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Developing a cancer drug without Big Pharma: this hospital shows it can be done

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Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#131

Post by fragmede »

DrScientist wrote: post #59
llamaimperative wrote: post #55

Earlier quoted context omitted.

Pointing the finger at regulation is misleading IMO. The regulations for bringing a drug to market are essentially quite simple: prove that it’s better than what currently exists. What makes it difficult is the word “ prove ” It turns out it’s obscenely hard to make a drug that’s good, and even harder to prove that it’s good.

> prove that it’s better than what currently exists. So how do you do that ethically? How do you justify taking off something that you know works to some extent and try something completely new or worse placebo? ie don't you have to construct the trial in the context of existing treatments etc? These are the kind of challenges that makes drug development slow - in the end you don't do one trial, but a series of trial…

This is particularly difficult for drugs that affect the brain, like MDMA for PTSD in veterans. What do you use as the control group for that, when patients and clinicians can tell that who got the real thing and who did not. I call this the bridge problem. In order to do science, you have to have a control group, but if I built a bridge across a ravine, we don't have to have cars drive off a cliff and fall into the ravine in order to scientifically prove that the bridge works and exists. We engineered a bridge and put it there and obviously if there was no bridge cars would just fall into the ravine so we don't need to test that the bridge exists. We design the bridge, we rate it up to a certain capacity, we don't test it until it fails, we simply prohibit really heavy trucks from driving on smaller bridges that can't take their weight.

We can't do any of that for drugs that affect emotions and consciousness because we're barely in the stone age of our understanding of the brain and the technology we have to affect it.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#132

Post by nkrisc »

InDubioProRubio wrote: post #89
wesselbindt wrote: post #66

Earlier quoted context omitted.

Yeah, not doing human testing on poor folks without a choice is really "angelic" and "perfect". Very high bar to set, how could we possibly achieve such high standards of morality?

They have a choice. To use the medicine or not. The choice is gone in the other case- where you can die of cancer for "ethical" comission reasons.

Step 1: Create economic conditions in which vast numbers of people can’t afford medical care

Step 2: Offer them the “choice” of possibly receiving care by being medical guinea pigs for those who created the situation that deprived them of medical care in the first place.

A coerced choice is a not a free choice.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#133

Post by edmundsauto »

mft_ wrote: post #92
ramraj07 wrote: post #41

Earlier quoted context omitted.

Got my PhD from a lab that works on antibody drugs, they eventually even released one to the market. I’d argue that our current system is broken. There’s no reliable metric of drug effectiveness in any of our pre-clinical models, and thus we end up going into clinical trials quite blind indeed. And more often than not, what drug gets into trials has more to do with ego and politics than actual scientific merit. And t…

It doesn’t (have to) cost billions to bring a (successful) drug to market. And if you pick a single successful example that was discovered in academia, was spun out into a small focussed biotech, and was in a disease area that didn’t require large or multiple studies to make it to market, you’ll have your anecdote to prove your point. Except… you’d be ignoring the costs of the 90% of drugs that fail in phase 1. You’d…

All of these things also apply to startups. And creates a VC groupthink of "portfolio theory" that necessitates huge (10,000x) returns, which costs the public a lot of viable small/medium enterprises that are not victims of the perverse incentives.

I wonder if the "optimal" theory is portfolio in this case, or if there is a new generation of VC/pharma investors who want a higher probability at a lower return.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#134

Post by refurb »

yread wrote: post #52
refurb wrote: post #46

Earlier quoted context omitted.

Exactly. I work in this field. Doing phase 3 clinical trials costs between $5,000 to $20,000 per patient per year. This particular drug did a phase 3 with 423 patients for 2 years, so you're looking at a cost of $4M to $16M just for this one trial alone. Then add on top all the CMC (manufacturing) research that needs to happen, the regulatory filing work, etc, etc. Unless someone has a few hundreds of millions sittin…

When hospitals are contracted to do work in a clinical trial setting they take their costs and multiply it by 10 (at least). This was done in house with in house resources. This hospital has its own pharmacy that can synthesize drugs and give it to the patients. The pharmacy probably charged just the material costs internally and not for the time.

I don't know of any hospital pharmacy that has a full fledge biochemistry lab and production facility.

