8 ms·

Every once in a while we get to read similar news, that this 'selective' cancer killer is just arriving. Can someone more knowledgeable in this field comment wh

Every once in a while we get to read similar news, that this 'selective' cancer killer is just arriving. Can someone more knowledgeable in this field comment whether this is just another clickbait article or not?

yazbo_mcclure 10y ago
Word.
quickben 10y ago
I am not a doctor, but from reading, there are many different cells and cancers (ways for these cells to misbehave but still not being killed by the body). As such, there is no singular 'cancer' and no singular 'cancer cure'. I may stand corrected by somebody more knowledgeable though.
- mirsadm 10y ago
  Basically this. Even though there isn't one particular cure all solution, there are many more treatments available which are more effective than in the past.
- berntb 10y ago
  The article discussed finding targets expressed by different cancers. The main problem is that a cancer can be quite heterogeneous. You really need multiple ways of killing a given cancer to be certain all is gone.
- danielbarla 10y ago
  I'm probably not more knowledgeable, but from my understanding, most (all?) cancers are related in that they start as a single mutated cell which replicates in an aggressive way which leads to problems / death. Since it's a mutated cell, I can imagine extracting DNA from the cancerous area, and doing a diff against your "normal" DNA from elsewhere in your body. This would enable you to identify the difference / unique signature of the cancerous cells, kind of how a software antivirus looks for binary patterns in things that it scans. A mechanism like CRISPR could then be used to effectively target all instances of the mutated DNA / cells in your body, effectively wiping it out. I suspect this is ridiculously hand-wavy and oversimplified, but something like this might just be viable in our lifetimes.
  - Waterluvian 10y ago
    I thought that there's constantly countless cells in your body with genetic mutations. Most just have benign effects. I'd better research this a bit more.
    - isp 10y ago
      Interesting keyword to research: "p53". Example (very readable): https://www.amazon.co.uk/dp/B00NB14L6Y https://www.amazon.co.uk/dp/B00NB14L6Y > If a cell makes a mistake in copying its DNA during the process of division, p53 stops it in its tracks, summoning a repair team before allowing the cell to carry on dividing. If the mistake is irreparable and the rogue cell threatens to grow out of control, p53 commands the cell to commit suicide. Cancer cannot develop unless p53 itself is damaged or prevented from functioning normally.
      - Waterluvian 10y ago
        Thank you! That's something I wouldn't have discovered so easily and makes my learning about it much easier.
  - isp 10y ago
    Parts of this are already possible. A challenge, though, is that cancer cells tend to have wildly unstable genomes. Further reading - with good summaries of current thinking: - https://en.wikipedia.org/wiki/Hallmarks_of_cancer https://en.wikipedia.org/wiki/Hallmarks_of_cancer - https://en.wikipedia.org/wiki/Two-hit_hypothesis https://en.wikipedia.org/wiki/Two-hit_hypothesis I think a very interesting research area is to find the core (original, required) mutations involved in a cancer (the current understanding is that normally multiple mutations are required, occurring in a particular progression).
- sjg007 10y ago
  The current hypothesis is that it is similar to bacterial antibiotic escape. Effectively the cells are growing rapidly and acquire mutations. This is why you want to treat with combination chemotherapy. However, there are some big issues. First, we only test drugs in isolation and then sometimes they will try two together after a long long time. This is how leukemia achieved high remission rates back back in the wild wild west days. Today there is a focus on targeted chemotherapies and then of course the holy grail of immunotherapy. I hope we figure out how to program the immune system to great effect. That and viral targeting therapies that use crisper. But these are early days and progress cannot come fast enough.
- cschneid 10y ago
  Also not a doctor, but my dad has lung cancer (never smoked, just a "surprise, stage 4 lung cancer"). Specifically, he has the ALK mutation. This occurs in 3-5% of non small cell lung cancers. He's on an inhibitor drug (a successor to Crizotinib) for this specific mutation. These drugs turned a ~6 month prognosis into a 5 year prognosis. But this set of drugs only works on this specific mutation. The cancer eventually mutates around the drug. State of the art cancer drugs are really amazing, but they're still so far away from a cure.
  - Ralfp 10y ago
    Perhaps this is how we'll eventually manage cancer. By frequent testing and moving from drug to drug as cancer sheds one mutation and adapts other one, turning cancer into manageable state.
    - benjaminjackman 10y ago
