However, even as scientists carefully and methodically approach whole genome sequencing to see if it has value for patients, some patients are taking matters into their own hands, hoping that running their own personal Human Genome Project will turn up the kind of answers that their doctors can’t give them.

Lukas Wartman is patient zero of the cure by sequencing movement. Wartman was researching acute lymphoblastic leukemia when, in a deeply ironic twist of fate, he fell ill with it. Wartman’s colleagues decided to search his entire genome sequence in the hopes of finding the gene behind the cancer. Using resources at Washington University, scientist Timothy Ley and colleagues sequenced the genes of his cancer cells and healthy cells, and also ran an RNA analysis.

Miraculously, the project turned up an answer ‑ a gene normally associated with kidney cancer ‑ and there was a new drug targeting that gene malfunction. Wartman went into remission and was stable at last report a year later.

The first complete human genome sequence was completed by National Human Genome Research Institute and Celera Corp. in 2003 at a cost of over $3 billion. The technology has reached a point where it is now feasible to run multiple full genome sequences to diagnose one patient, and, perhaps spurred by Wartman’s success, a number of vendors are ramping up sequencing services for the clinical market.

Leading the pack is Illumina Inc., which rolled out a clinical individual genome sequencing service in September 2012.

Science fiction writer Jay Lake has become an early adopter of Illumina’s offering, branded TruSight IGS Rapid TAT Whole-Genome Sequencing. Diagnosed with colon cancer in 2008, Lake has run through the available treatment options, and is hoping that whole genome sequencing of his cancer will lead to a treatment to put him in remission.

With rapid turnaround service, Illumina sequencing is priced at $13,000. The analysis would be a large, additional cost. As a friend of Jay, I encouraged him to pursue sequencing, and set up a fundraiser to allow his community of friends and fans help him with the cost of sequencing, as well as the miscellaneous costs associated with long term serious illness. The response was swift and overwhelming, and the fundraiser quickly topped its goal of $20,000. Extra funds beyond the goal have allowed Lake to explore multiple analysis options, and the possibility of RNA expression analysis.

A number of other commercial vendors and academic laboratories are exploring clinical genomic sequencing services. Representatives of Science Exchange encouraged Jay to post his sequencing job where he could receive multiple bids for sequencing.

Elizabeth Iorns, a representative of Science Exchange, said many of its providers are CLIA certified, and that the group is planning to expand into clinical services in partnership with Cancer Commons, a nonprofit open science initiative working toward bringing next-generation genomics technologies to patients.

It’s not clear whether whole genome sequencing will benefit patients with cancer, or any disease, or if it will continue to be more beneficial and cost effective to screen for specific, known mutations. The success in Lukas Wartman’s case is encouraging. However, one other early adopter of sequencing technology, Steve Jobs, didn’t fare as well. In a biography published after his death, it was revealed that Jobs spent about $100,000 on sequencing for his cancer, but was not able to find the kind of target that would have cured his disease.

While research subjects and sperm donors by and large want anonymity, others use DNA to find their relatives on the Internet, on sites like Y Search and the Sorenson Molecular Genealogy Foundation.

In other words, there is plenty of DNA out there that has an identity attached to it. And if that DNA belongs to a relative of the supposedly anonymous donor, parts of it can match exactly.

Most DNA is mixed up during conception, of course – that’s the beauty of sexual reproduction. But mitochondrial DNA is passed on unadulterated from mothers to all their children, and Y chromosomes are inherited wholesale from fathers by their sons.

The team now publishing in Science used the fact that something else is also almost always inherited from fathers to sons: surnames.

They started by using so-called metadata from the anonymous donors that is made public along with the DNA itself, such as the donor’s age and donation site, which allows a pretty good inference about the state they live in.

Using such characteristics, they were able to narrow down the potential donors by quite a bit. By then looking at the surnames of men with matching DNA in genealogy databases, they were able to identify a number of specific donors.

The method can’t identify every donor. But the team estimates that they could identify somewhere between 10 percent and 20 percent of all anonymous male donors using their approach. In response to the findings, the National Institute of General Medical Sciences and the National Human Genome Research Institute have removed some information about their donors from public view.