Drug production is very different from the typical work done in a hospital pharmacy.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#135

Post by ALittleLight »

shepherdjerred wrote: post #79
DrScientist wrote: post #45

Earlier quoted context omitted.

> Doctors want the best outcomes for themselves. If they’ve found an effective treatment that others are overlooking then they’ll seek to publish However often the work required to prove something is effective is beyond a capacity of a single Doctor. Also in terms of wanting the best outcome for themselves - sometimes that involves not putting their career at risk by trying unproven treatments on patients ( you are f…

I don’t disagree with anything you’re saying. But it sounds like the parent said there’s a miracle treatment that the medical community is ignoring for lack of a financial incentive (and they then go on to mention a financial incentive?)

That's a ridiculous reading of my comment. Vitamin C induces cell death in a variety of cancers. That's what I wrote and it's not controversial, it's documented in dozens of studies. I went on to link an article by medical doctors and cancer experts (on cancer.gov) who explain how this works and also explicitly state that it's not being researched due to lack of financial incentive.

I can't stop you from refusing to read sources - but you should know that you're totally wrong here. I can, and have in this thread, cited multiple high quality sources.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#136

Post by mpnagle »

ALittleLight wrote: post #109
ALittleLight wrote: post #3

That's interesting. I was just reading about how high dose IV vitamin c can induce cell death in a wide variety of cancers, but somehow, despite this being known for decades, nobody has done rigorous research on it. https://www.cancer.gov/research/key-initiatives/ras/news-eve... From what I can tell there are several things like this - that have promising anti cancer effects, that just don't really get that much atte…

Deeply disappointed by the comments replying to this. I would reply to each individually, but feel like I'd get throttled by hackernews, so I'll just reply to everyone here. --- shepherdjerred writes that this is unlikely because doctors want what is best for their patients and would notice a cure were it available. This is kind of true. Some doctors do know about and prescribe vitamin c with typical therapy. Here is…

Hi hi.

You may be interested in the VITALITY study out of China from 2022. 400+ people given FOLFOX + Avastin (standard of care, first line for colorectal cancer) vs FOLFOX + Avastin + high dose Vit C.

https://pubmed.ncbi.nlm.nih.gov/35929990/

Roughly showed no change for the overall population, but a significant increase in progression free survival for folks with RAS mutations.

As someone with a stage 4 colorectal cancer with a RAS mutation, this is interesting to me!

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#137

Post by bastloing »

bastloing wrote: post #124

AI will change everything. Especially disrupting pharma, Hollywood, law and lawyers, and medicine. Only question right now is who will win the race and be authoritative?

Even CNBC agrees with healthcare https://www.cnbc.com/2024/11/28/these-economists-say-ai-can-...

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#138

Post by binary132 »

datavirtue wrote: post #76
DrScientist wrote: post #59

Earlier quoted context omitted.

> prove that it’s better than what currently exists. So how do you do that ethically? How do you justify taking off something that you know works to some extent and try something completely new or worse placebo? ie don't you have to construct the trial in the context of existing treatments etc? These are the kind of challenges that makes drug development slow - in the end you don't do one trial, but a series of trial…

[flagged]

the minds and qualia of incarcerated human beings and of rodents are very unequal in import and value.

what’s more, establishing legal precedent that incarcerated human beings may be freely experimented on is a recipe for ethical catastrophe.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#139

Post by wordpad25 »

EternalFury wrote: post #14

Anyone 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.

There is an xkcd comics that says anytime somebody says they found a thing that kills cancer cells in a lab, remember that so does a handgun.

Re: Developing a cancer drug without Big Pharma: this hospital shows it can be done

#140

Post by robertlagrant »

vasco wrote: post #122
robertlagrant wrote: post #104

Earlier quoted context omitted.

There is certainly a difference between profit and revenue, yes.

I guess it's easier to casually mention you might not recoup your investment when it's not your $200mil but my point it's just that there's a lot of speculative technical research or cultural output that is very hard to predict outcome, some of these things also requiring high paid labor, and we don't have a huge thing around "omg if they don't all become billionnaires selling drugs nobody will make drugs because it'…

More people are developing drugs than going to space. And going to space is valuable and makes billionaires, because it's a super high risk, high reward industry. If you want to make it into only a high risk industry, no one is going to space.
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