Earlier quoted context omitted.
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Sorry, are you having difficulty with the concept that human prisoners should have more rights than mice?
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Developing a cancer drug without Big Pharma: this hospital shows it can be done
111–120 of 159 posts
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#112Earlier quoted context omitted.
Uber disrupted taxis because taxis were a sleazy experience, with dirty old cars, “broken” meters and rude drivers that tried to get you to pay extortionate prices if they knew you were in a pinch. Stop trying to venerate the taxi industry, they’re horrible.
I think that depends on what part of the world you live in. My experience of taxi companies in the UK is that they are generally safe, reliable and operate based on reputation. My experience of taxi's in the US is that they appear to be often operated by desperate people living on the edge of existence.
Isn't that every service in the US? It takes pride on pushing the under people to the brink of death.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#113Earlier quoted context omitted.
The current system is like Churchill's description of democracy: the worst system, except for all the others. Biology is extremely complex. There's no substitute for actually trying things out on subjects in vivo. For many diseases we don't even know the cause (Alzheimer's for example). Drug companies have all the incentive in the world to improve the system to get better odds; it's not like they want drug discovery…
We also don't understand how some drugs work, either (e.g. Tylenol).
I'd say we have a rather good idea about the mechanisms for pain relief from paracetamol. Even Wikipedia has a decent summary: https://en.wikipedia.org/wiki/Paracetamol#Pharmacodynamics
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#114Anyone can mix chemicals in a test tube and claim it’s the cure for something. That’s the easy part. Proving it’s safe and effective, that’s what requires a lot of capital expenditure. This statement is a drastic characterization, but you could say “half a dozen PhDs can form reasons to believe they may have found a cure for something”, and the paragraph would end the same.
This article is about a phase III RCT that the hospital managed to do without major industry capital injection. This truly was a major achievement (I have been involved in a phase III RCT myself). It was published in the New England recently: https://www.nejm.org/doi/full/10.1056/NEJMoa2402604
Argh, I'm so sorry, I linked to the wrong New England paper in my post above. (That is a different major achievement from the same institution, but the above was industry funded as others correctly pointed out).
The correct New England paper about this treatment is here:
https://www.nejm.org/doi/10.1056/NEJMoa2210233
This one is TIL therapy, where you basically take tumor-infiltrating lymphocyte from the patient, stimulate them ex vivo, and put them back.
The reason this is so impressive -- and highlighted by this article -- is that large phase III trials like this have now become so complicated due to various technical, financial, logistic, ethical, and above all regulatory challenges, that they are now mostly done by companies, or at least as joint ventures with companies (and often in jurisdictions with less of these issues, certainly not in the EU like this one). It is very, very impressive to pull off something like this as an academic institution (at least in Europe). What's more, the funding came from KWF (the Dutch cancer foundation), which is actually a public charity that mainly relies on donations.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#115Earlier quoted context omitted.
What do you think is correct instead?
> - Doctors want the best outcomes for their patients. They’ll use whatever treatment is most effective. They will often do what make them the most money. Also remember that is doctor is subject to rules and regulations. He risks loosing his license if he does not toe the line. Your average medical student is about half a million dollars in debt when he/she graduates. > - Doctors want the best outcomes for themselves…
Either you are not from the USA, are trolling, or don't really know the U.S. medical system. Yes, maybe a few private practice doctors are greedy, but generally, doctors "in the system" don't personally generate more funds by doing things different, prescribing more drugs, etc. They are on salary. As far as other types of doctors (eg. chiropractors), they DEFINITELY drive home more money by prescribing more, requiring return visits, etc. But I call them doctors only by the loosest of definitions.
I am baffled by your second paragraph. It is just plainly illogical.
The third paragraph tells me that you ARE possibly from outside the USA, or that you have only seen a few doctors and they were proud or rude. We (personally) have seen private doctors, hospital doctors, country doctors, etc. over 50 years (at least 50-60 different ones). And the preponderance of our evidence shows you are either misinformed, or you are a patient who wants to self prescribe treatments that are medically unsound or 'fringe'. And, yes, those WILL be ignored by any average doctor. But then you could always fly to Mexico and get those useless treatments for low cost...
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#116Looking for a “drug” is part of the problem.
Prevention is worth more than cure, sure, but cancer doesn't discriminate like that. You can still get unlucky.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#117Earlier quoted context omitted.
> - Doctors want the best outcomes for their patients. They’ll use whatever treatment is most effective. They will often do what make them the most money. Also remember that is doctor is subject to rules and regulations. He risks loosing his license if he does not toe the line. Your average medical student is about half a million dollars in debt when he/she graduates. > - Doctors want the best outcomes for themselves…
Either you are not from the USA, are trolling, or don't really know the U.S. medical system. Yes, maybe a few private practice doctors are greedy, but generally, doctors "in the system" don't personally generate more funds by doing things different, prescribing more drugs, etc. They are on salary. As far as other types of doctors (eg. chiropractors), they DEFINITELY drive home more money by prescribing more, requirin…
All I will say is this: We have different assessments of the situation. And yes I do live in US.
Some of what you point out is correct: Most doctors are on salary, but they are often (implicitly) required to bring in more business by the organization they work for. If they don't, they risk loosing their license/job on some pretext. In totality what I said overall hold true. These are statements from the renegade doctors themselves. Of course you are going to dismiss them as fringe, quacks etc.
Labeling someone is a fringe and easy way to dismiss them, it does not involve any work. What time have you spend listening to these fringe MDs? What time have you spent examining their patient outcomes/reports? Any yes, it goes without saying one has to be discerning even among the fringe MDs.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#118Earlier quoted context omitted.
Absolutely, and if you recall, even YC tried to get in on this idea. Except they did the same mistake anyone who comes up with this disruption plan commits (including Google with Calico, or Zuck with CZI) - they recruit existing academics to do the disruption. Unfortunately this just fails miserably because they’re culturally corrupted to think of standard dogmas (like there can never be a single cure for cancer). I…
Is there any plausible biological reason to think that there could ever be a single cure for cancer?
Some mammal species like bats, whales and naked mole rats seem to be extremely unlikely to get cancer. Which may be an indication that a very efficient immune system can keep cancer in check indefinitely.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#119Earlier quoted context omitted.
Perhaps immune-based therapies like CAR-T are based on the premise that there are many cancerous cells in your body all the time, but your immune system deals with them, and it’s only when it fails to do so that you end up in the pathological state. So the “single cure” is the normally-functioning immune system?
That might be part of it. And yet sometimes people with normally-functioning immune systems also get cancer. So while that might be an effective treatment for some patients it's not going to be a universal cure.
Human "normal" may not be enough.
Bat "normal" might be. Of course, now we are crossing the threshold from medicine to bio-augmentation.
Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done
#120Earlier quoted context omitted.
That might be part of it. And yet sometimes people with normally-functioning immune systems also get cancer. So while that might be an effective treatment for some patients it's not going to be a universal cure.
Human "normal" may not be enough. Bat "normal" might be. Of course, now we are crossing the threshold from medicine to bio-augmentation.
There is no free lunch in biology. Augmenting the immune system to better attack cancer is going to cause other problems. It's so naive to think there is some simple solution that will improve on a billion years of evolution. I mean it's not impossible but realistically what are the odds?
There won't be any magic for cancer. It's just going to be slow grind to solve one hard problem after another.