Here are my thoughts ( VC @ Balderton ) on why we invested, for what it's worth: https://medium.com/@jp_wise/the-hard-thing-about-hard-things...
MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
11–16 of 16 posts
Re: MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
#12Earlier quoted context omitted.
There's obviously potential downside, but for people with serious illnesses there's potential upside. For example: If you've got a disease that's going to kill you and unlikely helped by current medication/therapies, then dying a bit early is a small downside, not dying for however many more decades, on the other hand, is a huge upside. In this case, the upside/downside is asymmetrical in favour of the upside! It wou…
> not dying for however many more decades, on the other hand, is a huge upside. Looking at modern controversial cancer drugs we see that people get maybe six months of extra life, at very great expense, and these are the good drugs. The not so good drugs are even more expensive and provide perhaps two weeks extra life.
I agree! Current drugs aren't very effective, and there is a lot of room for upside in future therapies.
Re: MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
#13I don't understand how a startup will help here. The problem is regulatory hurdles (good or bad): there are laws that prevent patients from buying medicine before it's been thoroughly vetted. Will this company lobby to change those laws? Or is this an Uber situation where the fact that it's a VC-funded startup means that regulations magically don't apply.
Re: MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
#14Give patients unregulated access to under-tested, possibly lethal, drugs? What could go wrong?
There are multiple checks to ensure prudence of the use of development stage drugs. First of all a physician has to be convinced that the development stage drug could benefit his patient. If that’s the case, the physician can prescribe it to his patient. After that health authorities must grant permission before the physician can start treating his patient. Health authorities only allow treatment with such a developm…
But what happens when physicians' criteria don't align with the priorities of a patient?
Take this hypothetical example: you wake up with a dozen marble-sized tumors in your brain. A combination of BRAF and PD-1 inhibitors has a small chance of curing you. This is backed by science, this is already a known result. Without the treatment you are dead within six months. With the treatment, you have a small chance of being cured.
However, due to potential known complications of PD-1, it is not yet approved as first-line for patients with brain mets. So the doctor says you must first go through whole brain radiation.
Your oncologist's only goal is to extend your life, he doesn't care about what you value and what kind of life you want. Therefore WBR and then immune therapy is the logical choice.
But maybe you don't just care about not dying, maybe you expect a certain quality of life and are willing to take the risk of foregoing whole brain radiation, because life after whole brain radiation is not a life you'd want to live.
What right does anyone have to tell you you are not allowed to take that risk?
These pure theoretical reasons for not giving patients the right to choose are so far removed for the day-to-day reality of someone dying of cancer, it's ridiculous. We're not dealing with abstract data with the goal of reaching some life-expectancy maxima using one-size-fits all treatment. We're dealing with people who have different priorities, and maybe care about more than optimizing for the treatment that is statistically most likely to squeeze an extra month of existence out of them.
Re: MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
#15Give patients unregulated access to under-tested, possibly lethal, drugs? What could go wrong?
There's obviously potential downside, but for people with serious illnesses there's potential upside. For example: If you've got a disease that's going to kill you and unlikely helped by current medication/therapies, then dying a bit early is a small downside, not dying for however many more decades, on the other hand, is a huge upside. In this case, the upside/downside is asymmetrical in favour of the upside! It wou…
This line of reasoning can be equally applied to lottery, though.
Re: MyTomorrows Raises €4.5M to Give Patients Access to Development-Stage Drugs
#16Earlier quoted context omitted.
> not dying for however many more decades, on the other hand, is a huge upside. Looking at modern controversial cancer drugs we see that people get maybe six months of extra life, at very great expense, and these are the good drugs. The not so good drugs are even more expensive and provide perhaps two weeks extra life.
I agree! Current drugs aren't very effective, and there is a lot of room for upside in future therapies.
You missed the point that the very best newest cancer drugs are really expensive and if they're good give you an extra six months of life, and if they're not good give you perhaps an extra fortnight of low quality life.