Researchers Defend Open Access

Similar collisions between one person’s desire for anonymity and his relatives’ lack thereof have come about before. Children who were conceived using a theoretically anonymous sperm donor, or their mothers, were able to track down the sperm donor after first connecting with other relatives via genealogy sites. Researchers are already rallying to defend the importance of open-access databases – which is true enough.

It is, of course, also easy for them to say about someone else’s DNA. Especially since it is not yet clear what genetic information can and can’t be used for by those that uncover it. For example, health insurance cannot be denied on the basis of a person’s DNA, but no explicit law exists for other types of insurance such as long-term disability.

Individual DNA donors may decide that the risk of being “outed” is worth it for the advantages of contributing to scientific progress, and of open access data. But any potential donor needs to understand that, in the words of the Science paper’s authors, “data release, even of a few markers, from one person can spread through deep genealogical ties and lead to the identification of another person who might have no acquaintance with the person who released his genetic data.”

Or perhaps, men should take a page from women’s playbook and start lying about their age.

Fiction: 16^th Century England to 20^th Century Los Angeles

Diego Miralles, head of Janssen West Coast Research Center and Janssen Healthcare Innovation, recommended Wolf Hall by Hilary Mantel, calling the novel set in Tudor England “great fun and superbly well written.”

Donald R. Johnston, senior vice president and group publisher at AHC Media, BioWorld’s parent company, is working his way through Walter Mosley’s novels, based on mentions by author Greil Marcus in Like a Rolling Stone: Bob Dylan at the Crossroads – also recommended by Johnston. Early Mosley novels feature Easy Rawlins, a detective in 1950s and 1960s Los Angeles who was portrayed by Denzel Washington in the movie version of Mosley’s most famous work, Devil in a Blue Dress.

Anette Breindl, BioWorld’s science editor, recommended State of Wonder by Ann Patchett. The bestselling author’s novel of morality and miracles, science and sacrifice is set in the Amazon rainforest, offering a take on the difficult choices we make in the name of discovery and love.

Mary Webster, a patent attorney with Nixon Peabody LLP, is reading Intellectual Property: The Law of Trademarks, Copyrights, Patents, and Trade Secrets by Deborah Bouchoux (for a course she’s teaching at Georgetown University), the Game of Thrones series by George R.R. Martin (“everybody is talking about it”) and Extreme Rambling by Mark Thomas (“recommended by a friend”). But her favorite summer read is Prodigal Summer by Barbara Kingsolver. “The characters are full of heart, and the setting in the Blue Ridge and its valleys is lovely. Hunters, gatherers, lovers, haters, laughter, sadness, birth, death, hopes for rebirth and renewal, all interwoven within a wonderful cast of characters ranging in species, age, and gender,” Webster said. “I really think this work ranks ‘Masterpiece.’”

Biotech Nonfiction: Genes and Faith

Earlier this year, BioWorld staff writer Nuala Moran read Siddhartha Mukherjee’s The Emperor of All Maladies: A Biography of Cancer, “which not only captures all the science but also is a really interesting history that puts so many things in context,” she said.

BioWorld’s Breindl also cited The Forever Fix: Gene Therapy and the Boy Who Saved It by Ricki Lewis, which explores the next frontier in biomedicine through lives already touched by the science.

James Bradner, scientific founder of Tensha Therapeutics recommended RNA: Life’s Indispensable Molecule, in which author James Darnell offers a captivating account of RNA research, illuminated by his lifelong engagement in the field.

Am I My Genes: Confronting Fate and Family Secrets in the Age of Genetic Testing by Robert Klitzman was the pick of Alexis Borisy, CEO of Warp Drive Bio and partner at Third Rock Ventures. The book explores the vast implications of genetics testing and reveals how real people have balanced their desire, and fear, to learn their hereditary fate.

In a slightly different take on biotech, Mari Serebrov, BioWorld’s Washington editor, recommended The Language of God: A Scientist Presents Evidence for Belief by Francis Collins, which examines whether science undermines or supports faith in God.