      Yep, I think manage is the right way to put it. Fundamentally, viewing cancer as whole bunch of different adaptive adversaries as opposed to a single disease is probably correct. Under that view, consider 'cancer' as the mathematical outcome of the genes in the cells in your body attempting to revert to their fundamentally selfish nature and greedily replicate as much as possible. Every gene in your genome got there because its ancestor genes managed to replicate (though perhaps with a mutation or 2 along the way). So perhaps it's helpful to think of the organism as a giant prison of small bits of self replicating code (genes). Several checks are in place to ensure that no bit of code replicates beyond sane bounds. However every once in a while a guard get's knocked out or cellblock door switch is left unattended, or a prisoner disguises itself, or groups up with another to overpower or sidestep an existing control mechanism. And then it's off to the races. Higher levels of control can attempt to rectify the situation, but they can fail as well. Given that your body has 100 trillion cells, and about 20 thousand genes. You are talking about a 2 quintillion protein synthesizing programs executing, all of them are there for one reason, they had ancestors that were able to reproduce themselves. They don't have any notion of a greater good, or a serving their purpose or any of that. They can't be reasoned with, they are an adaptive chemical reaction, that either doesn't replicate, or does (and perhaps so much so that it takes down the whole system). So a lot of cancer treatment are going to revolve around, at our level of technology: - the ability to target specific classes of cells with certain noisy markers, which may or may not be reachable and with a lot of collateral damage and which contain the errant genes and killing them. (e.g. clusters of cells showing up as a visible tumor in an x-ray, cells having certain chemical signatures) - the ability to deprive (all or better yet classes of) cells of what they need to replicate to slow them down and potentially eventually have them die off taking the cancerous genes with them. - the ability to shore-up or reactivate compromised internal defenses. As well as prevention methods such as: - avoiding weakening systems that protect against replication (e.g. ) - avoiding encouraging massive amounts of mutation (e.g. repetitive inflammation or free radicals or radiation exposure like UV rays or cesium-137 ) ...etc Are any one of these things going to cure cancer? No, they aren't anymore than telling C programmer to use strncpy instead of strcpy is going to stop all buffer overflow attacks, which in turn prevents remote code execution, which in turn prevents botnets. Or marking all attachments to emails as un-executable is going to stop all computer viruses. But every bit helps, and saves countless lives, gradually this wack-a-mole approach has shown results. In the future, perhaps it'll be possible to solve cancer by scanning every cell in the body and selectively eliminating cells that fail some basic sanity checks. We aren't at that point yet, but if we were we would have a pretty effective cancer treatment. It would be adding another (very effective) layer on top of all the other systems walking the day to day beat and slowing stuff down. I'd hesitate to call it a cure though, because if it was halted it would just be a matter of time until one of the selfish genes blindly do their replication thing a little to well for everyone's good.
deleted 10y ago
[deleted]
kweks 10y ago
I've been closely following (and full disclaimer: have invested in) this company: http://www.snopes.com/scientists-find-australian-berry-can-cure-cancer-48-hours/ http://www.snopes.com/scientists-find-australian-berry-can-c... Their results for tumours are startling: once applied, the tumours fall off within days with no scarring, or damage to original hair follicles, etc. If I hadn't seen it for myself, I wouldn't believe it. They're up to human trials - it will be fascinating to see if it can come to fruition.
- JPLeRouzic 10y ago
  I am not sure to fully understand the article, but does it only apply to cancers that appear on skin?
raincom 10y ago
CAR-T therapy works in certain leukemias(blood related, hematological cancers). Yes, it works, but side effects can kill the patients due to cytokine storms. Recently, Juno therapeutics stopped one of the trials. We don't have a general 'cure' for all kinds of cancers.
marcosdumay 10y ago
I'm not that knowledgeable, but I've been following it. My impression is that it's quite boring. Most treatments fail at later stages, and nobody talks about them anymore, some treatments are successful and get to market, what means that chemo for a kind of cancer now has less collateral effects, and a higher surviving rate. Nothing has a huge, world changing impact the press makes claims it would have. Keep repeating that, and you get the nice increasing survival rates for cancer you see on the statistics... What is a huge world changing impact, but only in aggregate.
- vidar 10y ago
  To put it in startup terms, no silver bullit. Just a bunch of lead bullits. (cc Ben Horowitz)
DamnYuppie 10y ago
There are several companies that are doing some interesting work in this are. Check out www.cuebiopharma.com. They essentially take a sample of the cancer, then generate antibodies from the patient to attach it. It is a simple injection, no chemo, no surgery. They have been showing very impressive results with this treatment. It will not work on all cancers though, I believe liver.
searine 10y ago
This type of therapy (engineered cells) has been discussed for a long time but has yet to hit the mainstream. This trial is the first hit at that kind of mainstream success. The problems with this type of approach are 1. Safety 2. Cost and 3. Target. Gene therapy (and engineered cells) has a long history of deadly accidents. Before we start injecting people with engineered cells we need to be absolutely sure that those cells aren't going to turn into cancer themselves (or who knows what else). Results so far have been promising. This is niche personalized medicine, as a result it is extremely expensive. These cells need to be customized for each patient. However, considering what's at stake, it may be worth the it. As the article states, the target is a problem. Leukemia and Lymphoma are easy targets compared to more truculent solid tumors. For this to cause a revolution in cancer research it needs to be able to address a wider swath of cancers (not just blood cancers). Tl;DR : This is an incremental step along a new path. Another promising tool in growing toolbox.

