3 ms·
So I'm looking back over what he wrote: > Immune therapies, which seek to stimulate immune responses to cancer, have generated enormous excitement. Two researc
by mrosett 7y ago
So I'm looking back over what he wrote:
> Immune therapies, which seek to stimulate immune responses to cancer, have generated enormous excitement. Two researchers won the 2018 Nobel Prize for work related to immune therapies, and a new book, The Breakthrough: Immunotherapy and the Race to Cure Cancer, claims that they represent a “revolutionary discovery in our understanding of cancer and how to beat it.”
> According to a 2018 report in Stat News, drugs firms aggressively market immune therapies, and patients are “pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.” A 2017 analysis by oncologists Nathan Gay and Vinay Prasad estimated that fewer than 10 percent of cancer patients can benefit from immune therapies, and that is a “best-case scenario.”
Perhaps he's implicitly acknowledging that there are benefits, but in an article that essentially claims that cancer treatment doesn't accomplish anything, I interpreted it as being dismissive of the benefits. Maybe your reading of it is more reasonable.
The analysis underlying the 10% figure is basically correct. In fact, I think that article [0] is a narrower form of what this article would be if it were better: a harsh acknowledgment that immunotherapy, as the most meaningful breakthrough in the last couple decades, is being overhyped. The benefits are real, but writing books about it with subtitles like "The race to cure cancer" is deeply irresponsible.
Again, though, it's a matter of interpretation. They derived that 10% figure basically by multiplying: ~31% of cancers have approved use for immunotherapy, and it averages a 26% response rate. That 31% is a bunch of solid tumor cancers that didn't really have any particularly effective options beforehand. So for the 1/3 of least tractable cancers (~600k cases per year in the US), we now have something that benefits a quarter of patients. Is that enough? No. But it's still pretty amazing.
[0] https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/ https://www.statnews.com/2017/03/08/immunotherapy-cancer-bre...
- DFHippie 7y agoMy understanding is that immunotherapy has been shown to work great for cancers without solid tumors and results have been disappointing with solid tumors. It isn't that it's marching steadily forward and will eventually have been shown successfully everywhere. I think people running down John Horgan's editorial keep citing successes -- multiple myeloma! cured! -- but aren't addressing his overarching argument, which, as I understand it, is that people are being sold false hope in the majority of cases -- familiar cancers like breast cancer, lung cancer, prostate cancer, colo-rectal cancer -- which has the negative consequences of impoverishing them and increasing their suffering for negligible benefit. To be clear, I don't have any horse in this race aside from insurance bills.
- mrosett 7y agoMost of the indications for immunotherapy are cancers with solid tumors. This source [0] is a bit dated (2017) but it contains a chart showing which cancers had an indication for immunotherapy at the time, and they're almost all solid tumors. The initial approvals for the big immunotherapy drugs were for melanoma and non-small cell lung cancer. [0] https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/ https://www.statnews.com/2017/03/08/immunotherapy-cancer-bre...
- nonbel 7y ago2017 is a bit dated?
- mrosett 7y agoThe first immunotherapy was approved in March 2011. An article from 2017 listing diseases with approved immunotherapies misses fully 1/3 of the years (3 out of 9) in which immunotherapies have been approved.
- nonbel 7y agoMakes some sense, but that got me wondering if medical guidelines are going to start getting updates every few weeks like web browsers do.