3 ms·
Cancer, like aging, is an example where much of the research community is undertaking very challenging and expensive work with marginal expectation value becaus
by reasonattlm 10y ago
Cancer, like aging, is an example where much of the research community is undertaking very challenging and expensive work with marginal expectation value because that dovetails well with the types of fundamental research that can be funded, not because of any expectation that it is the best approach with the highest expectation value. This is an age of genetics, genetics is popular, and so people are getting funded for personalized medicine and ever more intricate mapping of cellular biology.
But there are hundreds of types of cancer, and taking the genetics/drug discovery approach for each of them is its own distinct and massively expensive undertaking. It'll never get done: the research community and its funding sources are not large enough to make significant progress on the whole of the problem in the next few decades. This isn't hacking cancer, this is hacking the cancer funding institutions in order to obtain funding to get on with the fundamental life science research goal of mapping all of cellular metabolism. Cancer is the excuse, but not the goal.
This is a cultural problem.
Hacking cancer would be to sit down and say, ok, the economics of this are not working, we need to find common points to target, a way to produce a universal cancer therapy at no greater expense than one of these single cancer therapies.
Some immunotherapies, like CAR-T approaches, are a small step in this direction, something that can be applied to multiple cancers with a lower cost of customization per cancer type.
The best target, however, is to block telomere lengthening; disabling both telomerase and alternative lengthening of telomere (ALT) mechanisms. This is a small area of biochemistry in comparison to the scope of most single cancer explorations. All cancers depend on telomerase or ALT or both. All of them. No exceptions. No cancer can evolve its way around a suppression of these mechanisms. It will simply die, losing its ability to replicate uncontrollably. Some noted research groups are making early inroads into disabling telomerase in a targeted way. ALT remains to be dealt with, but is easier to work with than telomerase interdiction by virtue of the fact that ALT doesn't happen in normal cells.
A telomere lengthening interdiction treatment would be applicable to all cancers, and it doesn't appear to be more expensive to develop than any other approach to a specific cancer. That is what hacking cancer research looks like; identifying a way to completely change the economics of the situation, and redirect the primary effort back to producing an effective cures as soon as possible.
Lastly, I have to fundamentally disagree with the final lines of this article; cancer can absolutely be dealt with robustly by killing cancer cells. You just need to be selective enough, early enough, and comprehensive enough, and raising the bar on these items is the whole point of the field.