yazbo_mcclure 10y ago

Word.

quickben 10y ago

I am not a doctor, but from reading, there are many different cells and cancers (ways for these cells to misbehave but still not being killed by the body). As such, there is no singular 'cancer' and no singular 'cancer cure'. I may stand corrected by somebody more knowledgeable though.

mirsadm 10y ago
Basically this. Even though there isn't one particular cure all solution, there are many more treatments available which are more effective than in the past.
berntb 10y ago
The article discussed finding targets expressed by different cancers. The main problem is that a cancer can be quite heterogeneous. You really need multiple ways of killing a given cancer to be certain all is gone.
danielbarla 10y ago
I'm probably not more knowledgeable, but from my understanding, most (all?) cancers are related in that they start as a single mutated cell which replicates in an aggressive way which leads to problems / death. Since it's a mutated cell, I can imagine extracting DNA from the cancerous area, and doing a diff against your "normal" DNA from elsewhere in your body. This would enable you to identify the difference / unique signature of the cancerous cells, kind of how a software antivirus looks for binary patterns in things that it scans. A mechanism like CRISPR could then be used to effectively target all instances of the mutated DNA / cells in your body, effectively wiping it out. I suspect this is ridiculously hand-wavy and oversimplified, but something like this might just be viable in our lifetimes.
- Waterluvian 10y ago
  I thought that there's constantly countless cells in your body with genetic mutations. Most just have benign effects. I'd better research this a bit more.
  - isp 10y ago
    Interesting keyword to research: "p53". Example (very readable): https://www.amazon.co.uk/dp/B00NB14L6Y https://www.amazon.co.uk/dp/B00NB14L6Y > If a cell makes a mistake in copying its DNA during the process of division, p53 stops it in its tracks, summoning a repair team before allowing the cell to carry on dividing. If the mistake is irreparable and the rogue cell threatens to grow out of control, p53 commands the cell to commit suicide. Cancer cannot develop unless p53 itself is damaged or prevented from functioning normally.
    - Waterluvian 10y ago
      Thank you! That's something I wouldn't have discovered so easily and makes my learning about it much easier.
- isp 10y ago
  Parts of this are already possible. A challenge, though, is that cancer cells tend to have wildly unstable genomes. Further reading - with good summaries of current thinking: - https://en.wikipedia.org/wiki/Hallmarks_of_cancer https://en.wikipedia.org/wiki/Hallmarks_of_cancer - https://en.wikipedia.org/wiki/Two-hit_hypothesis https://en.wikipedia.org/wiki/Two-hit_hypothesis I think a very interesting research area is to find the core (original, required) mutations involved in a cancer (the current understanding is that normally multiple mutations are required, occurring in a particular progression).
sjg007 10y ago
The current hypothesis is that it is similar to bacterial antibiotic escape. Effectively the cells are growing rapidly and acquire mutations. This is why you want to treat with combination chemotherapy. However, there are some big issues. First, we only test drugs in isolation and then sometimes they will try two together after a long long time. This is how leukemia achieved high remission rates back back in the wild wild west days. Today there is a focus on targeted chemotherapies and then of course the holy grail of immunotherapy. I hope we figure out how to program the immune system to great effect. That and viral targeting therapies that use crisper. But these are early days and progress cannot come fast enough.
cschneid 10y ago
