Hope this makes it to people soon. Have a family friend who was diagnosed with cancer a few days ago. It was here in Canada, so they offered her assisted suicide, literally within 30 seconds after telling her she had cancer. She didn't even really process the diagnosis before they were offering to help her die. They didn't offer to try any experimental medicine.
Experiencing cancer in my family I can tell for sure all of that buzz is quite exciting, but in the last 5 years there haven't been breakthroughs that would significantly improve outcomes for an average patient.
There have been massive improvements in treatments in the last 5 years. Sure, cancer is far from being "cured" - but survival today is far better than 5 years ago for many forms.
Among many others:
- CAR T therapy going from lab to oncology suite (first launch 2017, but use rapidly growing)
- Liquid biopsy going from lab to PCP's office - starting with Grail Galleri and moving from there (yes, the NIH results were weak, but the idea of a liquid biopsy at all would be laughed off 10 years ago)
- Move of Atezolizumab and Tecentriq from infusion (hour) to injection (minutes) to increase availability
- Lower dose CT scanning for lung cancer, including for non-smokers
And a long line of immunotherapies that are making the leap from lab to chair right now.
The last 5 years have probably been the most exciting in cancer research since the launch of the monoclonal antibodies in the early 2010s. There is still incredibly far to go, but the trend is in the right direction: https://employercoverage.substack.com/p/decline-in-cancer-mo...
Examples aside, 5 years isn't long enough for a treatment to move from early mice trials to clinical use. The average time from application to FDA approval is about 10 years.
The breakthroughs happening now will benefit average patients later. It's frustrating, but it's not because we've run out of innovations.
It may feel that way due to the iterative nature of medical improvements, but over the past few decades there has been a consistent reduction in cancer mortality rates across most types of cancer [0]. Treatments really are getting better and more targeted. Immunotherapy has made huge breakthroughs. Combination treatments allow for significantly improved lifespans and better quality of life during treatments. There are a few cancers that remain hard to treat, but I have a lot of confidence that in the coming decades we will make strides in attacking them. That being said, I'm very sorry to hear about the pain you and your family must be going through. I've had a few close loved ones undergo cancer treatment and it was tough.
Major breakthroughs of the kind you’re talking about are extremely uncommon. Instead it’s lots of little gains that keep adding up because cancer isn’t adapting overall people still get the same mutations they got 10,000 years ago.
So average person with cancer does better when any individuals cancer treatment improves and it keeps compounding over time. This doesn’t mean everyone with cancer gets a slight improvement, often it’s specific types or stages that improve without impacting others. Where general progress comes from is it’s not the same improvements year after year.
I agree, or at least I would stress that people should be allowed to consent to that.
I don't know what the prevailing medical ethics of doing that kind of thing in consenting patients
in that state, but my uninformed intuition is I would disagree with it.
Though one thing that I might think researchers might not want is people may be too sick to recover even if their cancer disappeared tomorrow.
That is exactly how clinical research works. My mother worked running clinical trials for two decades.
When she was diagnosed with leukemia she was able to get into a research study herself that gave us 10 more years together.
One of the horrible but necessary parts of trials is the control group, who receives placebo. This is only done in a few of the trial phases but is essential in measuring efficacy. If someone wants to throw their brainpower and a little bit of AI/tech at the problem, you could end up eliminating a lot of suffering.
"When we systemically administered our nanoagent in mice bearing human breast cancer cells, it efficiently accumulated in tumors, robustly generated reactive oxygen species and completely eradicated the cancer without adverse effects ..."
So it kills human cancer and doesn't harm the mouse in the process.
Actually, when in the lifecycle of developing a treatment does anyone have a real idea of what cost will be? Can anyone know this yet?
In terms of where _prices_ are set, that negotiation is a function of efficacy relative to other things in the market right? If it ends up treating cancers that each already have a reasonably effective treatment, maybe the pricing isn't that high -- but if it is effective in cases where currently there are no options, the price should be high?
But for something that potentially works against a range of cancers, should we expect to see a sequence of more specific trials (i.e. one phase 1 for basic safety, a bunch of phase 2s for efficacy on specific cancer types, a sequence of phase 3s in descending order of estimated market value? And in 10 years, Alice and Bob with different cancers will pay radically different amounts for almost exactly the same treatment but with small variations in some aspect of the formulation so they can be treated as distinct products?
Does the cost matter? Many countries subsidize healthcare, so there's either no charge or a token payment which doesn't even pretend to cover the cost of treatment.
