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A Universal Cancer Treatment?

nautil.us

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Re: A Universal Cancer Treatment?

#71

Post by notdonspaulding »

bnjemian wrote: post #66
nyx wrote: post #12

Earlier quoted context omitted.

I agree that my original comment is very optimistic--for what it's worth, Keytruda has thus far been very effective in the case I'm talking about, so I have some bias here. I concede that even in my "double the effectiveness" example, we're talking about doubling something like a 20% 5-year OS. By "around the corner" I'm really talking about, like, 20-30 years out, which I think is fairly soon in terms of cancer trea…

Not to be too pessimistic, but 600,000 people died of cancer in 2019, so 20-30 years is hardly "round the corner" when you extrapolate to the, let's say conservatively, 10 million families in the US losing loved ones in that time period. The history of cancer (The Emperor of All Maladies is a good book covering the history) is full of promising adjuvants, drugs, protocols that fail to generalize well. There are a lot…

My Dad is currently battling a GBM. Do you have any advice for a web dev who wants to get his toe in the door of understanding the computational biology of gliomas?

I don't expect I'll be able to do much, but all of the treatments we've undertaken so far seem very dated (not able to resect, one round of radiation, temodar+avastin for the last year, just switched to CCNU+avastin). I'd love to know where the state of the art is at and know how to nudge/prompt his oncologists to be looking at it through that lens.

My email is in my profile, feel free to reach out privately.

Re: A Universal Cancer Treatment?

#72

Post by wonder_er »

I can't help but mention that there are two dominant schools of thought regarding cancer treatments:

1. The Somatic theory of cancer ('bad genes/out-of-control cellular replication')

2. The metabolic theory of cancer ('cancer cells ferment blood sugar for energy via an ancient emergency metabolic pathway')

Both have merit, but a complete occlusion of one would be bad.

I wrote an open letter, long ago, to a wealthy person who was on the board of a cancer research center, suggesting they read a book and fund the key research scientist:

https://josh.works/mike-clayville-can-have-a-huge-impact-on-...

I thought of the metabolic theory of cancer as I opened this page, because all cancers have a similar reliance upon certain energy generation pathways, which implies a corresponding vulnerability for treatment.

Some people find it interesting enough to click through, read the article, and to read the book.

Re: A Universal Cancer Treatment?

#73

Post by throwaway12245 »

asdff wrote: post #37
mentos wrote: post #25

Early detection? Whats the best way to detect cancer (money is no object) and how do we get that cost down 10x and get everyone to participate?

You can detect tumor cells circulating in blood for certain cancers. You can get the cost down by having these tests covered at regular intervals by insurance companies.

Or make it over the counter and pay the $500.

Re: A Universal Cancer Treatment?

#74

Post by 01100011 »

dominotw wrote: post #11
nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

> in recent years, a very effective checkpoint inhibitor immunotherapy has been developed for the cancer in question. ~2x the success rates of traditional chemo > I think they've been saying this for a long time now, but it's truer than ever that a real cure for cancer is right around the corner. I think thats quite a leap. For prostate cancer( most common cancer among men), top line therapies are still androgen bloc…

Prostate cancer is, from what I understand, one of the cancers with the least amount of genetic differences from normal tissue. That makes it harder to target. It also explains the general failure of checkpoint inhibitors.

Re: A Universal Cancer Treatment?

#75

Post by adamredwoods »

borbulon wrote: post #18
nyx wrote: post #2

It really is remarkable how far cancer treatment has progressed, even in the last few years. I'm one of the unfortunate people who, through a close family encounter with cancer, knows more about this stuff than anyone should have to. The oncologist told my relative that if they had presented with this particular cancer just a decade ago, his recommendation would have been to start hospice care. However, in recent yea…

As a person who currently has stage IV NSCLC, I can add some context to this: YMMV. One thing to remember is that "Lung Cancer" is not just one thing. There are mutations of different genes, there are overexpressions of different genes. Each one has its own new medicines. Also, some peoples' cancers are more aggressive than others, and while for many they can find the right drug, for some nothing works. Keytruda work…

https://en.wikipedia.org/wiki/Sotorasib ?

I am hopeful we can move metastatic cancer (which is the true evil of cancer) to a controlled chronic condition.

BTW-- our oncology doctor believes in synergies between chemo and pembro, but I sometimes wonder if it's truly the chemo. Also, Pembro is not without its side-effects.

Re: A Universal Cancer Treatment?

#76

Post by Gatsky »

Here is the only clinical data: https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.46...

Looks as promising as any other promising cancer therapy in phase I trials!

There is a renaissance in cancer drug delivery at present, exemplified by antibody drug conjugates. The tech in the article is very interesting, and a superb bioengineering effort. A caveat is that complex multi-unit therapies don’t have a great track record. They are hard to manufacture reliably, and have a very large optimisation volume, so it’s difficult to increment the development as you only have finite resources for human trials. Contrast this with small molecules where there is a well defined process over various chemical and pharmacokinetic factors, prior to testing in humans. We also lack a good system for developing and trialing ‘platform’ tech like this - the current system is set up for single drugs/combos to be tested and eventually reimbursed in each cancer type separately. If you have a platform for delivering tailored therapies agnostic of cancer type, you will run into many barriers. There is currently only one drug I know of simultaneously approved across multiple cancer types (pembrolizumab in mismatch repair deficient tumours, a rare population). So many challenges ahead of the hype here.

Re: A Universal Cancer Treatment?

#77

Post by Gatsky »

sam537 wrote: post #28

Oncologist here. You can think of drug development as an extremely wide funnel with a minuscule exit hole. At any given time a medium sized pharmaceutical company has 300-500 drug candidates. From this group 50 make it to phase 1 trials. 40 get slashed due to toxicity, company abandons them, gets bought by third party and sits in sleepy storage. 10 advance to phase 2 trials where 5-8 may not end up having enough effi…

Glad to see another oncologist on HN!

Re: A Universal Cancer Treatment?

#78

Post by yshrestha »

pazimzadeh wrote: post #63
yshrestha wrote: post #24

I may be missing something but the article does not explain how the bacteria target is actually targeting the cancer cells. Of course, if you can design an ideal universal cancer targeting mechanism, the active ingredient itself is beside the point. Did anyone else catch this? Stopping DNA replication across the body will be fatal. This is what eventually kills with radiation toxicity.

The article is missing lots of detail. They use antibodies to target receptors which are highly expressed by tumors, such as Epidermal growth factor receptor (EGFR). "Given that the EDV surface is coated with lipopolysaccharide (LPS), single-chain bispecific antibodies were attached to the EDV surface where one arm of the antibody is directed to the O-polysaccharide epitopes and the other arm is directed to a tumour…

Ah. Thanks for finding this. That makes more sense. Bacteria that are attracted to cancer cells are a fascinating concept.

It is very exciting to see another tool in the toolbox to achieve higher cancer cell therapeutic specificity.

Re: A Universal Cancer Treatment?

#80

Post by Subsentient »

Watch all the funding dry up and the researcher get framed for some random, stupid crime, with just enough prison time to make sure he won't see the inside of a lab again before he's too senile to use it or dead. Could also be a slip in the tub etc.

There's a lot of money in suffering, and if you think there aren't people sick enough out there to do real horrible shit to protect that income stream, you're kidding yourself.

How do you think this fucked up civilization was twisted into the giant pulsating tumor it currently is?

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