And BioWorld staff writer Cormac Sheridan cited Experiment Eleven: Deceit and Betrayal in the Discovery of the Cure for Tuberculosis by Peter Pringle, a fascinating read that details how Selman Waksman claimed sole credit for discovering streptomycin and attempted to disregard the key role of his PhD student, Albert Schatz.

At the intersection of science and business, Janssen’s Miralles suggested The Social Transformation of American Medicine by Paul Starr, which offers interesting insights into the reasons that socialized medicine did not take root in the U.S. – at least not yet. Miralles recommended the book “for those who are trying to understand how doctors and hospitals developed in America and why the U.S. is the only developed country that does not have social provision of medical care.”

And Carolyn Wang, group director for healthcare at WCG, just finished Eric Topol’s The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, a book that’s also on the reading list of many biotech clients. Topol provides terrific context for the evolution of each part of the industry, Wang said, concluding that technology has already revolutionized every important industry except health care.

More Nonfiction: Avarice, Courage and Ingenuity

Johanna Holldack, CEO of Telormedix SA, described Thinking Fast and Slow, by Nobel Prize-winning economist Daniel Kahneman, as “useful for every aspect of life.” The book summarizes more than 50 years of research seeking to understand how humans make choices when faced with uncertainty.

Chris Raymond, equity research analyst at Robert. W. Baird & Co., just finished reading Boomerang: Travels in the New Third World by Michael Lewis, which investigates the tidal wave of cheap credit that rolled across the planet between 2002 and 2008. Raymond called the book enlightening “for anyone wondering how we got to this surreal place where the outcome of an election in Greece can influence the financing environment of the U.S. biotech industry.”

Leslie J. Williams, president and CEO of ImmusanT, described as “provocative” The Tyranny of Dead Ideas: Revolutionary Thinking for a New Age of Prosperity by Matt Miller, which focuses on the theme of “letting go of the old ways of thinking to unleash new prosperity.” With the U.S. at a crossroads, it’s imperative “to think in news ways to remain competitive on the global stage,” Williams said.

Arthur Hiller, CEO of SciFluor Life Sciences recommended Unbroken: A World War II Story of Survival, Resilience, and Redemption by Laura Hillenbrand, author of the bestseller Seabiscuit: An American Legend. “Unbroken is the true story of Louis Zamperini’s miraculous survival after his plane went down in the Pacific during World War II,” Hiller wrote. “Zamperini and his pilot survived on a fragile raft traveling roughly 2,000 miles in about seven weeks. He then survived unimaginable tortures in Japanese prison camps, and his persistence and unbroken spirit is a true inspiration for anyone facing the daily hurdles of business or life.”

Hiller also suggested the more recent Lone Survivor: The Eyewitness Account of Operation Redwing and the Lost Heroes of SEAL Team 10 by Marcus Luttrell, a Navy Seal who was the only member of his team to survive a mission in Afghanistan. “It’s one of the most inspiring stories I’ve ever read or heard,” Hiller observed. “The writing isn’t spectacular, but you come away from it with a profound sense of the importance of never giving up.”

And Kollol Pal, president and CEO of Mnemosyne Pharmaceuticals Inc. cited The Boy Who Harnessed the Wind: Creating Currents of Electricity and Hope, by William Kamkwamba and Bryan Mealer as “a truly inspirational book about a student in Malawi who learned how to build a windmill from a book and brought electricity and hope to his village.”

Advice and Personal Improvement, with a Bio Twist

Jason Slingsby, CEO of ProtAffin AG is reading SHAOLIN: You Must Not Fight in Order to Win (Shaolin: Du Must Nicht Kampfen Um Zu Siegen) by Bernhard Moestl. The book examines the Chinese martial arts, which are rooted in learning about oneself in order to defeat others in battle.

ImmusanT’s Williams recommended two books in this category. True North: Discover Your Authentic Leadership by Bill George “is a great book on leadership,” she said. “Follow your passion and internal compass, and your leadership will be authentic and people will follow.” She called The Complexity Advantage by Susanne Kelly and Mary Ann Allison a “fascinating” book that uses complexity theory to help adapt individual strengths to working teams.