Also not a doctor, but my dad has lung cancer (never smoked, just a "surprise, stage 4 lung cancer"). Specifically, he has the ALK mutation. This occurs in 3-5% of non small cell lung cancers. He's on an inhibitor drug (a successor to Crizotinib) for this specific mutation. These drugs turned a ~6 month prognosis into a 5 year prognosis. But this set of drugs only works on this specific mutation. The cancer eventually mutates around the drug. State of the art cancer drugs are really amazing, but they're still so far away from a cure.
- Ralfp 10y ago
  Perhaps this is how we'll eventually manage cancer. By frequent testing and moving from drug to drug as cancer sheds one mutation and adapts other one, turning cancer into manageable state.
  - benjaminjackman 10y ago
    Yep, I think manage is the right way to put it. Fundamentally, viewing cancer as whole bunch of different adaptive adversaries as opposed to a single disease is probably correct. Under that view, consider 'cancer' as the mathematical outcome of the genes in the cells in your body attempting to revert to their fundamentally selfish nature and greedily replicate as much as possible. Every gene in your genome got there because its ancestor genes managed to replicate (though perhaps with a mutation or 2 along the way). So perhaps it's helpful to think of the organism as a giant prison of small bits of self replicating code (genes). Several checks are in place to ensure that no bit of code replicates beyond sane bounds. However every once in a while a guard get's knocked out or cellblock door switch is left unattended, or a prisoner disguises itself, or groups up with another to overpower or sidestep an existing control mechanism. And then it's off to the races. Higher levels of control can attempt to rectify the situation, but they can fail as well. Given that your body has 100 trillion cells, and about 20 thousand genes. You are talking about a 2 quintillion protein synthesizing programs executing, all of them are there for one reason, they had ancestors that were able to reproduce themselves. They don't have any notion of a greater good, or a serving their purpose or any of that. They can't be reasoned with, they are an adaptive chemical reaction, that either doesn't replicate, or does (and perhaps so much so that it takes down the whole system). So a lot of cancer treatment are going to revolve around, at our level of technology: - the ability to target specific classes of cells with certain noisy markers, which may or may not be reachable and with a lot of collateral damage and which contain the errant genes and killing them. (e.g. clusters of cells showing up as a visible tumor in an x-ray, cells having certain chemical signatures) - the ability to deprive (all or better yet classes of) cells of what they need to replicate to slow them down and potentially eventually have them die off taking the cancerous genes with them. - the ability to shore-up or reactivate compromised internal defenses. As well as prevention methods such as: - avoiding weakening systems that protect against replication (e.g. ) - avoiding encouraging massive amounts of mutation (e.g. repetitive inflammation or free radicals or radiation exposure like UV rays or cesium-137 ) ...etc Are any one of these things going to cure cancer? No, they aren't anymore than telling C programmer to use strncpy instead of strcpy is going to stop all buffer overflow attacks, which in turn prevents remote code execution, which in turn prevents botnets. Or marking all attachments to emails as un-executable is going to stop all computer viruses. But every bit helps, and saves countless lives, gradually this wack-a-mole approach has shown results. In the future, perhaps it'll be possible to solve cancer by scanning every cell in the body and selectively eliminating cells that fail some basic sanity checks. We aren't at that point yet, but if we were we would have a pretty effective cancer treatment. It would be adding another (very effective) layer on top of all the other systems walking the day to day beat and slowing stuff down. I'd hesitate to call it a cure though, because if it was halted it would just be a matter of time until one of the selfish genes blindly do their replication thing a little to well for everyone's good.

