Interviewee: Zhu Yeqing, Bachelor's degree in Biochemistry from the School of Life Sciences of Peking University and MBA degree from Guanghua School of Management of Peking University, Director of China Cancer Foundation, Former Executive Director and CEO of New Horizon Health
Field: Genetic Testing for Cancer Early Detection
Date: Mar. 4th, 2024
Interview Record:
Why did you choose to work in this industry?
I started college in 1988, and I chose biochemistry as my major simply because the entrance score was high enough for me to get in. My mom wasn’t really educated and didn’t understand what biochemistry was all about, so she asked me, “What’s this field even about? What do you do?” I remember it clearly—one summer in 1988, I thought that maybe studying biology would allow me to research cancer treatments someday. Where I’m from, there were quite a few cases of gastrointestinal cancer, so it felt somewhat relevant. And, well, I didn’t expect that it would turn out to be true. Maybe it was fate or
something.
As for why I stuck with this path, for most of us studying biology, the end goal is to circle back to medicine. It works in steps: you get sick, and medicine helps you get better. Doctors know what drugs to prescribe and how to use them, but often, they don’t know why the drugs work. That’s where pharmacologists come in. But even they might not fully understand why biological molecules are used to create these treatments. So, it’s up to biochemists and molecular biologists to figure out how the drugs work and how they affect genes. That’s the process in a nutshell.
Another reason I chose this field is that the major diseases threatening human health today—heart disease, diabetes, Alzheimer's, and cancer—are the ones we focus on. Cancer, in particular, requires the most resources, both in terms of costs and research. Treatments for late-stage cancer are incredibly expensive, and the fatality rate is still high. So, we started thinking: with China’s current healthcare system, how can we better address cancer? One of my partners, who’s a tumor specialist, used to work on cancer drugs. He realized that these new treatments were getting more and more expensive but only offered limited value in extending life. That’s when we thought, maybe the key is to move the
timeline forward—start with screening. If we can catch cancer early, or even before it starts, and take action, we can make a bigger difference in reducing the death and incidence rates. That was our main motivation for entering this field.
Another point is market potential. If your target is only people who are already sick, it’s a very limited market. But if you target the general population, the potential is much bigger. China’s population is aging rapidly, with over 10 million people turning 60 each year. Cancer rates go up with age, because cancer is essentially caused by genetic mutations that accumulate over time. The older you get, the more health issues you might develop, and this realization led us to focus on cancer early detection research.
What do you think about the future of biotechnology?
I think biotechnology has made a lot of progress in the past decade, especially in clinical applications. However, the actual number of practical uses, especially in genetic testing, is still quite limited. Genetic testing started with detecting birth defects in children, then moved to hereditary gene testing, and now it's involved in cancer drug development.
The future of biotech is heading in two directions. One is disease treatment, including prevention, screening, diagnosis, treatment, and post-surgery recovery—basically, helping people live healthier lives. The second direction is improving quality of life. One hot trend right now is weight-loss drugs—another example of biotechnology at work. In the past, medicines were only for treating diseases, but as living standards improve, people want to live longer and better. Biotechnology is now moving from just saving lives to improving the quality of life, with applications in areas like weight loss and aesthetic medicine. I think this shift will become a major focus in the future.
Did you encounter any difficulties during product development?
Of course, there were difficulties. Product development starts with understanding the problem you’re trying to solve. Then you look for scientific solutions and bring them to the lab, turning those ideas into actual products. Next, you need to validate the product’s effectiveness in clinical trials, and finally, you seek regulatory approval—through the FDA in the U.S. or the NMPA in China—before commercialization. After that, you have to prove that the product works just as well in the market as it did in the lab. That’s roughly the process.
Each step is challenging. First, you need to find the right solution. In biology, this often means finding the right target or biomarker. But you can’t have too many biomarkers, because that would make the process costly and complicated. The more biomarkers you use, the more combinations you have, and this increases the uncertainty of the results, which then need to be tested one by one. You have to balance clinical effectiveness with cost-efficiency.
Then, in the lab, you need to finalize the product. For example, how much emphasis should each biomarker carry? Will the final results be straightforward, or will they require algorithms for analysis?These are all factors to consider.
Next comes small-scale testing, which is also tricky. You need to define your target demographic—who is going to use this product? Based on this, you design your clinical trials. The scale of these trials depends on the incidence rate of the disease you’re targeting.
