms of prognosis and median survival time, the
recovery rate of patients with this disease is not high. The median survival time for patients with grade 4 glioma
was 14.6 months with less than 30% patients living to 2 years and less than 10% living to 5 years. The median
survival time of patients with grade III glioma is about 2 years, and the median survival time of patients with
grade II is 4-8 years. Generally, recurrence occurs in about 5 years. The five-year mortality of gliomas is only
second to pancreatic and lung cancers.
TMZ is currently the most widely used glioma chemotherapy drug, but it is an alkylating agent and is prone to drug
resistance. To Doctor Zhu's clinical experience, the way to decrease TMZ drug resistance mainly includes depletion
of drug-resistant enzymes, increased drug density, and long-term chemotherapy. However, the effect of these measures
is not very good and will cause great damage to the human body. Therefore, he agreed that if our experiment goes
well and can be successfully used for drug development, it will have a very promising application future.
Doctor Zhu also introduced that the public's awareness of glioma is not high currently, so if it appeared poor
prognosis of chemotherapy, many people will lose confidence, and even worsen the conditions of the disease.
Therefore, it is very necessary to strengthen science popularization. In addition, due to the impact of Covid-19,
China's medical resources have been tilted towards the anti-epidemic, so the burden of medical insurance has
increased, which objectively adds some pressure to the treatment of glioma patients.
4、Interview with Li Wei, Associate Professor of Nanjing University and Associate Chief Physician of Neurosurgery
Department of Nanjing Drum Tower Hospital
We also contacted another doctor Li Wei, who specializes in surgical treatment of cerebral hemorrhage,
craniocerebral trauma, cerebrovascular disease, neurotumor and other diseases.
Online meeting with Dr. Li
According to Dr. Wei Li's clinical experience and our research, gliomas are primary tumors in the brain, and most of
these are malignant and have a high incidence. There is no clear answer to the cause of the disease, but there are
several hypotheses: congenital genetic predisposition, environmental factors (electromagnetic radiation, cell
phones, and computers, environmental pollution). The most likely symptoms of brain tumors are localized brain loss,
headache, nausea, vomiting, seizures, vision loss, facial paralysis, hearing loss, etc. Because of the different
shapes and locations of brain tumors, the incidence of brain tumors is about one in 100,000 people. The incidence
rate is about 6-8 per 100,000 people. Patients can be noted by some of the symptoms just described: functional
decline in the body and edema. In addition, it can also be derived from MRI. The current clinical approach to glioma
includes surgery, radiation therapy, chemotherapy, targeted therapy, or electric field therapy, depending on the
patient.
Per his experience in clinical, TMZ is generally used for intermediate to high-grade gliomas: TMZ is also used for
grade 3-4 meningiomas, and its efficacy is relatively reliable and can extend the life span of patients. Serious
adverse reactions occur infrequently and there may be some blood cytopenia, drug allergy, and physical
sensitization. If there is a significant reaction, discontinuation of the drug may be taken to test whether it is a
drug problem. The emergence of drug resistance is relatively common. Different drugs are used for different
patients, and the pathology is analyzed by removing the patient's tumor. Combination therapy, angiogenesis,
cisplatin, electric field therapy, and other measures alternative regimens may be taken for drug resistance. The use
of targeted drugs is currently not a mainstream approach. According to previous data, people can get gliomas at a
young age. Usually, tumors appear in adults, and as they develop mutations in genes as they age, they appear in
younger age groups, and appearing at an age when they should not be means that the changes in their bodies will be a
more rapid and therefore higher grade.
The national funding for glioma drug development and treatment innovation has been increasing year by year in recent
years. The medical insurance is very strong, which includes outpatient and TMZ medication costs, about 70%-80%.
There is no special care for minors, just like most adults. It is worth noting that,there are some differences
between the above statement on the state investment and the strength of medical insurance reimbursement and Doctor
Zhu's view. Considering their different regions (one is in Jiangsu, the other is in Shandong), we believe that the
differences in financial status and economic development level of different provinces might affect the government
support policies for the treatment of glioma in local patients.
Team Meetups
The wet lab and dry lab closely communicates with each other on line at night after we finish that day’s tasks to
catch up. In addition, we held around 3 offline seminars when both were available for reviewing the project
progress. Increase the affections between the wet lab and dry lab to ensure the whole team in the same page.
The round-table meeting between wet lab and dry lab
In the first meeting, we communicated the ultimate goal of both teams and the tasks of both sides. The dry lab will
be responsible for the business plan, the promotional video and organizing the charity sale in the early stage,
while the wet lab was responsible for the technical research related to the experiment.
In the second meeting, we discussed the problems we encountered in the early stage. For example, the team members
were a little constrained, and the communication will be a little estranged. So in this meeting, we sat together to
spend more time talking to each other and promoted the team spirit.
At the third meeting, we exchanged the progress between the wet lab and dry lab, communicated the understanding deviation between us, and further came together to draw our team plan for the next step.
At the third meeting, we exchanged the progress between the wet lab and dry lab, communicated the understanding deviation between us, and further came together to draw our team plan for the next step.