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A Universal Cancer Treatment?

nautil.us

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Re: A Universal Cancer Treatment?

#11

Post by dominotw »

nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

> in recent years, a very effective checkpoint inhibitor immunotherapy has been developed for the cancer in question. ~2x the success rates of traditional chemo

> I think they've been saying this for a long time now, but it's truer than ever that a real cure for cancer is right around the corner.

I think thats quite a leap. For prostate cancer( most common cancer among men), top line therapies are still androgen blockage that was discover 70 yrs ago, chemo and radiation. Keytruda failed to deliver any significant survival benefits[1].

Yes we've gotten better at slash, burn , poison methods. Radiation is more trageted and sophisticated. Diagnostics are more precise. Chemo drugs have better safety profiles.

But these are all marginal improvements. None of which indicate anything that we are close to a cure.

Only hope we still have is to catch it earlier and go ham on it. Most of the slash,burn, poison methods are being FDA approved for earlier use.

The other two things(one of which you've mentioned) are immune checkpoint blockade if you have MSI-hi/dMMR or PARP inhibition if you have BRCA2+. Even if you are lucky to have these mutations these drugs are a hit or miss[1].

I don't feel optimistic about a cure at all.

1. https://www.businesswire.com/news/home/20220803005334/en/Mer...

Re: A Universal Cancer Treatment?

#12

Post by nyx »

dominotw wrote: post #11
nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

> in recent years, a very effective checkpoint inhibitor immunotherapy has been developed for the cancer in question. ~2x the success rates of traditional chemo > I think they've been saying this for a long time now, but it's truer than ever that a real cure for cancer is right around the corner. I think thats quite a leap. For prostate cancer( most common cancer among men), top line therapies are still androgen bloc…

I agree that my original comment is very optimistic--for what it's worth, Keytruda has thus far been very effective in the case I'm talking about, so I have some bias here. I concede that even in my "double the effectiveness" example, we're talking about doubling something like a 20% 5-year OS.

By "around the corner" I'm really talking about, like, 20-30 years out, which I think is fairly soon in terms of cancer treatment progress. You're right that it reads like a leap in the context of my comment.

Re: A Universal Cancer Treatment?

#14

Post by Joel_Mckay »

It is not a single disease, but rather a result of several errant biological outcomes. The mortality rates have improved a lot with better treatments, and around 60% of the population will develop some form of the disease in their lifespan.

The most disturbing part is most people are unaware they are ill until relatively late stages of the disease.

If you live long enough, one will know many good people that go this way. It is a worthy area of research, as it improves the lives of many families. =)

Re: A Universal Cancer Treatment?

#15

Post by Retric »

dominotw wrote: post #11
nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

> in recent years, a very effective checkpoint inhibitor immunotherapy has been developed for the cancer in question. ~2x the success rates of traditional chemo > I think they've been saying this for a long time now, but it's truer than ever that a real cure for cancer is right around the corner. I think thats quite a leap. For prostate cancer( most common cancer among men), top line therapies are still androgen bloc…

Part of this is because prostate cancer has such a high success rate. With treatment, the 5 year survival rate for early prostate cancer is over 99%, and is was close to 98% 20 years ago.

The current approach of regular prostate exams + treatment isn’t perfect but it’s extremely effective.

Re: A Universal Cancer Treatment?

#16

Post by harmmonica »

nyx wrote: post #10
harmmonica wrote: post #9

Earlier quoted context omitted.

