Lung cancer pill cuts risk of death by half • Hacker News Board

Re: Lung cancer pill cuts risk of death by half

#71

Post by breck » Sun, Jun 04, 2023, 6:35 PM UTC

ProjectArcturis wrote: post #56

breck wrote: post #53

> After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. My chance of living 5 years goes from 78% to 88% by taking an expensive pill everyday with side effects? That's not an amazing thing. If it was 78% to 95% with one or two pills, or a positive healthy lifestyle change, then that's something. I'm going to…

Far too cynical. You are incredibly uninformed about the significance of this drug.

I could be wrong. Absolutely. I am always open to more information.

However, I'm usually not wrong about these things. This pattern is so common in big pharma it's an easy bet right now.

Based upon the limited information released I would bet:

1) it has high odds of being very lucrative for a small number of people

2) it will be a net negative for patients^

^ Patients would be better off with more money and using an alternative treatment strategy. This drug is priced at $12,750 per month, according to Wikipedia.

Re: Lung cancer pill cuts risk of death by half

#72

Post by thangalin » Sun, Jun 04, 2023, 6:51 PM UTC

Teslazar wrote: post #67

According to the CDC, 80-90% of lung cancer deaths are linked to cigarette smoking (1). It seems like a simple solution for people to just not smoke... (1) https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm#... .

'Nicotine releases a chemical called dopamine in the same regions of the brain as other addictive drugs. It causes mood-altering changes that make the person temporarily feel good. Inhaled smoke delivers nicotine to the brain within 20 seconds, which makes it very addictive—comparable to opioids, alcohol and cocaine. This "rush" is a major part of the addictive process.

'When the person stops using tobacco, nicotine levels in the brain drop. This change triggers processes that contribute to the cycle of cravings and urges that maintains addiction. Long-term changes in the brain caused by continued nicotine exposure result in nicotine dependence, and attempts to stop cause withdrawal symptoms that are relieved with renewed tobacco use.'

https://www.camh.ca/en/health-info/mental-illness-and-addict...

Re: Lung cancer pill cuts risk of death by half

#73

Post by [deleted] » Sun, Jun 04, 2023, 6:55 PM UTC

londons_explore wrote: post #30

chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

[deleted]

Re: Lung cancer pill cuts risk of death by half

#74

Post by lm28469 » Sun, Jun 04, 2023, 7:07 PM UTC

londons_explore wrote: post #31

londons_explore wrote: post #30

Earlier quoted context omitted.

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

It always surprises me how little effort we put into getting things from the lab to the people quicker. As soon as we have compelling data some discovery (medical or otherwise) might help lots of people, it should be almost a manhattan project type effort to get it into the hands of everyone worldwide asap.

That's not how capitalism works though

Re: Lung cancer pill cuts risk of death by half

#75

Post by giantg2 » Sun, Jun 04, 2023, 7:08 PM UTC

netrus wrote: post #60

giantg2 wrote: post #21

Earlier quoted context omitted.

"1.4% of all cancers" This actually seems large to me. Although that is suspiciously large. Looking at the numbers I think it should be much lower. A 51% reduction doesn't mean it helps 51% if the people. In this case it looks like about 10% of the people are effected given the 88% vs 78% survival rates, right? Maybe something like .28% of all cancer?

I mean, the people who die of cancer are the problem. If 88% survive instead of 78%, 55% of those who would have died survived (taking these numbers just from your comment).

Yes, and?

Re: Lung cancer pill cuts risk of death by half

#76

Post by lm28469 » Sun, Jun 04, 2023, 7:10 PM UTC

chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

With 70 to 90% of cancer being caused by environmental factors I think we have a lot of areas of improvement before reaching for cures

Re: Lung cancer pill cuts risk of death by half

#77

Post by rob74 » Sun, Jun 04, 2023, 7:18 PM UTC

Halfway through the article, they spell out what they mean by "cuts risk of death by half":

> After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo.

...which is still remarkable, but doesn't sound quite as good as "cutting by half".

Re: Lung cancer pill cuts risk of death by half

#78

Post by haldujai » Sun, Jun 04, 2023, 7:31 PM UTC

londons_explore wrote: post #30

chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

Not sure if you're specifically referring to the drug in this article but osimertinib has been FDA approved for ~8 years and has been part of routine clinical practice for quite a while now.

The system is actually really fast at getting promising cancer therapies into the hands of patients, especially when there aren't good alternatives.

Even if something isn't yet approved and the patient is ineligible for a clinical trial, an intervention can be offered to patients under compassionate grounds/special access.

Re: Lung cancer pill cuts risk of death by half

#79

Post by panabee » Sun, Jun 04, 2023, 7:36 PM UTC

londons_explore wrote: post #30

chrisamiller wrote: post #8

This is a great example of where cancer treatment is headed and why it's so hard - namely that cancer isn't one disease, it's many thousands of diseases. This is a drug that targets lung cancer (~12% of cancers) and only one type of lung cancer (non-small cell lung cancer, ~80% of cases). It targets a particular mutated gene that occurs in about 30% of that subtype. And then, about 50% of those patients respond. So d…

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

the FDA face an unenviable challenge: how to promote healthcare innovation without endangering patients?

regulations that are too loose may cause suffering and death while regulations that are too strict will delay or block prevent helpful treatments.

regulating healthcare is extremely difficult and largely a thankless job.

one solution is to approach national healthcare like national security and let people volunteer for treatments like volunteering for the army.

in short, overstate risks but let patients decide.

adopt cigarette-simple consent forms that state in bold words that an experimental treatment is likely to cause death or crippling side-effects like paralysis, blindness, stroke, Alzheimer's, or worse.

perhaps require multiple signatories from family members to guard against irrational behavior.

this protects the FDA while minimizing barriers to innovative therapies and treatments.

Re: Lung cancer pill cuts risk of death by half

#80

Post by dantheman » Sun, Jun 04, 2023, 7:40 PM UTC

panabee wrote: post #79

londons_explore wrote: post #30

Earlier quoted context omitted.

Thats still 1366 people every day worldwide. Think about that... If the committee whose job is approving this medicine get results in on Friday, but don't sit down to approve it till the following Monday, then 4098 people die unnecessarily.

the FDA face an unenviable challenge: how to promote healthcare innovation without endangering patients? regulations that are too loose may cause suffering and death while regulations that are too strict will delay or block prevent helpful treatments. regulating healthcare is extremely difficult and largely a thankless job. one solution is to approach national healthcare like national security and let people voluntee…

Anyone should be allowed to take any medicine that they desire. The FDA can still approve treatments, the problem with the FDA is that forbid patients from access to treatment they desire.