For all the folks complaining about "it's only in mice! things never work in humans!" -- I work at MSK and we definitely have seen success treating PDAC in humans: https://www.nature.com/articles/s41586-023-06063-y "Why don't I see these treatments hitting the general public?" Because trials like these are phase I/II. Then you need a phase III that takes a long time to recruit a large cohort and has overall survival…
How expensive? Let's say you're Bill Gates or, say, Steve Jobs. What would it cost for someone with their wealth to get that shot?
> Clinical implications: While more research will be needed before trials in humans can begin Why? Seriously, think about it. Most people with pancreatic cancer have nothing to lose and many of them have just weeks or months to live. Daraxonrasib, Afatinib, and SD36 are molecules that can already be purchased in bulk, and what's the worst that can happen? Our society's morbid, irrational fear of quack medicine causes…
> what's the worst that can happen? The patient dies from complications of the drug's use before the cancer.
In a purely rational world who cares. 4 months is not all that far away from 6 months and with cancer you’d probably prefer to not be alive for those last two months anyway. We should be willing to do Hail Marys with 5-10% chances of success rather than doing absolutely nothing.
IN MICE. (To be fair, also IN SOME OTHER BETTER MICE). https://jamesheathers.medium.com/in-mice-explained-77b61b598... (mostly a joke, but I'd be in favor of adding context to the HN headline if possible)
This context is very important. "Little by little, over-inflated results and breathless breakthroughs betray trust. They throwing dimes in a wishing well which people rapidly start to expect will never pay compound interest." "Then, when one of those people is elected to parliament, or Congress, and start to cut the budget for the National Science Foundation, or declares that All Research Should Be In The National In…
If I had 6 months to live, and had no other options, I wouldn't care if a drug killed me in 10 days. Give me the option.
It's not just those two choices though. It could be "6 months in relative comfort" and "10 days begging each minute to die but you can't because you're borderline unconscious". Or anything in between. Just saying. Medical guidelines are there for a reason and are often, as they say in the military, "written in blood".
Having seen the last ten days of pancreatic cancer, there isn’t really a difference with what you’re describing.
> Clinical implications: While more research will be needed before trials in humans can begin Why? Seriously, think about it. Most people with pancreatic cancer have nothing to lose and many of them have just weeks or months to live. Daraxonrasib, Afatinib, and SD36 are molecules that can already be purchased in bulk, and what's the worst that can happen? Our society's morbid, irrational fear of quack medicine causes…
> Our society's morbid, irrational fear of quack medicine
It is not an irrational fear.
Brandolini's Law applies: "The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it."
The only way to prevent quackery is to cut it off hard before it gets started.
Wakefield demonstrated the disaster that happens when you don't.
(And if you have been reading this site for very long, you know the experimental treatments are already around--we're not currently lacking for possible cancer treatments. The problem is finding the trial. Then the problem is getting people through the process and then getting them to the trial. See: "Please be dying, but not too quickly": https://bessstillman.substack.com/p/please-be-dying-but-not-...)
> Clinical implications: While more research will be needed before trials in humans can begin Why? Seriously, think about it. Most people with pancreatic cancer have nothing to lose and many of them have just weeks or months to live. Daraxonrasib, Afatinib, and SD36 are molecules that can already be purchased in bulk, and what's the worst that can happen? Our society's morbid, irrational fear of quack medicine causes…
> Our society's morbid, irrational fear of quack medicine It is not an irrational fear. Brandolini's Law applies: "The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it." The only way to prevent quackery is to cut it off hard before it gets started. Wakefield demonstrated the disaster that happens when you don't. (And if you have been reading this site for very…
Even if I grant that argument, what I've described isn't even quackery. It is legitimate medical research and experimentation, and what doctors in olden times would call a "heroic" intervention -- but, sadly, now this sort of thing has become collateral damage in the war between medicine and quackery. And patients are the ones who die and suffer because of it.
> Clinical implications: While more research will be needed before trials in humans can begin Why? Seriously, think about it. Most people with pancreatic cancer have nothing to lose and many of them have just weeks or months to live. Daraxonrasib, Afatinib, and SD36 are molecules that can already be purchased in bulk, and what's the worst that can happen? Our society's morbid, irrational fear of quack medicine causes…
Yeah putting myself in the shoes of someone with this disease or a loved one with this disease I would be so incredibly angry that we weren't allowed to try something when the alternative is certain death
There is a lot of money to be made selling snake oil to the desperate, so we definitely want regulation…
> Clinical implications: While more research will be needed before trials in humans can begin Why? Seriously, think about it. Most people with pancreatic cancer have nothing to lose and many of them have just weeks or months to live. Daraxonrasib, Afatinib, and SD36 are molecules that can already be purchased in bulk, and what's the worst that can happen? Our society's morbid, irrational fear of quack medicine causes…
The ethics of life and death are murky at best. When is it acceptable? 6 months to live? 1 year to live? 5 years? What is the cut point? The answer is, there isn't a clear answer. Yes, that is a cop out, but it is also true. I agree with allowing people of sound mind to make informed healthcare decisions towards the end of their lives that involve high risk. but I would be wary of weakening the process too much. We should have a push-back because people in these positions are exceptionally vulnerable and therefore easy to take advantage of and, even worse, likely to be unable to defend against abuse for very long. Weakening this process would likely lead to drug companies doing what they always do, abuse their position for money. Why even go to expensive traditional trials? Just give some promising, cherry picked, results in a press release and now people are coming to you signing every waiver and paying their last penny to live next to the trial that will kill them because the drug wasn't even close to ready. I would likely feel very different if I was near death, but that is the point isn't it? Again, I'm not saying this shouldn't be an option. I just think it needs a lot of scrutiny and a high level of skepticism.