deleted 10y ago

[deleted]

kweks 10y ago

I've been closely following (and full disclaimer: have invested in) this company: http://www.snopes.com/scientists-find-australian-berry-can-cure-cancer-48-hours/ http://www.snopes.com/scientists-find-australian-berry-can-c... Their results for tumours are startling: once applied, the tumours fall off within days with no scarring, or damage to original hair follicles, etc. If I hadn't seen it for myself, I wouldn't believe it. They're up to human trials - it will be fascinating to see if it can come to fruition.

JPLeRouzic 10y ago
I am not sure to fully understand the article, but does it only apply to cancers that appear on skin?

raincom 10y ago

CAR-T therapy works in certain leukemias(blood related, hematological cancers). Yes, it works, but side effects can kill the patients due to cytokine storms. Recently, Juno therapeutics stopped one of the trials. We don't have a general 'cure' for all kinds of cancers.

marcosdumay 10y ago

I'm not that knowledgeable, but I've been following it. My impression is that it's quite boring. Most treatments fail at later stages, and nobody talks about them anymore, some treatments are successful and get to market, what means that chemo for a kind of cancer now has less collateral effects, and a higher surviving rate. Nothing has a huge, world changing impact the press makes claims it would have. Keep repeating that, and you get the nice increasing survival rates for cancer you see on the statistics... What is a huge world changing impact, but only in aggregate.

vidar 10y ago
To put it in startup terms, no silver bullit. Just a bunch of lead bullits. (cc Ben Horowitz)

DamnYuppie 10y ago

There are several companies that are doing some interesting work in this are. Check out www.cuebiopharma.com. They essentially take a sample of the cancer, then generate antibodies from the patient to attach it. It is a simple injection, no chemo, no surgery. They have been showing very impressive results with this treatment. It will not work on all cancers though, I believe liver.

searine 10y ago

This type of therapy (engineered cells) has been discussed for a long time but has yet to hit the mainstream. This trial is the first hit at that kind of mainstream success. The problems with this type of approach are 1. Safety 2. Cost and 3. Target. Gene therapy (and engineered cells) has a long history of deadly accidents. Before we start injecting people with engineered cells we need to be absolutely sure that those cells aren't going to turn into cancer themselves (or who knows what else). Results so far have been promising. This is niche personalized medicine, as a result it is extremely expensive. These cells need to be customized for each patient. However, considering what's at stake, it may be worth the it. As the article states, the target is a problem. Leukemia and Lymphoma are easy targets compared to more truculent solid tumors. For this to cause a revolution in cancer research it needs to be able to address a wider swath of cancers (not just blood cancers). Tl;DR : This is an incremental step along a new path. Another promising tool in growing toolbox.