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Lung cancer pill cuts risk of death by half

theguardian.com

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Re: Lung cancer pill cuts risk of death by half

#31

Post by londons_explore »

londons_explore wrote: post #30
chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

It always surprises me how little effort we put into getting things from the lab to the people quicker.

As soon as we have compelling data some discovery (medical or otherwise) might help lots of people, it should be almost a manhattan project type effort to get it into the hands of everyone worldwide asap.

Re: Lung cancer pill cuts risk of death by half

#32

Post by haldujai »

ramraj07 wrote: post #27
chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Just because this approach works doesn't mean this is the only approach out there. I sincerely believe that this thought has singlehandedly retarded progress towards more generic cancer treatments. Immune checkpoint inhibition is a clear proof that you could make one drug that could attack a wide swathe of cancers. Heck even chemo is proof of that. If this is the research you want to focus on, please go ahead. But do…

You’re both kinda right, personalized or targeted cancer therapy is definitely an incredibly promising field and the early results in various cancers are promising. Most notably in disseminated disease.

Simultaneously, one of the largest criticisms of osimertinib in resectable NSCLC has been that some oncologists got overexcited about the DFS results and patients have been unfortunately not receiving the traditional standard of care adjuvant therapy (old school platinum based drugs) which have a proven overall survival benefit (until today osimertinib did not, it now possibly does).

Targeted gene-directed therapy is cool but conventional chemotherapy is still really important.

ICIs are magic when they work.

Re: Lung cancer pill cuts risk of death by half

#33

Post by londons_explore »

ramraj07 wrote: post #27
chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Just because this approach works doesn't mean this is the only approach out there. I sincerely believe that this thought has singlehandedly retarded progress towards more generic cancer treatments. Immune checkpoint inhibition is a clear proof that you could make one drug that could attack a wide swathe of cancers. Heck even chemo is proof of that. If this is the research you want to focus on, please go ahead. But do…

Isn't there a high chance that research aimed at one type of cancer will end up transferrable to other types? Either the actual treatment/drug, or at least the methods and approaches to designing the treatment.

Re: Lung cancer pill cuts risk of death by half

#34

Post by TrackerFF »

wahnfrieden wrote: post #20
xivzgrev wrote: post #18

My mother in law has stage 4 lung cancer. Tagrisso is extending her life. The cancer has been shrinking since going on it with few side effects. Unfortunately stage 4 cannot be cured, and at some point tagrisso stops working. My understanding is the cancer mutates and eventually develops resistance. Then she will go on chemo and her quality of life will go down. I am thankful for modern medicine that we get some extr…

advice on how to catch earlier?

Lifestyle changes for one.

Do you smoke? quit smoking. Do you live in areas with lots of air polution? High levels of radon where you live? Move.

Do you work with a bunch of carcinogenic chemicals? Find something else to do.

You can also get a gene test do see if you're suspectable to certain cancers.

But most importantly: listen to your body. If you feel that something is wrong, take it up with your doctor.

Re: Lung cancer pill cuts risk of death by half

#35

Post by seanmcdirmid »

londons_explore wrote: post #31
londons_explore wrote: post #30

Earlier quoted context omitted.

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

It always surprises me how little effort we put into getting things from the lab to the people quicker. As soon as we have compelling data some discovery (medical or otherwise) might help lots of people, it should be almost a manhattan project type effort to get it into the hands of everyone worldwide asap.

They do fast track drugs if studies show overwhelming success, and it is no longer ethical to keep it from the control group.

Re: Lung cancer pill cuts risk of death by half

#36

Post by haldujai »

semenko wrote: post #14
chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Agreed! This specifically is for adjuvant osimertinib for EGFR+ Stage IB–IIIA completely resected NSCLC. The headline here is really strong -- and the actual abstract is much more sober: "5-year OS rate was 88% with osimertinib vs 78% with placebo" [Full abstract is here: https://meetings.asco.org/abstracts-presentations/219805 ] P.S. Hi Chris! (I think I picked up a summer student from you last week!)

Very sober given the costs and %age of patients who didn’t receive adjuvant chemo in the initial trial.

Interested to see their detailed results but I’m mildly suspicious this will be AstraZeneca PR buffing underwhelming results.

Re: Lung cancer pill cuts risk of death by half

#39

Post by phtrivier »

The pricing of drugs is always weird to me. Is there a good book / article / primer on why a drug can cost the price of a good house per person ? Is it just about recouping R&D, does manufacturing requires very rare raw materials, is the bill going up because of regulation, etc... ?

How big a check would a government have to do to just "buy" the rights to a drug ? (Both in the "legal" and in the "an offer the CEO can't refuse" version ?)

Re: Lung cancer pill cuts risk of death by half

#40

Post by haldujai »

dangwhy wrote: post #19
xivzgrev wrote: post #18

My mother in law has stage 4 lung cancer. Tagrisso is extending her life. The cancer has been shrinking since going on it with few side effects. Unfortunately stage 4 cannot be cured, and at some point tagrisso stops working. My understanding is the cancer mutates and eventually develops resistance. Then she will go on chemo and her quality of life will go down. I am thankful for modern medicine that we get some extr…

My father is in this situation with prostate cancer. First line therapies have stopped working and now its on to chemo. I am hoping chemo won't damage him too much. There are also radioligand therapies like lutetium 177 but they haven't been sequenced on chemo naive patients yet. So soc is chemo first.

I wasn’t involved in this study but the cancer center I just left was one of the sites for the upfront Lu177 vs chemotherapy trial. Speaking casually with the physician involved recently he said the results weren’t promising thus far.

I don’t think this is published yet and I’m not familiar with prostate ca treatment literature so take this with a grain of salt.

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