4 ms·

Do you study biochemistry or medicine? Because it would seem that your first point is completely true but technically an oversimplification when it comes to tre

by mehrzad 11y ago

Do you study biochemistry or medicine? Because it would seem that your first point is completely true but technically an oversimplification when it comes to treatment of common cancers. https://en.wikipedia.org/wiki/Asparaginase#As_a_drug https://en.wikipedia.org/wiki/Asparaginase#As_a_drug https://en.wikipedia.org/wiki/Bcr-Abl_tyrosine-kinase_inhibitor https://en.wikipedia.org/wiki/Bcr-Abl_tyrosine-kinase_inhibi...

suchire 11y ago
Those are classic success stories mainly because they were the low-hanging fruit for targeted cancer treatment. For blood-cell cancers like leukemia and lymphoma, treatment has come a long way due to advances like the ones you mentioned. For "solid" tumor cancers like breast, pancreatic, prostate, and skin cancer, we're still struggling to make a dent in the death rate.
- frozenport 11y ago
  Lets distinguish between diagnosis and treatment. Many cancers can be identified by the over-expression of genes or other genetic material. This knowledge is immediately useful to clinical staff. Although its hard to use this information to target specific cells, it hints at mechanisms that are of interest to academic research.
- bsder 11y ago
  > For "solid" tumor cancers like breast, pancreatic, prostate, and skin cancer, we're still struggling to make a dent in the death rate. Actually, we are not "struggling" on breast cancer. The death rate comes down a reasonable percentage each year. It's just that a small percentage compounds slower and slower once you take out the low hanging fruit. As you point out, the problem is that cancer isn't just one disease with one mechanism. Even "breast" cancer isn't just one disease with one mechanism. So, it's not terribly profitable to go after say "cancer X with mutations P, D, and Q". This really needs government funding. We'd have been far better off with a governmental "War on Cancer" than on any of the other "War on X" that they've done.
  - danieltillett 11y ago
    >So, it's not terribly profitable to go after say "cancer X with mutations P, D, and Q". This really needs government funding. This is one of the key problems. The effective size of most true cancers types is so small that pharmaceutical companies can’t make a profit developing a drug that targets these cancers. Imagine you identify a new drug that 100% cures people with a cancer that has three specific mutations. Now lets assume that out of the millions of people who get cancer each year only 500 have this particular combinations of mutations. This drug will cost the same as any other drug to develop (lets assume $1 billion), but you can only sell it to 500 people per year. Even if you set the price at $100,000 per person you don’t come close to earning enough money to pay back the development costs. Add in the fact that very few drugs make it through the whole development process you can see why we have a problem.
    - astazangasta 11y ago
      This is not as big a problem as: 1. Enrolling enough people in a trial to prove you can cure with a combination therapy 2. Evolved resistance with an entirely new set of mutations
      - danieltillett 11y ago
        Well these two problems are technical problems that can only occur if the key economic problem can be overcome. You can only have issues with enrolling people in a trial if the trial is at least attempted. The current thinking is that cancers are not evolving for resistance during treatment, but that there are a sub-population of cells present in the tumour mass that are being selected for by treatment (i.e. we kill 99% of the tumour that is sensitive and the 1% that is resistant grows back). We know how to solve this problem from HIV. HIV evolves resistance to drugs faster than any cancer yet we can treat patients for years by using HAART (i.e. give lots of drugs at once that target different key components). We need to do this with cancer, but this will require developing new drugs that are less lethal since you can't just give a patient a dozen standard anti-cancer drugs and expect them to live.

by mehrzad 11y ago

suchire 11y ago

Those are classic success stories mainly because they were the low-hanging fruit for targeted cancer treatment. For blood-cell cancers like leukemia and lymphoma, treatment has come a long way due to advances like the ones you mentioned. For "solid" tumor cancers like breast, pancreatic, prostate, and skin cancer, we're still struggling to make a dent in the death rate.

frozenport 11y ago
Lets distinguish between diagnosis and treatment. Many cancers can be identified by the over-expression of genes or other genetic material. This knowledge is immediately useful to clinical staff. Although its hard to use this information to target specific cells, it hints at mechanisms that are of interest to academic research.
bsder 11y ago
> For "solid" tumor cancers like breast, pancreatic, prostate, and skin cancer, we're still struggling to make a dent in the death rate. Actually, we are not "struggling" on breast cancer. The death rate comes down a reasonable percentage each year. It's just that a small percentage compounds slower and slower once you take out the low hanging fruit. As you point out, the problem is that cancer isn't just one disease with one mechanism. Even "breast" cancer isn't just one disease with one mechanism. So, it's not terribly profitable to go after say "cancer X with mutations P, D, and Q". This really needs government funding. We'd have been far better off with a governmental "War on Cancer" than on any of the other "War on X" that they've done.
- danieltillett 11y ago
  >So, it's not terribly profitable to go after say "cancer X with mutations P, D, and Q". This really needs government funding. This is one of the key problems. The effective size of most true cancers types is so small that pharmaceutical companies can’t make a profit developing a drug that targets these cancers. Imagine you identify a new drug that 100% cures people with a cancer that has three specific mutations. Now lets assume that out of the millions of people who get cancer each year only 500 have this particular combinations of mutations. This drug will cost the same as any other drug to develop (lets assume $1 billion), but you can only sell it to 500 people per year. Even if you set the price at $100,000 per person you don’t come close to earning enough money to pay back the development costs. Add in the fact that very few drugs make it through the whole development process you can see why we have a problem.
  - astazangasta 11y ago
    This is not as big a problem as: 1. Enrolling enough people in a trial to prove you can cure with a combination therapy 2. Evolved resistance with an entirely new set of mutations
    - danieltillett 11y ago
      Well these two problems are technical problems that can only occur if the key economic problem can be overcome. You can only have issues with enrolling people in a trial if the trial is at least attempted. The current thinking is that cancers are not evolving for resistance during treatment, but that there are a sub-population of cells present in the tumour mass that are being selected for by treatment (i.e. we kill 99% of the tumour that is sensitive and the 1% that is resistant grows back). We know how to solve this problem from HIV. HIV evolves resistance to drugs faster than any cancer yet we can treat patients for years by using HAART (i.e. give lots of drugs at once that target different key components). We need to do this with cancer, but this will require developing new drugs that are less lethal since you can't just give a patient a dozen standard anti-cancer drugs and expect them to live.