Everyone hopes the timeline can be short, but for some diseases, the underlying mechanisms make it hard to see results in a short time frame. For example, cervical cancer in women is caused by HPV infection, but the process from HPV infection to cervical cancer usually takes 3-5 years. So, just detecting an HPV infection doesn’t guarantee that it will develop into cancer. That’s a challenge. Except for cases like COVID-19, where there’s an urgent need, products with insufficient data would never get approved under normal circumstances. This is another difficulty. For a company, we can’t afford to wait forever—we have time constraints. The challenge is whether we can reach an agreement with the regulatory authorities to ensure that within a specified time, we can achieve a certain level of performance that meets their requirements. Only then can the product be approved for market entry, and that’s a big challenge.
Lastly, after getting regulatory approval, you face the challenge of marketing the product. Will doctors and patients accept it? Every stage presents its own difficulties, and I believe the R&D process is all about solving one problem after another.
What are the benefits of genetic testing for cancer early screening?
The biggest benefit is that, in China, most people don’t go to the hospital unless they have symptoms. Early screening allows high-risk individuals to be identified before symptoms even appear, so proactive measures can be taken.
For as creening product to be effective, it must meet three criteria: First, it must have clear clinical significance. Second, it needs to provide a simple method for confirming if there’s an issue. And third, there must be feasible intervention methods. Without these, screening isn’t really meaningful. In terms of societal benefits, early screening could reduce medical costs for families. Studies show that 80% of healthcare costs in China are spent in the last six months of life. If we can spread out healthcare spending over a person’s entire life, we could ease the financial burden on families.
From a public health perspective, early screening reduces overall healthcare costs. For example, instead of recommending invasive procedures like colonoscopies for everyone, simple screenings can identify who actually needs further testing, saving resources.
Do you think genetic engineering will lead to ethical concerns?
Yes, I think it will. Back when I started university in 1988, the discovery of the double-helix structure had already made genetics a hot topic. While technologies like genetic modification and gene editing offer promising possibilities, they also raise ethical concerns. One issue is cross-breeding, especially with animals and even humans. Another concern is the potential harm of genetic modification. For instance, the gene-edited babies born in China raised serious ethical questions. There’s a lot of uncertainty about how gene editing might affect long-term health, and an even bigger concern is whether people will attempt to “optimize” the human race based on perceived genetic flaws. This kind of human intervention could lead to unpredictable consequences, which is why genetic research must remain strictly within scientific boundaries.
Any advice for those interested in biotechnology careers?
I believe now is a great time to get into the field. The rise of new drugs has opened up many opportunities for biotechnology, and there is strong demand, particularly in the domestic market for innovative drug development.
Another trend is the integration of AI into biology. In the future, AI will likely play a bigger role in analyzing data, such as medical images, which will help make diagnosis more accurate and standardized.
Third, research in biology and its related fields will continue to grow, especially in cross-disciplinary studies. With so much potential for interdisciplinary work, I think the job market will offer plenty of opportunities in the future. Ultimately, all research aims to improve quality of life, whether you’re working on the environment or other aspects of human health. In China, for example, the aging population is a long-term issue that’s going to take at least 30 years to reverse, if it even can be. So, industries related to health and wellness will definitely be booming.
Another point to consider: China has spent the last 40 years solving basic problems like food, clothing, housing, and transportation. Your generation doesn’t have to worry about having enough to eat or a place to live. Now, the biggest issue is how to live healthier lives. Where does quality of life come from? First, it comes from not getting sick. And if you do get sick, you should have access to good medical care. When you grow old, you should have access to quality elder care. All of these aspects are tied to biotechnology. So, I think the future job market will be even broader than it is now. Many industries will revolve around this central idea. For example, future housing will prioritize health and comfort—something that wasn’t considered much in the past but is now a key factor. People also care more about being near hospitals, and in the future, elder care facilities and other healthcare services will be equally important.
Lastly, after COVID-19, we’ve all seen how infectious diseases can have a far greater impact on humanity than regional conflicts. As a result, people are more willing to invest in the biotech industry. Even figures like Elon Musk are getting involved in biotech, with his brain-machine interface projects. I believe biotechnology has a very bright future. Many industries may be replaced by AI, but when it comes to research on humans, I think people won’t fully trust AI to take over completely. So, there’s no need to worry about job security in this field.