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Administering immunotherapy in the morning seems to matter. Why?

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Re: Administering immunotherapy in the morning seems to matter. Why?

#101

Post by teekert »

ch4s3 wrote: post #54
sixo wrote: post #50

Earlier quoted context omitted.

Amazing. And shameful (for them.)

It’s not shameful, it’s how evidence based medicine works. One case is interesting but not a basis for changing a protocol by itself. Tons of things could have influenced the outcome and you need a proper study to know that.

It is not shameful indeed. One never knows what the father had experienced if he had been given the therapy during the day.

The oncologist could have written a paper (there are many single case papers), or started a trial by himself (requires a lot of organizing) if he was very intrigued. But of course one can’t do that for every above average case.

I have to say, in this particular case there is a very plausible mechanism and the trial would not be that hard. So it is a real shame that nothing was done with this.

Re: Administering immunotherapy in the morning seems to matter. Why?

#102

Post by nothrabannosir »

echelon wrote: post #78
_qua wrote: post #77

Earlier quoted context omitted.

Move fast and break things in human medicine means unethical researchers maim and kill people, often marginalized people. Nazis, Japanese experimenting on prisoners, Tuskegee airmen syphilis experiments, Cincinnati radiation experiments and many others stand as testament to what ambitious unethical scientists will do to further their knowledge and career. Thus we have strict guardrails that slow down how we do things…

We've been able to clone mammals for 30 years and haven't acted on it. We're still toying with molecular systems beyond the limit of detection. Clone humans. Cut off their brain stem during development. Turn off cephalization signals for good measure. Scale it up to industrial scale. Research problems solved. We'd have every study at our fingertips. We'd have organs and tissue and blood for everyone. We could possibl…

This comment, more than any other, has sold me on the value of red tape in medical research.

Re: Administering immunotherapy in the morning seems to matter. Why?

#104

Post by HexPhantom »

raylad wrote: post #48

My father was on chemotherapy with fludarabine, a dna base analog. The way it functions is that it is used in DNA replication, but then doesn’t work, and the daughter cells die. Typically, patients who get this drug experience a lot of adverse effects, including a highly suppressed immune system and risk of serious infections. I researched whether there was a circadian rhythm in replication of either the cancer cells…

It's frustrating (but not surprising) that even with a clear positive outcome, the system couldn't adapt without a clinical trial to back it up

Re: Administering immunotherapy in the morning seems to matter. Why?

#105

Post by HexPhantom »

unnamed76ri wrote: post #22

I used to be on a chemo drug and had to take folic acid every day to stop it from doing bad things to me. I had awful ulcers in my mouth from the chemo drug and had been taking the folic acid in the morning. Through forgetfulness I ended up shifting the folic acid to the afternoon and the ulcers went away and never came back.

How many side effects people just accept because no one thought to tweak the schedule

Re: Administering immunotherapy in the morning seems to matter. Why?

#106

Post by HexPhantom »

rendaw wrote: post #6

I'm doing CedarCure. You're required to not exercise or bath/shower for 2h after taking, which is fairly difficult in the morning, so I asked the doc if I could do it in the evening instead (despite explicit instructions to do it in the morning). The doc said it was fine, confirmed by the pharmacist. I should know better by now than to trust doctors to act based on research and not gut feeling, but I hope this doesn'…

Yeah, that tension between convenience and protocol is so real and frustrating

Re: Administering immunotherapy in the morning seems to matter. Why?

#107

Post by HexPhantom »

jmward01 wrote: post #7

I wonder if other basic processes could be at play here like when patients go to the bathroom. If you do this in the morning they may be more likely to not need that for a while while in the evening they may do that immediately. I'm not saying this is the mechanism, just pointing out that there are a lot of timing dependent things in a person's schedule that could be a factor here. It is a great thing to point out th…

We tend to treat the body like a static system when it's actually dynamic across the day

Re: Administering immunotherapy in the morning seems to matter. Why?

#108

Post by cluckindan »

EricPhy wrote: post #100

“Let’s pretend you have very early-stage cancer. The dendritic cells are in their normal cycle of desperately presenting tumor fragments to T cells, the T-cells rightfully getting upset, activating themselves, and going off to hunt the cancer. But cancer simply shuts them down by expressing an immune blocker protein: PD-L1. In response, the T-cell mostly shuts down, wanders back to the lymphatic system, and gets a li…

And not necessarily just an analog, given how there is an immune component to stress.

Re: Administering immunotherapy in the morning seems to matter. Why?

#109

Post by taneliv »

HexPhantom wrote: post #104
raylad wrote: post #48

My father was on chemotherapy with fludarabine, a dna base analog. The way it functions is that it is used in DNA replication, but then doesn’t work, and the daughter cells die. Typically, patients who get this drug experience a lot of adverse effects, including a highly suppressed immune system and risk of serious infections. I researched whether there was a circadian rhythm in replication of either the cancer cells…

It's frustrating (but not surprising) that even with a clear positive outcome, the system couldn't adapt without a clinical trial to back it up

Isn't it also quite understandable? Otherwise we risk the new way working well for half the patients and killing the other half, to exaggerate.

Re: Administering immunotherapy in the morning seems to matter. Why?

#110

Post by echelon »

nothrabannosir wrote: post #102
echelon wrote: post #78

Earlier quoted context omitted.

We've been able to clone mammals for 30 years and haven't acted on it. We're still toying with molecular systems beyond the limit of detection. Clone humans. Cut off their brain stem during development. Turn off cephalization signals for good measure. Scale it up to industrial scale. Research problems solved. We'd have every study at our fingertips. We'd have organs and tissue and blood for everyone. We could possibl…

This comment, more than any other, has sold me on the value of red tape in medical research.

Our genome is a machine, from the nucleotides to the packing, to the enzyme activity, to the metabolic flux.

Our bodies are bigger machines made of lots of little machines.

Our minds or conscious egos or "souls" are the neurotransmitter and activation activity of the connectome and all of its cells and synaptic weights and metabolic activity. They're our lived experiences for as long as our brains can function. Minds experience and produce wonderful things.

If you divorce the body from the mind, there is no "person". Just a very complicated machine. A very valuable machine full of parts.

A human body in a vegetative state is not a person. It's a dormant machine. People may have emotional attachment to that vestige, but it is no longer capable of being a person. It is not a person.

We use brain dead humans for organ transplant all the time. If you understand the premise, then it isn't that far-fetched that we might grow vegetative humans in a lab for medical use and research.

Bodies that never have brains can never become persons. They're no different from plants.

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