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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

#201

Post by Teever »

caddemon wrote: post #81
bwb wrote: post #64

Earlier quoted context omitted.

That is not true, look up medical outcome data. Most of europe is far ahead or even with the USA.

Unless you are looking at outcomes of only the top institutions it's not really what he was saying. The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best care. If you have medical outcome data that disputes that specifically I'd be interested.

> The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best...

That's basically the case for everything in America, so I'm not sure that it says anything remarkable about the American healthcare system.

Like can you think of anything else in America that you couldn't apply that statement to?

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

#202

Post by trasz »

caddemon wrote: post #109
trasz wrote: post #93

Earlier quoted context omitted.

In most developed countries heart transplants are literally free. That's what proper healthcare system is for.

The US alone does ~2/3 of worldwide heart transplants, I think there is a tradeoff here. It's also not actually $1 million out of pocket for most people.

Only because you are looking at the country total. Adjusted per capita, US has 7.6 transplants per million population, while eg France has 6.2. Which means, it’s pretty close.

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

#203

Post by weezin »

pas wrote: post #189
weezin wrote: post #181

Earlier quoted context omitted.

No, the prices for drugs don't follow the same fundamentals that a normal economic market does. If you want to learn more about pricing in healthcare the "Pricing, Value, and Ethics" lectures for this course is really interesting. https://openlearninglibrary.mit.edu/courses/course-v1:MITx+1...

Could you explain that a bit? How does that interact with this? https://www.fda.gov/about-fda/center-drug-evaluation-and-res...

dodobirdlord's explanation is solid. Basically your link describes "generic" versions of a drug (aka a "brand" drug) with an expired patent. For new drugs they don't have competition like a normal market does because of these patents. To give a summary of the section of the course I linked the market forces for "brand" drugs is the willingness for payers (insurance companies/ governments) to pay.

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

#204

Post by caddemon »

Teever wrote: post #201
caddemon wrote: post #81

Earlier quoted context omitted.

Unless you are looking at outcomes of only the top institutions it's not really what he was saying. The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best care. If you have medical outcome data that disputes that specifically I'd be interested.

> The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best... That's basically the case for everything in America, so I'm not sure that it says anything remarkable about the American healthcare system. Like can you think of anything else in America that you couldn't apply that statement to?

I'm not making any argument about what it means, I'm just saying the response from OP is not actually a counter argument

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

#205

Post by caddemon »

bwb wrote: post #197
caddemon wrote: post #81

Earlier quoted context omitted.

Unless you are looking at outcomes of only the top institutions it's not really what he was saying. The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best care. If you have medical outcome data that disputes that specifically I'd be interested.

Why would you think the best hospitals in the USA outperform any other developed country's best hospitals? Especially when those countries already deliver better average results across the board. Why do you have this belief and what is it based on? One example of cancer outcomes on a per country basis: https://worldpopulationreview.com/country-rankings/cancer-su... Just google medical outcomes for any disease on a pe…

It is extremely plausible that worst case, average case, and best case have different rankings - it's a little telling that you have no data and your only counter is to say that average should have the same trend.

I am aware that most of the cutting edge clinical trials in my field occur in the US. I have also seen people travel to the US for treatment of rare diseases. And I know that this isn't a surprising thing for the US in general, just look at our universities.

It's actually pretty funny that the only other response I got was someone saying that this is super obvious/true across fields in the US and thus not an interesting statement.

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

#206

Post by caddemon »

trasz wrote: post #202
caddemon wrote: post #109

Earlier quoted context omitted.

The US alone does ~2/3 of worldwide heart transplants, I think there is a tradeoff here. It's also not actually $1 million out of pocket for most people.

Only because you are looking at the country total. Adjusted per capita, US has 7.6 transplants per million population, while eg France has 6.2. Which means, it’s pretty close.

The developed world as a whole is not even close to 2/3 US citizens, so per capita the original statement is still a large difference.

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

#207

Post by bwb »

caddemon wrote: post #205
bwb wrote: post #197

Earlier quoted context omitted.

Why would you think the best hospitals in the USA outperform any other developed country's best hospitals? Especially when those countries already deliver better average results across the board. Why do you have this belief and what is it based on? One example of cancer outcomes on a per country basis: https://worldpopulationreview.com/country-rankings/cancer-su... Just google medical outcomes for any disease on a pe…

It is extremely plausible that worst case, average case, and best case have different rankings - it's a little telling that you have no data and your only counter is to say that average should have the same trend. I am aware that most of the cutting edge clinical trials in my field occur in the US. I have also seen people travel to the US for treatment of rare diseases. And I know that this isn't a surprising thing f…

It is extremely weird that you think the best hospitals in the USA are not the same as the best hospitals in other developed countries. Especially given that their medical systems outperform the US system on a general basis.

I don't know if it is a weird American bias or what. I'd take a look at the bias there and this belief in American exceptionalism as it doesn't pan out in the data.

Cutting edge clinical trials and those companies are global in nature. I mean just look at the Moderna team and where they conducted those.

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

#208

Post by scoopertrooper »

hp48fan wrote: post #184
Wowfunhappy wrote: post #180

Earlier quoted context omitted.

The more we use antibiotics, the more opportunities there are for bacteria to evolve resistance.

So Ive been told. And yet the Dr gives them out in exactly the same circumstances as I would if I could. Perhaps more liberally, since Im far more concerned about the consequences to my kids of destroying their gut flora.

It seems like you want to create a general rule entirely based on your own personal experience.

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

#209

Post by chris_wot »

brigandish wrote: post #52
chris_wot wrote: post #46

Earlier quoted context omitted.

I’m sorry, but that’s a non sequitur. The alternative is not that the drug wasn’t produced. It is that the drug wasn’t developed by private enterprise .

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…

Your response assumes that all medical research is done solely to make a profit.

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

#210

Post by abirch »

mft_ wrote: post #144
abirch wrote: post #140

Earlier quoted context omitted.

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…

I appreciate your feedback. That said this is a message board for a bunch of nerds so hopefully people would discuss this with an oncologist.

>> 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.

Can we agree that Clinical trials are a small subset of all experiments? And that Phase 1 isn't as large?

For your second two points you're correct and I agree with you.

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