Trista Morrison, former BioWorld Insight editor and now associate director of corporate communications at Ironwood Pharmaceuticals, suggested a peek into the beginnings of the biotech industry with Career Imprints: Creating Leaders Across An Industry, penned by Monica Higgins, spouse of Ironwood CFO Michael Higgins. The book not only offers insight into industry icons but also a compelling theory about the events that shape the careers of leaders in innovation and entrepreneurship.

Morrison also recommended Genentech: The Beginnings of Biotech by Sally Smith Hughes. Released last year, the book draws on two decades of research, thousands of conversations and hundreds of documents to portray the deals, the science and the business strategies that helped to launch one of the biotech industry’s behemoths.

The Classics

Kosta Steliou, president and CEO of PhenoMatriX Inc. and professor emeritus at the Cancer Research Center in the Boston University School of Medicine, recently finished The Iliad and The Odyssey by Homer and The Landmark Herodotus: The Histories, edited by Robert B. Strassler. In a trifecta of Greek classics, Steliou is now reading The Landmark Thucydides: A Comprehensive Guide to the Peloponnesian War by Thucydides, also edited by Strassler. “One cannot understand the present without knowledge of the past, and there can be no future without surviving the present,” Steliou observed.

Lynn Yoffee, BioWorld’s executive editor, picked an American classic. To Kill a Mockingbird by Harper Lee is “a favorite movie of mine but I never read the book,” Yoffee said. Since 2012 is the 50th anniversary, “I’m spending the summer with Atticus, Scout, Jem, Dill and Boo.”

Yoffee’s also about to dive into a story about the 1904 Herero genocide in German South-West Africa that served as the training ground for the Holocaust in a completed manuscript called Mama Namibia, by none other than BioWorld’s Washington Editor Mari Serebrov, who is shopping it for a publisher.

And Finally . . .

As for me, I suggest The Ride of Our Lives: Roadside Lessons of an American Family by television journalist Mike Leonard. This book is the perfect antidote for hectic days filled with research, business development, financing and regulatory minutiae. The story of a classic American family road trip – with laughter and tears along the way – will put almost anyone’s summer vacation into perspective.

Really? To me, it seems like an inevitable part of hope is that it might be false.

To illustrate, I don’t hope that my neighbors will be nice to me, because it’s a sure thing. They are always nice. They are the best neighbors anyone could have. They have been unfailingly nice for years now. If I were still “hoping” that they will be nice the next time I see them, it would be as good a sign as any that it’s time to think about anti-anxiety meds.

Likewise, I don’t hope that my children will be well nourished. I have the money to buy them good food, the time and inclination to cook it, and the mean-mommy genes to make them eat it. Most nights, there’s going to be a healthy dinner, and hope has nothing to do with it.

Instead, what I hope is that my neighbors will live long and healthy lives, right next door. I hope that in feeding my kids well, I will lay a foundation for them to do the same thing for themselves once they are responsible for their own meals. Because those things might not come to pass.

Now, I understand the concept of a long shot. I understand it particularly well for neuroprostheses, which were once the subject of my own dissertation research.

That research may or may not end up ever benefiting a patient. But that was certainly what I hoped back then, and still do.

I mean, really. What else would I be hoping for as the long-term result of my work? That I might one day be able to remote control the family hamster? Of course it’s about hope for patients. I still feel that hope every time I read that another neuroprosthetic advance has been made.

Reviewer Carl Zimmer puts the quote, and the book he is reviewing, into context by using it to illustrate what analyst Jackie Fenn has termed the Hype Cycle. That cycle consists, basically, of inflated expectations of new technologies, followed by a crash when they have their inevitable setbacks, followed by a long slow slog to get the technology to do what it realistically can.

I agree with Zimmer and his unnamed neuroprosthesis researcher that there has got to be a better way of reporting about new technologies that are in the “gee whiz” part of the hype cycle, before they crash down into the “oh crap” stage. Rather than hyperbole followed by angry denunciations, those technologies need a balanced look, right from the beginning.

When writing about spectacular, but preliminary findings, it’s worth remembering, and conveying to readers, the spirit of a slide I saw at last year’s American Society of Clinical Oncology meeting: “If you’re a mouse with cancer, it’s been nothing but good news since 1965!”

