Grass-roots entrepreneurship complements traditional top-down innovation in lung and breast cancer

Abstract

The majority of biomedical research is funded by public, governmental, and philanthropic grants. These initiatives often shape the avenues and scope of research across disease areas. However, the prioritization of disease-specific funding is not always reflective of the health and social burden of each disease. We identify a prioritization disparity between lung and breast cancers, whereby lung cancer contributes to a substantially higher socioeconomic cost on society yet receives significantly less funding than breast cancer. Using search engine results and natural language processing (NLP) of Twitter tweets, we show that this disparity correlates with enhanced public awareness and positive sentiment for breast cancer. Interestingly, disease-specific venture activity does not correlate with funding or public opinion. We use outcomes from recent early-stage innovation events focused on lung cancer to highlight the complementary mechanism by which bottom-up "grass-roots" initiatives can identify and tackle under-prioritized conditions.

Fig. 1. Global burden of breast and lung cancers.

a Worldwide incidence and b mortality for breast and lung cancer in 2018. Data are shown as the ratio of breast cancer to lung cancer. Values higher than 1 (pink) or less than 1 (blue), respectively reflect greater breast cancer, or lung cancer, incidence/mortality. Mortality data for African countries are shown in Supplementary Fig. 2 for clarity due to high breast to lung ratios for those countries. Maps generated using Google GeoChart API under Creative Commons Attribution 4.0 License.

Fig. 2. Research and development activity in breast and lung cancers.

a US National Institutes of Health (NIH) funding for breast and lung cancers. b Total number of active clinical trials per year for breast and lung cancers. c Cumulative new molecular entities (NMEs) approved by the FDA from 2004 to 2020. Cumulative number calculated from NME approvals starting 1985. d Percentage of cases based on the stage at diagnosis of both breast and lung cancer (2009–2015).

Fig. 3. Social media trends and sentiment.

a Normalized search engine search frequency for “Breast Cancer” and “Lung Cancer” in the US. b Average polarity and c subjectivity of tweets for breast and lung cancer. Error bars signify Standard Deviation. d Percentage of breast and lung cancer tweets with negative (−1 to −0.1), neutral (−0.1 to 0.1), and positive (0.1 to 1) sentiment. e Percentage of breast and lung cancer tweets with different levels of subjectivity (0 to 1 in increments of 0.05). ****P < 0.0001; n.s. not significant, unpaired t test with Welch’s correction.

Fig. 4. Funding raised by cancer ventures.

a Cumulative venture funding raised over time for lung and breast cancer companies in the United States, and b lung, breast, and overall cancer companies. c Cumulative venture funding raised over time for lung and breast cancer companies worldwide, and d lung, breast, and overall cancer companies. Lines reflect linear regressions.

Fig. 5. MIT HM 2018 Health hackathon data.

a Participant background and b solution approach by the team at an early-stage innovation event focused on lung cancer.

Fig. 6. Combining top-down and bottom-up innovation.

Complementary roles for traditional top-down and grassroots-driven innovation and and metrics to assess the activity of each.