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Lung Cancer Patients Live Longer with Immune Therapy

nytimes.com

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Re: Lung Cancer Patients Live Longer with Immune Therapy

#41

Post by patall »

DubiousPusher wrote: post #5
hprotagonist wrote: post #2

complaints about study funding aside, checkpoint inhibitors really are stunningly effective for some cancers. it’s the first major advance we’ve had in oncology in maybe 25 years.

Haven't there been fairly significant advances in using specialized chemotherapies for specific forms of cancer? This at least has been my impression from a few books I've read.

More or less correct, the parent comment is nonsense. There are multiple special types of cancer that can be specifically targeted now (for example CML), though few of those are chemotherapies aside some improved targeting mechanisms via antibodies. Also, prognosis accuracy has and is improving dramatically. And there are HPV vaccinations now, targetted virus treatments comming up and so much more. Immunotherapies are great but not the first and only thing in 25 years.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#42

Post by aaavl2821 »

Clubber wrote: post #20

>They cost more than $100,000 a year, can have serious side effects and help only some patients, generally fewer than half. Fuck you and the fuck the US healthcare system. Daddy or mama gets to live a few more years, but it will put the family into lifelong debt. I'll say it again, fuck you.

It will be cheaper in the future. Right now there are only ~4 PD-1 or PD-L1 inhibitors on the market, so it is an oligopoly. In a few years there will be a wave of competing drugs (many developed in China) and prices will fall

Also, these drugs don't just extend life a few years for a few patients. Over 50% of patients are responding to these drugs, and some of these can live 10 full years. Is $10,000 / year too much to spend so a loved one can live a healthy life? $50K / year is generally the threshold used by health economists to determine the value of a quality adjusted life year, and in this case these treatments fall below that threshold

And if you have insurance, it will cover much of that cost

Re: Lung Cancer Patients Live Longer with Immune Therapy

#43

Post by aaavl2821 »

This is a really significant public health advance.

In the US, cancer is the second leading cause of death, and lung cancer is one of the largest causes of cancer death. Curing this disease, even in a subset of patients, is really amazing

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

https://jamanetwork.com/journals/jama/fullarticle/2678018

Re: Lung Cancer Patients Live Longer with Immune Therapy

#44

Post by mft_ »

throwawayf98 wrote: post #26
aantix wrote: post #17

Earlier quoted context omitted.

PhDs that have dedicated their lives to specializing in specific cancers, failed drugs, research that leads nowhere, failed clinical trials because of XYZ. It's all highly specialized. And if done with a rigorous protocol, it's all expensive. You're not doing a lifetime of cancer research in hopes that you earn an average salary. For the company, if you finally get somewhere with a drug that is affective, you have to…

> How else do you fund future research? Taxes?

That's kind-of what happens... only in the US, it's a huge tax on ill people, rather than a smaller tax on healthy people.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#45

Post by mft_ »

danieltillett wrote: post #33
Clubber wrote: post #27

Earlier quoted context omitted.

Government needs to subsidize research and put price caps on resulting drugs. Fair market isn't possible with inelastic demand. That's where the fuck you comes from. Someone has cancer and their kids are wanting the treatment (of course, it's false hope, we don't want daddy to die) without realizing what they are asking for (lifelong debt). So in addition to cancer, the patient has to grapple with that shit. Anyone w…

Well governments do subsidise research quite a lot (NIH et al). Putting caps on prices without doing something about research costs is just going to kill research. All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs. A more productive approach might be to look into why drug development ha…

> Putting caps on prices without doing something about research costs is just going to kill research. All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs.

European countries pay much lower prices (although still relatively high vs. an average salary) vs. the US. The dirty secret is that the US is generally milked by pharma, because it can be. Until the US gets its act together and fixes this --and how likely is that, with the essentially broken system of government?-- it will continue.

> A more productive approach might be to look into why drug development has become so expensive. It is certainly not because pharma companies have suddenly become greedier.

It's expensive because a) it's a long and hard slog, and b) the regulators set very high standards. You can't affect a), and there is a strong disincentive for regulators to change b): in essence, regulators exist to prevent bad things happening, so are only incentivised to ever-tighten regulations.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#46

Post by mft_ »

iooi wrote: post #12

> After a median follow-up of 10.5 months, the estimated rate of overall survival at 12 months was 69.2% in the pembrolizumab-combination group versus 49.4% in the placebo-combination group. Seriously groundbreaking. This is a once-in-a-decade paper. [1] [1] http://www.nejm.org/doi/full/10.1056/NEJMoa1801005?query=fea...

There have been lots of similar 'groundbreaking' data from the various anti-PD1/-PDL1s over the pest few years. This is great, but not greater than lots of others.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#48

Post by wbl »

SteveNuts wrote: post #28
byteCoder wrote: post #8

I’m now 5.5 years post-treatment with immunotherapy for Stage IV melanoma and have had no evidence of disease for over four years. When immunotherapy works, it can be impressive. For me, my treatment (adoptive cell therapy using tumor infiltrating lymphocytes) used my own white blood cells (130 billion in lab-selected and expanded form) to overwhelm the mutated cancer cells. It was a one-time treatment (over 3-4 week…

What was the treatment like? I've heard it's similar to having the worst flu of your life * 1000.

He has a life. Melanoma is insanely deadly and painful.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#49

Post by refurb »

Retric wrote: post #23
aantix wrote: post #17

Earlier quoted context omitted.

PhDs that have dedicated their lives to specializing in specific cancers, failed drugs, research that leads nowhere, failed clinical trials because of XYZ. It's all highly specialized. And if done with a rigorous protocol, it's all expensive. You're not doing a lifetime of cancer research in hopes that you earn an average salary. For the company, if you finally get somewhere with a drug that is affective, you have to…

Most US medical research is highly dependent of public funding. Company's are only interested once the risks drop enough and the rewards are very near. Looking at just research and eliminating patent dogging efforts, Drug companies don't pay for nearly as much research as you might think.

Company's are only interested once the risks drop enough and the rewards are very near.

Clearly not true. Less than 5% of molecules that drug companies pick up make it to market. Huge failure rate.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#50

Post by refurb »

maxerickson wrote: post #36
Clubber wrote: post #34

Earlier quoted context omitted.

>All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs. You paint such a sad, desperate picture, but based on their numbers, it sounds like they are doing it to save a buck. Look at those profit margins. 10-43 percent on billions of investment. I should be so lucky. http://www.bbc.com/news/…

Medicare drug prices are negotiated by the private companies that administer most of the drug coverage. There is a clause in the law establishing Part D that says the government can't interfere with those negotiations, but this is different than the prices not being negotiated at all. http://www.pewtrusts.org/en/research-and-analysis/fact-sheet... Medicaid prices aren't negotiated, but the government dictates that th…

This is all correct, and, research has found that sometimes the Part D plans actually negotiate a lower price for their Medicare patients than commercial.

Also, Medicaid does not only get the lowest price ("best price"), they also get another 23% knocked off.

So to be entirely accurate, the US gov't doesn't negotiate drug prices for Medicaid, it creates it's own discounts and tell the company to screw off if they won't accept them.

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