But it’s also worth remembering another quote: “Hope springs eternal in the human breast.” That’s true – and as I’ve written about before, it means that if science refuses to give patients hope, they will go looking elsewhere. And leaving those who need hope to the ministrations of the quacks who are only too happy to recommend their own “cures,” with none of the reservations that most scientists have, seems like – well, like the greater sin.

On Business

“Biotech is all about picking the exception. Granting access to capital to everyone doesn’t strike me as the right idea.”

‑ Bob More, general partner with Frazier Healthcare Ventures, taking an optimistic view on capital constraints. Private biotechs continued to struggle in 2011, raising about as much money as in 2010.

"I think we're going to see a regression to quality."

‑ Jim Healy, general partner at Sofinnova Ventures, on how the venture contraction will mean that only the highest quality companies get funded. Several venture groups pulled out of biotech investing during 2011.

“The take-home message is that it’s easy to build a $25 million company with $100 million cash.”

‑ Tillman Gerngross, CEO of Adimab LLC, on the trend of sliding valuations post-initial public offering. Although a handful of biotechs went public in 2011, the window did not open as wide as some had hoped.

"You can't save your way to success in this business."

‑ Marina Biotech Inc.'s CEO Michael French on the tough financial choices small biotechs must make, such as accepting harsh terms to keep a company moving forward.

“Monday, I was in Chicago, presenting at ASCO. Tuesday, I’m in California, pitching at Goldman (Sachs). And Wednesday, I’m in New York, presenting at Jefferies. How many red-eye medallion miles does it take to get one deal?”

‑ A jet-lagged biopharma CEO, taking a break at the Jefferies 2011 Global Healthcare Conference, and illustrating just how hard biotechs had to work to close financings and partnerships in 2011

On Science

“What happens when the next 10 patients you see require eight different drug combinations based on the mutations in their tumors?”

‑ Outgoing ASCO president George Sledge, on the exponential increases in complexity required to tackle “chaotic” tumors with high mutational load. Personalization of medicine continued to be a theme at ASCO and AACR in 2011.

"You do have to be somewhat of a Talmudic scholar to prescribe this drug."

‑ Lawrence Friedman, member of the FDA Antiviral Drugs Advisory Committee, referring to the regimen for Merck & Co. Inc.'s hepatitis C candidate boceprevir. His comments illustrate the difficulties of putting more personalized treatment regimens into practice.

"The fact that it's inefficient doesn't mean it hasn't made great contributions."

‑ John Mendelsohn, president of the M.D. Anderson Cancer Center, on the National Cancer Institute-sponsored collaborative clinical trials program

“It disturbs me that people are willing to accept this: treating the symptoms and allowing the disease to progress.”

‑ Jerry Colca, president and chief scientific officer at Metabolic Solutions Development Co., on new diabetes drugs

“For every target, almost every company has an inhibitor against it. Medically, as well as economically, we truly need something to get beyond that."

‑ Chiang Li, CEO of Boston Biomedical Inc.

General Wisdom

"A lot of innovation is incremental, not breakthrough."

‑ Glen Giovannetti, global biotechnology leader at Ernst & Young

“I realize it’s absurd to talk about 10Xs or even 5Xs these days.”

‑ Roger Longman, CEO of Real Endpoints LLC

“A combination of good science, good collaborations, good timing and some good luck.”

‑ Mace Rothenberg, Pfizer Inc.’s senior vice president of clinical development and medical affairs in the Oncology Business Unit, on the secrets to the success of lung cancer drug Xalkori (crizotinib)

"You can only set yourself on fire once."

‑ Oleg Nodelman, partner at Biotechnology Value Fund, referring to how pharma stocks tend to jump when they severely cut R&D budgets

"Clearly, there are easier and less insane ways to make a living."

‑ Jim Greenwood, BIO president and CEO, at the BIO 2011 keynote luncheon

The past year brought the biotech sector a mixed bag of news. Some of it was positive – for instance, the FDA picked up its drug approval pace in 2011 and, in some cases, even surprised the most hardened biotech investors by granting approval of some drugs a month or two before their PDUFA dates – while other headlines hailed discouraging trends such as the failure of Prospect Ventures to close its latest round, confirming predictions of a venture capital contraction.