Would you be willing to share the type of cancer? Also, was the person you're referring to (can't tell if it was a relative) able to bypass traditional chemotherapy and go straight to the immunotherapy given the prognosis? Or did the oncologists require chemo first and only then your contact was able to receive the immunotherapy? Thanks for sharing anything you can. If more comfortable sharing in private, I can be re…

Stage IIIC NSCLC, specifically a superior sulcus tumor, advanced enough to be considered inoperable. Standard of care in this case was induction radiotherapy, followed by a single course of combination chemotherapy consisting of carboplatin, pemetrexed, and pembrolizumab (the last of which is the cutting-edge immunotherapy I'm talking about; brand name Keytruda.) After that, patients are prescribed the pemetrexed and…

Thank you for pointing out the standard of care in this case, given inability to resect, was the immunotherapy from the start. Obviously very specific for that type of lung cancer and the state of your contact's tumor, but I've been learning more and more about this and have been told by multiple oncologists that immunotherapy is typically only given after more conventional treatments are first attempted and fail to stop progression or shrink the mass(es). Needless to say that's far from categorical so in my next conversations I can be a bit more educated in my questioning.

And 80% reduction after that first course... Amazing. How long after the first course did they do the scan that showed that reduction?

Btw, very happy for you (and even moreso for your contact). Great news.

Re: A Universal Cancer Treatment?

#17

Post by NetWonk_me »

Someday soon they'll look at our insane chemotherapy with the same level of utter disbelief as we do about bloodletting and tapeworm diets

I mean untargeted chemotherapy kills -the one thing- that protects us since before we were born from cancer, our immune system.

Killing our immune system to kill cancer makes as much sense as shooting off the leg you lead with so to run faster.

Its idiotic, stupid and, yeah its basically trying to stop the copy errors in genes that cancer does, before all the massive amount of DNA errors kill the cancer victim ...

It's like a really really bad CRISPR process as I understand it, like the computer program SED was majorly crapping out and it made your program an utter mess.

Anyway, chemotherapy is DAMN foolish, and I for one will be glad when we're rid of it with better therapies

Re: A Universal Cancer Treatment?

#18

Post by borbulon »

nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

As a person who currently has stage IV NSCLC, I can add some context to this:

YMMV.

One thing to remember is that "Lung Cancer" is not just one thing. There are mutations of different genes, there are overexpressions of different genes. Each one has its own new medicines. Also, some peoples' cancers are more aggressive than others, and while for many they can find the right drug, for some nothing works.

Keytruda works wonders for some. It did not for me. I had 4 treatments of the CPP (carboplatin, pemetrexed, and pembrolizumab) triad, which had some success. They then put you on "maintenance," which is the PP without the carboplatin (which is the really old school platinum-based chemo). Maintenance did nothing for me. My main tumor grew more than 50% in 2 months.

Last summer I started 9 months on a chemo/immuno that was geared towards my specific mutation. It actually did wonders. It resulted in a 98% shrinkage of my main tumor before I ended up with pneumonitis from it and had to stop. But I've been able to be off treatment for the entire summer. I know there are others who have tried this, and it didn't work.

So yeah, I'm really, really glad your relative was able to get some relief from the Keytruda. But I also wish it were the wonder cure for everyone that it was for them.

Re: A Universal Cancer Treatment?

#19

Post by mcbain »

harmmonica wrote: post #9
nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

Would you be willing to share the type of cancer? Also, was the person you're referring to (can't tell if it was a relative) able to bypass traditional chemotherapy and go straight to the immunotherapy given the prognosis? Or did the oncologists require chemo first and only then your contact was able to receive the immunotherapy? Thanks for sharing anything you can. If more comfortable sharing in private, I can be re…

Of course it varies by cancer. Look up "adjuvant immunotherapy".

It is now standard of care for melanoma, for one, but it isn't successful for all cancers, (or even all melanoma mutations).

Re: A Universal Cancer Treatment?

#20

Post by slyrus »

NetWonk_me wrote: post #17

Someday soon they'll look at our insane chemotherapy with the same level of utter disbelief as we do about bloodletting and tapeworm diets I mean untargeted chemotherapy kills -the one thing- that protects us since before we were born from cancer, our immune system. Killing our immune system to kill cancer makes as much sense as shooting off the leg you lead with so to run faster. Its idiotic, stupid and, yeah its ba…

I'd argue that our future retrospective view of chemotherapy will be more of how we view hunting with a club rather than, say, a bow and arrow. Not optimal but, at least in many cases, proven to be better than nothing by multiple randomized clinical trials.
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