3 ms·

1) Aside from significant increase in cost and experiment turn-around time, there's a more basic question: if you don't use a replicable and scalable model of

1) Aside from significant increase in cost and experiment turn-around time, there's a more basic question: if you don't use a replicable and scalable model of the disease, how do you induce the cancer you're interested in studying? Wait around for one of ~5000 mice to develop pancreatic cancer? 2) There's already significant efforts underway to sequence many thousands of human tumors (e.g. you probably know about TCGA). Once the cost drops a bit more, then it might be feasible to sequence all tumors. However, a pathologist can still tell you quite a bit that's hard to reverse-engineer from sequencing (e.g. does the cell look like a melanocyte?). Classifying by tissue of origin (+ the ontology of cancer subtypes) does actually capture a lot of the variation between cancers. Sequencing adds a little on top of that, but surprisingly not as much as people hoped. For example, how often can you predict actionable drug sensitivity from RNAseq or WES? In my experience so far, there's only even the possibility of clinical benefit in a small number of special cases (e.g. BRAF V600E). 3) Newly diagnosed patients often have great treatment options! Do you really want to RCTs with placebo arms on stage I breast cancer patients? 4) "Go all out on the immune approach" there's been a huge boost of funding in that direction (by the NCI/NIH and private donors like Sean Parker). "with an emphasis on developing treatments with minimal side-effects that can be given to healthy people as a preventative treatment." That's an interesting idea and I don't know who's working on it. Write it up as a grant proposal and send it to the CRI?

danieltillett 11y ago
Glad to be getting some thoughtful responses rather than idiotic down votes. 1. Basically yes, although I would centralise the breeding of mice and then farm them out to researchers as they developed each of the different cancers. Another option that we are not making as much use of as we can is natural cancer in human pets. We have millions of dogs and cats developing natural cancers that we could use. 2. Yes sequencing has not shown the promise for treatment that we hoped, but that is because the treatments we have were not developed with genomic data. It doesn't matter how much you know about a cancer if you don't have any tools to actually attack the weaknesses identified. We need to use the genomic data to indentify weaknesses, then use these identified weaknesses to screen for new treatments. The best targets will be those genes that are not normally expressed in adult tissue that are expressed in cancer tissue. When I was an academic I had a student look into this area and there are literally hundreds of genes that are regularly expressed in cancer that are not expressed in adults. These are perfect targets for immune treatments provided you have enough of them to draw on. 3. Actually most newly diagnosed patients have deceptively great treatment options. For most cancers most of our treatments are just delaying tactics, not curative. Anyway for those few cancers where we have great curative cancers treatments are not the areas that I would start on. 4. Many people have tried to get funding in this area without success. You appear to know something about the funding process so you would know that any such grant would fail to get funded. Because of the needs for a proper animal model infrustucture it would not be possible to do anyway. I would rather concentrate on getting the animal models right before working on any new treatments.
- carterehsmith 11y ago
  People downvote because you come across as either a dummy, or a snake oil peddler. Based on your blog, you know about PHP, Windows... That is great, but does not exactly qualify you to be NHS czar. If you think it does, well... good luck.
  - danieltillett 11y ago
    I actually know about a lot of things :) I am actually a former tenured academic scientist in the School of Pharmacy and Applied Science at Latrobe University here in Australia. I currently run a genomics software company (Nucleics). Cancer is one area I have had an active research interest in over the years and have thought a lot about these questions. While I may be wrong I hope I am not a dummy.
- minthd 11y ago
  You say that one key is experimenting on pets(which will have huge barriers in the west). In china, eating dogs is legal.So why haven't we seen such research coming from china, and especially successful drugs from there?
  - danieltillett 11y ago
    Actually there has been some research into cancer treatment using pets in the west, just not as much as we should be doing [1]. We really need to organise all the pets into clinical trials of new treatments. People have done surveys of pet owners and most people are happy for their pet to participate in such trials especially if they know that they are helping human research and other pets. We just need to start using this amazing resource rather than giving mice artificial cancers. As for why more research has not come out of China, a lot of really interesting research is going on right now in China, it will just take a little time to filter out to us in the west. Drug development is a 15 to 20 year journey and China has only recently entered this domain. 1. http://vetmed.illinois.edu/translational-cancer-research-benefits-dogs-and-people/ http://vetmed.illinois.edu/translational-cancer-research-ben...

danieltillett 11y ago

Glad to be getting some thoughtful responses rather than idiotic down votes. 1. Basically yes, although I would centralise the breeding of mice and then farm them out to researchers as they developed each of the different cancers. Another option that we are not making as much use of as we can is natural cancer in human pets. We have millions of dogs and cats developing natural cancers that we could use. 2. Yes sequencing has not shown the promise for treatment that we hoped, but that is because the treatments we have were not developed with genomic data. It doesn't matter how much you know about a cancer if you don't have any tools to actually attack the weaknesses identified. We need to use the genomic data to indentify weaknesses, then use these identified weaknesses to screen for new treatments. The best targets will be those genes that are not normally expressed in adult tissue that are expressed in cancer tissue. When I was an academic I had a student look into this area and there are literally hundreds of genes that are regularly expressed in cancer that are not expressed in adults. These are perfect targets for immune treatments provided you have enough of them to draw on. 3. Actually most newly diagnosed patients have deceptively great treatment options. For most cancers most of our treatments are just delaying tactics, not curative. Anyway for those few cancers where we have great curative cancers treatments are not the areas that I would start on. 4. Many people have tried to get funding in this area without success. You appear to know something about the funding process so you would know that any such grant would fail to get funded. Because of the needs for a proper animal model infrustucture it would not be possible to do anyway. I would rather concentrate on getting the animal models right before working on any new treatments.

carterehsmith 11y ago
People downvote because you come across as either a dummy, or a snake oil peddler. Based on your blog, you know about PHP, Windows... That is great, but does not exactly qualify you to be NHS czar. If you think it does, well... good luck.
- danieltillett 11y ago
  I actually know about a lot of things :) I am actually a former tenured academic scientist in the School of Pharmacy and Applied Science at Latrobe University here in Australia. I currently run a genomics software company (Nucleics). Cancer is one area I have had an active research interest in over the years and have thought a lot about these questions. While I may be wrong I hope I am not a dummy.
minthd 11y ago
You say that one key is experimenting on pets(which will have huge barriers in the west). In china, eating dogs is legal.So why haven't we seen such research coming from china, and especially successful drugs from there?
- danieltillett 11y ago
  Actually there has been some research into cancer treatment using pets in the west, just not as much as we should be doing [1]. We really need to organise all the pets into clinical trials of new treatments. People have done surveys of pet owners and most people are happy for their pet to participate in such trials especially if they know that they are helping human research and other pets. We just need to start using this amazing resource rather than giving mice artificial cancers. As for why more research has not come out of China, a lot of really interesting research is going on right now in China, it will just take a little time to filter out to us in the west. Drug development is a 15 to 20 year journey and China has only recently entered this domain. 1. http://vetmed.illinois.edu/translational-cancer-research-benefits-dogs-and-people/ http://vetmed.illinois.edu/translational-cancer-research-ben...