As we get ready to head into 2012 (and possibly an apocalyptic count-down, if those Mayans are to be believed), let’s take a look back at some of the highs and lows of the biotech industry in 2011.

‘Me-First’ Instead of ‘Me-Too’

Biotech execs always talk about tackling unmet medical needs. So it was exciting to see in 2011 the flurry of breakthrough drugs hitting the market. An informal BioWorld poll tagged Seattle Genetics Inc.’s lymphoma drug Adcetris (brentuximab vedotin), the first approved antibody-drug conjugate, as the biggest drug approval of the year, tied with HCV game-changers Incivek (telaprevir) from Vertex Pharmaceuticals Inc. and Victrelis (boceprevir) from Merck & Co. Inc. But other notable approvals included Human Genome Sciences Inc.’s Benlysta (belimumab), the first lupus drug approved in 50-plus years, and Yervoy (ipilimumab) from Bristol-Myers Squibb Co. and Zelboraf (vemurafenib) from Roche AG and Daiichi Sankyo Co. Ltd. as the first two drugs approved for melanoma that actually improved overall survival in clinical testing. And, late in the year, Incyte Corp. scored a win with Jakafi (ruxolitinib), the first approved JAK inhibitor and the first drug for myelofibrosis.

Let’s all hope that trend of “firsts” continues in 2012.

A ‘Nobel’ Death

In a bit of irony (in an Alanis Morissette kind of way), the Nobel committee awarded one-half of the 2011 Nobel prize in physiology or medicine to Ralph Steinman, unaware that the Rockefeller University professor had died of pancreatic cancer three days earlier. Posthumous Nobels are unusual but, after brief debate, the committee wisely decided to allow Steinman to remain a Nobelist. And I’m glad. He certainly earned the title for his discovery of the dendritic cell and its role in adaptive immunity. Plus, according to BioWorld’s science editor, Anette Breindl, who heard Steinman speak in 2007, he was a pretty nice guy.

Best Bang for the Buck?

The biggest M&A deal in 2011 was easily Sanofi SA’s $20-billion-plus-contingent value rights buyout of Genzyme Corp., which followed nine months of often less-than-friendly negotiations. But it wasn’t the best deal for biotech investors. Genzyme shareholders already have lost out on the $1 CVR connected to manufacturing capacity for enzyme replacement therapies Cerezyme and Fabrazyme. Whether they will be able to earn the remaining $13 linked to multiple sclerosis drug Lemtrada (alemtuzumab) is up for debate, and, for the most part, analysts are not optimistic.

If I were to choose, I’d say that Daiichi Sankyo Co. Ltd.’s bid for Plexxikon Inc. and Shire plc’s buyout of Advanced BioHealing Inc. were far more successful M&A deals. Daiichi’s hefty $935 million payment for Plexxikon – a move validated when Zelboraf gained approval in August – came despite only getting U.S. co-promotion rights to the melanoma drug under Plexxikon’s existing partnership with Roche AG. The Shire/ABH deal, meanwhile, showcased the kind of investor returns rarely seen these days. The big pharma firm shelled out $750 million for ABH, a whopping 15x return for ABH’s largest shareholder.

‘Weighed’ Down by Safety

Despite health experts clamoring for new ways to treat the so-called obesity epidemic, drugs aimed at helping people lose weight have not had an easy time of it at the FDA. Industry observers had expected 2011 to usher in not one, but three obesity therapies; instead, all three were rejected by the FDA. Orexigen Inc.’s Contrave got stalled on cardiovascular concerns, while Vivus Inc.’s Qnexa raised worries of birth defects related to one of its generic components and Arena Pharmaceuticals Inc.’s Lorquess bumped up against carcinogenicity concerns. Contrave is set to start a large cardiovascular outcomes study, which would delay its approval until 2014. But Qnexa and Lorquess could have a shot at getting approved in 2012. That’s assuming that no additional safety issues crop up. Given the track record in the obesity space, that’s definitely no guarantee.

