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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

#61

Post by Retric »

refurb wrote: post #49
Retric wrote: post #23

Earlier quoted context omitted.

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.

1:20 is relatively good odds. A random molecule is something like 0.000000001%.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#62

Post by mft_ »

adventured wrote: post #57
mft_ wrote: post #44

Earlier quoted context omitted.

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.

You have it exactly backwards. The healthy people are in fact paying for the ill people (who typically don't come even remotely close to ever paying for the cost of their treatment/care). The real cost to cover healthy people is extremely low, they pay artificially inflated prices for their insurance that subsidizes care & coverage for other sick people. In the US, 5% of patients represent over 50% of the cost of hea…

> You have it exactly backwards. The healthy people are in fact paying for the ill people (who typically don't come even remotely close to ever paying for the cost of their treatment/care). The real cost to cover healthy people is extremely low, they pay artificially inflated prices for their insurance that subsidizes care & coverage for other sick people.

Agree - that's indeed how insurance works. :)

I was referring to high co-pays on vastly expensive new drugs, and was also being slightly facetious.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#63

Post by mft_ »

adventured wrote: post #59
mft_ wrote: post #45

Earlier quoted context omitted.

> 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 t…

> European countries pay much lower prices To be fair, European big pharma also lives off the US market to plump their margins. That subsidizes their ability to charge lower prices in Europe and elsewhere. They also constantly poach cutting edge biotech & pharma companies out of the US to keep their stables full, such as AveXis, Genzyme, Genentech, etc. Without constantly buying up elite US biotech, Europe would have…

> To be fair, European big pharma also lives off the US market to plump their margins.

...as I said in my very next sentence? :)

> They also constantly poach cutting edge biotech & pharma companies out of the US to keep their stables full, such as AveXis, Genzyme, Genentech, etc. Without constantly buying up elite US biotech, Europe would have practically no biotech industry at all.

Can I ask, what's the problem with this?

All of the companies you refer to are pretty-much global - they have a presence in many countries, including the US, and by being publicly traded, ownership isn't especially linked to their country of origin. AZ (for example) being based in the UK means little for the UK, apart from that being where it pays some tax, and employs some people in its head office.

To take one of your examples, Roche (Swiss) bought Genentech (US), and still maintains the same huge presence in SF, still employs people in SF, still pays taxes there. And presumably the previous owners of Genentech stock did nicely out of this?

Re: Lung Cancer Patients Live Longer with Immune Therapy

#65

Post by mrnobody_67 »

abarringer wrote: post #30
stochastic_monk wrote: post #4

The prohibitively expensive nature of any immunotherapy leaves me profoundly skeptical of its practical usefulness. $100,000/year? That's more than twice the median income in this country. Is it simply that expensive to get mabs from animals, is drug development disgustingly expensive, or is there unbounded greed in pharmaceutical companies?

I've been in and out of the hospital a bit lately (broken back). That seems downright cheap. I average about $4,000 an hour when I'm in. The most recent "study" took an hour with one low paid tech using one ultrasound machine and it cost over $2,000. CT Scan? 15 minutes $7K. Heck, they charged nearly $800 to "start an IV" when they didn't even start it, it was the ambulance EMT that put it in (billed separately) they…

Have you tried shopping around?

https://www.healthcarebluebook.com and a bunch of others are trying to provide price transparency. Sometimes 30 min drive means thousands in savings.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#66

Post by randcraw »

shadowtree wrote: post #29

This is truly exciting and only just the beginning. There is a host of bio-tech startups following this initial wave - with two main goals: 1., Improve the treatments to become 100% cures 2., Lower the price This is very similar to tech and, say, the storage space. Went from 100k for a few GBs to peanuts for TBs on AWS pretty quickly. That's what momentum in a crowded space will do. Healthcare systems around the glob…

Yes, this news is exciting. But right now we're a very long way from curing cancer.

