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A cancer trial’s unexpected result: Remission in every patient

nytimes.com

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Re: A cancer trial’s unexpected result: Remission in every patient

#141

Post by scoopertrooper »

mchusma wrote: post #138

This brings up again the sorry state of medicine being "default banned". Should this treatment be banned for patients? Absolutely not. Is it a small, underpowered study that needs to be replicated? Absolutely. Could it warrant banning in the future? Sure. Should it be covered by insurance? Complicated. We need to unbundle these things.

70% of Phase 2 trials fail and 50% of Phase 3 trials fail[1]. Why should the default to be to approve drugs in the early stage of human experimentation?

Here are some interesting case studies of drugs graduating from Phase 2 trials only to fail Phase 3 trials on efficacy and safety grounds: https://www.fda.gov/media/102332/download

[1] https://www.parexel.com/application/files_previous/5014/7274...

Re: A cancer trial’s unexpected result: Remission in every patient

#143

Post by ok123456 »

qgin wrote: post #40
ta988 wrote: post #22

Earlier quoted context omitted.

Is that the real price of a nursing home in the US? Who can afford that?

You either have enough to pay or you pay until all your assets are exhausted to $0 and then Medicaid takes over.

Medicaid will force you to sell your house once that happens.

Re: A cancer trial’s unexpected result: Remission in every patient

#144

Post by mft_ »

abirch wrote: post #140
satellite2 wrote: post #134

Earlier quoted context omitted.

A placebo control group when there is an established standard of care? That sounds highly unethical. The above link to the abstract don't mention this and I don't have access to the full text paper. If you do can you clarify what the control arm received?

I intentionally avoided using placebo group. The control cohort may not have had cancer at all _____________ The plan is to enroll six patients with MSI, regardless of their primary cancer diagnosis. This cohort will serve to generate hypothesis and initial data to plan a larger study. All analyses from this cohort will be exploratory https://clinicaltrials.gov/ct2/show/NCT04165772

I appreciate your good intentions, but you should consider not writing things on the internet like this - as both of your posts are effectively misinformation.

> As with most experiments

This isn't true. It's absolutely standard in earlier trials of investigational agents to not have any sort of control arm.

> there's a control group (6 patients).

This isn't true. Within the study you posted, there are two different cohorts, with different patient types included.

> The control cohort may not have had cancer at all

This isn't true. The group you're calling a control cohort (cohort 2) must all absolutely have cancer, and are all actively treated with the study drug (TSR-042).

Re: A cancer trial’s unexpected result: Remission in every patient

#146

Post by spfzero »

ta988 wrote: post #22
georgeburdell wrote: post #21

Earlier quoted context omitted.

This is why although I’ve almost got enough money to retire (~20x yearly expenses) but I’ll keep on working for another decade or two. All of these whiz-bang new treatments are going to be expensive. The most expensive medical procedure right now is a heart transplant at about $1M. Then there’s the $10k/mo for a nursing home

Is that the real price of a nursing home in the US? Who can afford that?

It's the type of nursing home. If you are in an "assisted living" home, it is less. As a data point, maybe $5800/mo in CA, which includes food and various social programs.

Re: A cancer trial’s unexpected result: Remission in every patient

#147

Post by hprotagonist »

civilized wrote: post #3
hprotagonist wrote: post #2

relatedly, the only good reason to stop a trial early is that it becomes unethical not to treat the control group because the effect size in the treatment group is so huge. And it does happen, sometimes.

I sometimes wonder if the exhilaration of such a result comes with a twinge of regret that the result could not have been foreseen before the science reached it, and more people given the lifesaving treatment immediately. But that is the human condition, I guess. Scientific progress and learning brings regrets, often very momentous ones in retrospect.

generally speaking, “holy shit it worked?!!!” drowns out a lot. It’s not so much exhilaration as it is a kind of astonished joy.

Re: A cancer trial’s unexpected result: Remission in every patient

#149

Post by rzz3 »

scoopertrooper wrote: post #141
mchusma wrote: post #138

This brings up again the sorry state of medicine being "default banned". Should this treatment be banned for patients? Absolutely not. Is it a small, underpowered study that needs to be replicated? Absolutely. Could it warrant banning in the future? Sure. Should it be covered by insurance? Complicated. We need to unbundle these things.

70% of Phase 2 trials fail and 50% of Phase 3 trials fail[1]. Why should the default to be to approve drugs in the early stage of human experimentation? Here are some interesting case studies of drugs graduating from Phase 2 trials only to fail Phase 3 trials on efficacy and safety grounds: https://www.fda.gov/media/102332/download [1] https://www.parexel.com/application/files_previous/5014/7274...

Because (at least) for people with a high risk of dying, and operating under well-informed consent, that decision should be between patients and their doctors alone.

Re: A cancer trial’s unexpected result: Remission in every patient

#150

Post by astrange »

pmyteh wrote: post #71
brigandish wrote: post #52

Earlier quoted context omitted.

Please don't give insincere apologies, they're rhetorically weak and pairing insincerity with something that should be sincere isn't a good look. Which segues nicely to this pairing of public funding and private enterprise. No, if the drug wouldn't be sold for a profit then the incentive to make it wouldn't exist and the funds would not be applied for and the ironic pairing - if it is ironic, which I don't think it i…

I don't know about medical research, but that's exactly what the rest of us in universities do.

You get social rewards like titles, getting into vicious personal arguments over personal things, and being able to reject younger researchers’ work in peer review if it would disprove yours.

Can’t displace Chomsky as a famous linguist if he writes a letter to everyone’s dissertation committee if they criticize him.

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