The Rough Side of Town

While 2011 had its much-lauded drug approvals (as noted above), the year was not without its disappointments. Two promising areas of research suffered blows – Roche pulled out of the RNAi space, dumping a high-dollar collaboration with RNAi powerhouse Alnylam Inc., while Geron Inc. abandoned its position as embryonic stem cell pioneer to focus on a less-risky cancer drug. But the biggest disappointment of the year – as chosen by 41 percent of respondents to a BioWorld poll – was the slow sales of Dendreon Corp.’s prostate cancer vaccine Provenge (sipuleucel-T). Sales fell way below estimates, and, over the course of the year, Dendreon’s shares have lost about 80 percent of their value. The Seattle-based company has since retrenched and is hoping European approval, now pending, will help accelerate revenue growth. We’ll be watching in 2012.

And the Strange Bedfellows Award Goes to . . .

Probably one of the most bizarre deals ever in biotech was 2011’s short-lived merger agreement between Allos Therapeutics Inc. and AMAG Pharmaceuticals Inc. Having in common only commercially underperforming products – Allos’ Folotyn (pralatrexate) for peripheral T-cell lymphoma and AMAG's iron deficiency drug Feraheme (ferumoxytol) – execs from both firms tried hard to convince investors and analysts of the logic in combining the companies by pointing out a handful of “cost synergies.” But the merger was met with opposition from the get-go and even prompted hedge fund MSMB Capital Management to make an unsolicited bid for AMAG. Unsurprisingly, the deal was voted down by AMAG shareholders. Seriously, what were they thinking?

Well, that’s my list of headline-grabbing biotech news in 2011. But it’s hard to remember a whole year, and I’m sure I’ve forgotten something. What do you think were the biggest events in biotech in 2011?

Most of those privacy concerns focus on medical issues, which makes a lot of sense. Certainly, most people would not feel warm and fuzzy about having their insurance companies know that, like Craig Venter, they have a higher-than-average risk of developing Alzheimer’s disease.

Nor do people necessarily want to know these things themselves, especially when there’s nothing to be done about the disease in question. Nobelist James Watson recounted specifically refusing to have his ApoE status made public, or even to find out about it himself. He had a grandmother with late-onset Alzheimer’s disease and doesn’t really want to know what the future may or may not hold.

Watson’s ApoE status can, of course, be inferred from his variants in nearby genes.

And the question of how medically useful genomes will be if their owners refuse to find out about the medically relevant alleles is a whole other question, of course. I suppose that this one will be solved with the passage of time, as more and more risk variants are discovered and that stretch of base pairs that is now mind-numbingly boring turns out to harbor a risk variant for something nasty.

Still, one thing I haven’t heard mentioned is this: the best guess for the percentage of children born to married parents whose biological father is someone other than the husband of their mother is 8 percent to 15 percent. Precise data, for obvious enough reasons, are hard to come by. But for men whose suspicions are large enough to get paternity testing done, the number is 30 percent.

If genome or exome sequencing becomes part of routine medical care, what happens when the sequence data doesn’t align?

Watson is clearly less worried about his wife than he is about his grandmother. In his plenary talk, he expressed his frustration that his son Rufus, who has schizophrenia, refuses to be sequenced – to ease his own worries: “The moment you have a son that’s not normal, you wonder whether you could have done something different,” he told the audience. In such cases, he thinks that sequencing of parents and their children could put the parent’s mind at ease that their children’s condition is due to “a genetic injustice, not something you did . . knowing that won’t make their child healthy, but parents won’t have the double whammy of thinking they did something wrong.”

I feel for Dr. Watson; and at the same time, I think about some other family that does get sequenced, and then has its own double whammy of illness and paternity to deal with. Or of the family that refuses to get sequenced. Will such refusal, for whatever reasons, in time come to be seen as a tacit admission that there’s something to hide?

I have no answer – I doubt there is a good answer. Certainly, the answer cannot be to forgo sequencing and the medical opportunities it offers. Still, I’m glad I’m not the family doctor who, in a few years, will take those cheek swabs ‑ and then, every so often, will need to figure out what to say about the results.