In 50% of the full range of cancer types treated so far by the drug in question, immunotherapy does absolutely nothing. And for another 25% it helps only a little. Only about 25% see a game-changing response. Even then, among high responders, most are not cured. They do live longer than if treated only with chemo. (In this study announcement, there's a 51% better survival rate after one year. That's great for those who are near death. But it offers them additional months of life, not decades.)

As of today, the fraction of patients who are fully cured of cancer by immunotherapy is unhappily small. It's also important to remember that these therapies are too new for us to know how long the positive effects will last. Will the lucky ones add months or years to their lives? We don't know. As of today it's just too soon to tell.

I do agree that the potential of treating cancer using the immune system is exciting. Certainly. But right now we're nowhere near able to declare victory or start worrying about the implications of ending cancer. That's not fair to the unlucky majority of cancer patients.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#67

Post by leodeid »

suyash wrote: post #64

Bad reporting - fails to explain what Immunotherapy actually is, jargons all over. Can anyone explain in simple terms?

Check out the cancer.gov page[1], which does a decent job of giving an overview. The drug in question, pembrolizumab, is a monoclonal antibody (you can tell because the name ends with '-mab'), and you can read more about how those work on this page[2].

[1] https://www.cancer.org/treatment/treatments-and-side-effects...

[2] https://www.cancer.org/treatment/treatments-and-side-effects...

Re: Lung Cancer Patients Live Longer with Immune Therapy

#68

Post by waynecochran »

Immunotherapy is not new. My mom went to Greece in 1980’s and received it. It was illegal in the US then. She would go to Mexico for booster shots. I believe it really extended her life w quality. She passed in 1990 but looked good... not a bag of bones like chemo patients.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#69

Post by leodeid »

delbel wrote: post #47

Cuba has a lung cancer vaccine for $2. Peer reviewed. You don't hear about it. Edit: I don't even know why I go here if this site is so toxic I get downvoted for pointing out something. Enjoy your guys toxic conformation bias

The "vaccine" you refer to here is racotumomab. It's not a vaccine in the common-parlance sense ("prevents disease"), but a different immunotherapy treatment which is only approved for use in Cuba and Argentina. I'm mildly curious why it doesn't exist in the US. All of the clinical trials in the USA which I can find on that drug are either incomplete[1] or completed-but-without-results[2][3][4]. For all of those trials, "Laboratorio Elea" is the sponsor or a collaborator, so I presume they have the rights to the drug in the USA. That's apparently a company out of Argentina[5]. I don't know why they seem to have given up on getting the drug approved in USA, but wikipedia says "[a study] is underway in Argentina, Brazil, Cuba, Indonesia, Philippines, Singapore, Thailand and Uruguay", though the citation for that seems incredibly suspect[6].

[1] https://clinicaltrials.gov/ct2/show/NCT02998983

[2] https://clinicaltrials.gov/ct2/show/NCT01460472

[3] https://clinicaltrials.gov/ct2/show/NCT01598454

[4] https://clinicaltrials.gov/ct2/show/NCT01240447

[5] http://www.elea.com/

[6] https://en.wikipedia.org/wiki/Racotumomab#Clinical_trials

Re: Lung Cancer Patients Live Longer with Immune Therapy

#70

Post by randcraw »

keepper wrote: post #32

Odd they don't mention the cuban work on this field. "Researchers with Cuba’s Center for Molecular Immunology have developed and approved an immunologic cancer therapy that improves survivability for certain types of cancers in some cases; as of January 2017, the drug has begun clinical trials for the treatment in the United States." https://www.usatoday.com/story/news/world/2018/01/09/cuba-ha...

Vaxira / Racotumomab

https://www.ncbi.nlm.nih.gov/pubmed/25420897

https://www.frontiersin.org/articles/10.3389/fonc.2012.00150...

This drug has completed a limited Phase II study in 2014 (71 patients), adding about 5 months of life over the control group (11 mo vs 6 mo). Then it began a large international phase III NSCLC (lung) study which apparently hasn't ended yet.

It's approved for use in Cuba and Argentina, probably only for lung cancer.

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