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Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

technologyreview.com

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Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#51

Post by awinder »

popey456963 wrote: post #36
gdulli wrote: post #31

Earlier quoted context omitted.

Some people don't have $4000 so it's not a matter of deciding whether parting with that much money is worthwhile. And the status of a lot of people's health insurance is suddenly up in the air.

First result on Googling the normal cost of cancer treatments > Newly approved cancer drugs cost an average of $10,000 per month, with some therapies topping $30,000 per month, according to ASCO, which discussed the costs of cancer care at a recent meeting. Just a decade ago, the average cost per month of new drugs was about $4,500. It seems $4,000 is rather a small fee in comparison.

Nitpick: it's $4000 per dose, and you're comparing to the monthly cost

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#52

Post by jstalin »

andruby wrote: post #46
jstalin wrote: post #38

Earlier quoted context omitted.

How much were the first large-screen LCDs? How much are they now?

Technology products often decrease in price. But for cancer treatments it's the opposite. New treatments used to cost $4,500 a decade ago and cost $10,000 to $30,000 now.

Agreed. Patent and insurance reform are crucial.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#53

Post by apathy »

andruby wrote: post #46
jstalin wrote: post #38

Earlier quoted context omitted.

How much were the first large-screen LCDs? How much are they now?

Technology products often decrease in price. But for cancer treatments it's the opposite. New treatments used to cost $4,500 a decade ago and cost $10,000 to $30,000 now.

That's a function of perverse incentives, rather than some sort of immutable truth. If there were stronger penalties for (e.g.) cartel-like pricing (e.g. TKIs), and more price transparency for the true costs of care (ibid), we might see less of this. Or if, say, the primary market for such drugs adopted a single-payer system where the payer negotiated on behalf of the patients, rather than on behalf of its shareholders.

Gleevec and Sprycel are the canonical examples of "competition makes the price go up" but if a single payer dominated the market and used this as leverage, it would be simple enough to just say "not at that price" and force manufacturers to play ball. The real problem is regulatory and legislative capture which prevents this from happening.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#54

Post by mikeash »

ryeguy_24 wrote: post #5

"The ready-made approach could pose a challenge to companies including Juno Therapeutics and Novartis, each of which has spent tens of millions of dollars pioneering treatments that require collecting a patient’s own blood cells, engineering them, and then re-infusing them." Is author serious with this statement? Two kids lives were saved with a potentially inexpensive technique and the author think's this point is r…

I read that as a caution that these companies could try to fight this technique, or that it could face problems getting to market, not saying that it was somehow sad that these companies would face trouble.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#55

Post by emiliobumachar »

woliveirajr wrote: post #40
_ihaque wrote: post #10

Earlier quoted context omitted.

Standard approach would likely be to choose a population of patients, randomize them between "chemo" and "chemo+immune" treatment groups, and then test for a significant difference in the metric of choice such as response rate or progression-free survival. The graphical analysis of these data is often done using Kaplan-Meier curves ( https://en.wikipedia.org/wiki/Kaplan%E2%80%93Meier_estimator )

So, can't simple take some (or all) other children who are going through "just chemo" in any other hospital, or even in the same hospital? I think there are plenty of children in the world that are doing (suffering?) chemo everyday.

No, they can't. To do so would introduce confounding variables in the inevitably unique way they treat their subjects, even if it's just knowing you're part of the experiments.

For maximum assurance of conclusions, such studies need to be double-blind: neither the subjects nor the researches who interact with them are to know who's taking just chemo and who's taking the new treatment.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#56

Post by replicatorblog »

omegaworks wrote: post #24
L_Rahman wrote: post #19

Earlier quoted context omitted.

I can explain the first quote. In a universal donor scenario, the T-cells are engineered, error corrected and tested once. From there, they can be multiplied pretty cheaply. Most of the cost is in the initial engineering. In a patient cell scenario, each individual patient's cells must be engineered, tested and delivered. This is obviously much more expensive. A very crude computer science analogy would be the differ…

Private insurers are too fragmented and small to negotiate a reasonable price for treatment. They lack the leverage that something like a national single-payer system would have.

The largest insurer in the US covers more people than the NHS. The second and third largest insurers rival other continental health services.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#57

Post by yellowMoneky »

JPLeRouzic wrote: post #16
guard-of-terra wrote: post #7

Earlier quoted context omitted.

However, given that cancer cells do not evolve between individuals (as opposed to bacteria and virii), if we are to find a efficient immunological treatment it's going to stay efficient. If anything, we will evolve for our cancers to respond better to it.

Somehow it is strange that cancer cells do not try to propage to other organisms, given they try hard to invade their host? Is there any known reason for that (absence of) behavior?

They do https://en.wikipedia.org/wiki/Clonally_transmissible_cancer

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#58

Post by JunkDNA »

mediocrejoker wrote: post #11

> “We estimate the cost to manufacture a dose would be about $4,000,” she says. That’s compared to a cost of around $50,000 to alter a patient’s cells and return them. > Either type of treatment is likely to cost insurers half a million dollars or more if they reach the market. Can someone more familiar with the pharmaceutical industry explain this?

Because it's not about how expensive it is to actually make the drug. To use a software analogy, Oracle doesn't price their database software by what it costs in bandwidth for you to come to their site and download the latest version. Or in the days of shrink-wrapped software, the cost of software was far from the cost of the materials (cardboard and discs).

Books similarly aren't priced based on the cost of printing and distribution.

The cost is directly related to recouping R&D costs as well as the clinical trials. In addition, with these therapies specifically, you actually have pay lots of highly trained people to administer them in the first place.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#59

Post by mikeash »

woliveirajr wrote: post #40
_ihaque wrote: post #10

Earlier quoted context omitted.

Standard approach would likely be to choose a population of patients, randomize them between "chemo" and "chemo+immune" treatment groups, and then test for a significant difference in the metric of choice such as response rate or progression-free survival. The graphical analysis of these data is often done using Kaplan-Meier curves ( https://en.wikipedia.org/wiki/Kaplan%E2%80%93Meier_estimator )

So, can't simple take some (or all) other children who are going through "just chemo" in any other hospital, or even in the same hospital? I think there are plenty of children in the world that are doing (suffering?) chemo everyday.

You'd want to eliminate as many potential confounding variables as possible. If they took the control group from another hospital, maybe that other hospital does something that improves or hurts their chances. Even if you pull from the same hospital, just being in the study might change the treatment they get in subtle ways.

There's also the issue of blinding. If the control group is some outside group, then you know that everyone in the study group is receiving the new treatment. It would be much better if everyone involved didn't know whether any given patient was getting the new treatment or not until after all the results were in. For that, you need to recruit patients into the study, then randomly assign them to the new treatment or the conventional sort.

Re: Two Infants Treated with Universal Immune Cells Have Their Cancer Vanish

#60

Post by karthikb »

jstalin wrote: post #38
pmiller2 wrote: post #23

Earlier quoted context omitted.

I hardly think a treatment costing $4000/dose to manufacture is inexpensive.

How much were the first large-screen LCDs? How much are they now?

Unfortunately the market for therapies does not follow the same market scaling model as consumer electronics due to the various financial models of insurance companies, government subsidies, etc.
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