Other countries use insurance, so once again the end cost is essentially irrelevant.
Targeted delivery of anti cancer methods is hard. Weather it is multiple radiation beams or anti-body cross linked chemo agents it’s never easy. Chemotherapy poisons the entire body but the cancer cells die faster. A generally administered compound that only affects cancer would be huge.
Literally reactive oxygen species targets cancer cell DNA. We are taking advantage of the unique chemical environment of the inside of a cancer cell and using it to generate oxygen in a double-whammy to destroy itself.
This is perhaps the best targeted method devised as it seems to collect basically entirely in tumors. Chemo and Radio therapy just aren't that targeted.
quantummagic|1 hour ago
xbar|2 hours ago
javiramos|9 minutes ago
throwup238|55 minutes ago
That's also Caltech's mascot!
Bernoulli the Beaver.
Tagbert|2 hours ago
calgoo|1 hour ago
Barbing|2 hours ago
me too
RomanPushkin|2 hours ago
slapshot|2 hours ago
Among many others:
- CAR T therapy going from lab to oncology suite (first launch 2017, but use rapidly growing)
- Approval of Keytruda and similar for many additional forms of cancer (see the 2021-2026 milestones here: https://www.drugs.com/history/keytruda.html )
- Liquid biopsy going from lab to PCP's office - starting with Grail Galleri and moving from there (yes, the NIH results were weak, but the idea of a liquid biopsy at all would be laughed off 10 years ago)
- Move of Atezolizumab and Tecentriq from infusion (hour) to injection (minutes) to increase availability
- Lower dose CT scanning for lung cancer, including for non-smokers
And a long line of immunotherapies that are making the leap from lab to chair right now.
The last 5 years have probably been the most exciting in cancer research since the launch of the monoclonal antibodies in the early 2010s. There is still incredibly far to go, but the trend is in the right direction: https://employercoverage.substack.com/p/decline-in-cancer-mo...
greygoo222|12 minutes ago
The breakthroughs happening now will benefit average patients later. It's frustrating, but it's not because we've run out of innovations.
ImageXav|2 hours ago
[0] https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...
Retric|2 hours ago
So average person with cancer does better when any individuals cancer treatment improves and it keeps compounding over time. This doesn’t mean everyone with cancer gets a slight improvement, often it’s specific types or stages that improve without impacting others. Where general progress comes from is it’s not the same improvements year after year.
fnord77|1 hour ago
yup. every time
msie|4 hours ago
gimmeThaBeet|4 hours ago
Though one thing that I might think researchers might not want is people may be too sick to recover even if their cancer disappeared tomorrow.
mike_d|9 minutes ago
When she was diagnosed with leukemia she was able to get into a research study herself that gave us 10 more years together.
One of the horrible but necessary parts of trials is the control group, who receives placebo. This is only done in a few of the trial phases but is essential in measuring efficacy. If someone wants to throw their brainpower and a little bit of AI/tech at the problem, you could end up eliminating a lot of suffering.
mcc1ane|5 hours ago
jbotz|5 hours ago
"When we systemically administered our nanoagent in mice bearing human breast cancer cells, it efficiently accumulated in tumors, robustly generated reactive oxygen species and completely eradicated the cancer without adverse effects ..."
So it kills human cancer and doesn't harm the mouse in the process.
YarickR2|5 hours ago
esafak|4 hours ago
abeppu|3 hours ago
In terms of where _prices_ are set, that negotiation is a function of efficacy relative to other things in the market right? If it ends up treating cancers that each already have a reasonably effective treatment, maybe the pricing isn't that high -- but if it is effective in cases where currently there are no options, the price should be high?
But for something that potentially works against a range of cancers, should we expect to see a sequence of more specific trials (i.e. one phase 1 for basic safety, a bunch of phase 2s for efficacy on specific cancer types, a sequence of phase 3s in descending order of estimated market value? And in 10 years, Alice and Bob with different cancers will pay radically different amounts for almost exactly the same treatment but with small variations in some aspect of the formulation so they can be treated as distinct products?
alansaber|3 hours ago
stevekemp|3 hours ago
Other countries use insurance, so once again the end cost is essentially irrelevant.
Flere-Imsaho|3 hours ago
[deleted]
Larrikin|3 hours ago
wombatpm|3 hours ago
dyauspitr|4 hours ago
lightedman|4 hours ago
This is perhaps the best targeted method devised as it seems to collect basically entirely in tumors. Chemo and Radio therapy just aren't that targeted.