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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

#71

Post by lopmotr »

schappim wrote: post #37

My Father is currently on a trial in Australia which combines Immune Therapy with traditional chemo treatment. The results can only be described as a miracle. He has gone from being inoperable stage IV melanoma (with the disease first being spotted in his lung, not his skin) to showing next to no evidence of the disease. When I read many medical studies in the media, they often sound too good to be true. In this inst…

Not to be dismissive, but those other media stories often had someone incredibly improve their condition too and that someone would have had children to go around saying "this is the real deal" but it's still only an anecdote and it still only works on some patients. Even quack therapies have people recovering naturally sometimes. Not so say immunotherapy is quackery.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#72

Post by marckemil »

I'm a radiation oncologist specializing in lung cancer. Here's my take:

Immunotherapy is really revolutionizing the treatment of locally advanced and metastatic lung cancer. However, a "revolution" in our world is improving 5-year survival by 10-15% in absolute value. It's not outstanding, but when your baseline is around 10%, improving it by 10% means doubling it. That's why immunotherapy is being adopted so quickly despite its price.

A poster mentioned $100 000 is not a lot if it adds 10 years. It's not as simple. Right now we don't really know if we can stop the treatment. So people often receive the treatment until they progress. If it's 4 years, we're looking at $400k... The cost on society in general will have to be dealt with (and debated) at some point. I doubt insurance companies will continue paying for those treatments "forever", especially considering how prevalent lung cancer is.

Immunotherapy benefits from a great "romantic" story, which helps with its marketing like no other drug. It's your own immune system, your army, waking up and attacking the greatest villain of all; cancer. The alternative, chemotherapy, is often seen as poison. Granted, it has fewer side effects, but it has some, and they can be nasty. Basically, the immune system is in a constant state of equilibrium. You stimulate it too much and it starts attacking your own body. We're seeing some cases of thyroid problems, lung inflammation (pneumonitis), skin problems... Generally speaking though, it's better than most chemos.

Overall, it’s a great treatment but obviously not perfect, crazy expensive to a point that it’s likely not sustainable in the long run. Despite all of the drawbacks, it’s a really exciting time for oncologists as we can finally offer more hope to our lung cancer patients.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#73

Post by danieltillett »

mft_ wrote: post #45
danieltillett wrote: post #33

Earlier quoted context omitted.

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 t…

It is only a long hard slog because of the regulators.

You are 100% right that the problem all comes back to regulation. What is missing from the drug development area is any cost benefit analysis. Regulations are made as if there is no cost to the ever tightening and restrictive regulations.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#74

Post by murukesh_s »

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…

CT scan is less than 100$ in most places in India. It could go up to 200$ in some hospitals and is considered expensive by the patients.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#75

Post by murukesh_s »

murukesh_s wrote: post #74
abarringer wrote: post #30

Earlier quoted context omitted.

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…

CT scan is less than 100$ in most places in India. It could go up to 200$ in some hospitals and is considered expensive by the patients.

And ultrasound is 10-20$. I find it seriously expensive in US. One thing is the health insurance or public backed healthcare is not widely adopted and patients still pay from their own pockets in India so charging exorbitant amounts is a big no-no.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#76

Post by mdekkers »

randcraw wrote: post #66
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 annou…

But it offers them additional months of life

Personally, I always wonder why people go through the pain and expenses to add a few more months. Years/cure - yes, go for it. A few months? I'll take the painkillers and anti anxiety drugs, thanks - it was a good run.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#77

Post by shadowtree »

randcraw wrote: post #66
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 annou…

absolutely, but also a chicken and egg problem.

a lot of immuno-onco is currently only approved for late-stage cancer patients. basically once you're near death and chemo/radio is done, you get the new stuff. and even within those groups you get people that are cancer-free within weeks. astonishing.

long term survival is unknown - sure. no one has been treated ten years ago with this stuff. besides a time machine there is no way of knowing, just waiting.

watching companies like https://www.modernatx.com/ building whole platforms is super exciting though. as someone who has lost family and young colleagues to cancer, this shit cannot come soon enough.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#78

Post by byteCoder »

bengarrr wrote: post #60
byteCoder wrote: post #51

Earlier quoted context omitted.

Yes, for the two days of high dose IL-2 every 8 hours, it was pretty bad. My experience was limited to nausea, fever, sweating, and bed-shaking rigors. I've heard that some patients experience hallucinations. Note: IL-2 was administered after I received my lab-grown white blood cells. It acts as signal to one's immune system to activate. It was used to jumpstart my immune system after it had been replaced.

I wonder how a combination of aggressive immunotherapy and "sickness" counteracting effects of cannabis (for the nausea, fever, sweating) would do in making the immunothrerapy more effective and tolerable.

Since the treatment was performed on site at the National Institutes of Health using Federal research dollars, this wouldn't have been an option. So, I have no idea.

Re: Lung Cancer Patients Live Longer with Immune Therapy

#79

Post by keepper »

randcraw wrote: post #70
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, pro…

Thanks! Weird I got down voted for my comment..
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