12 ms·

We’re a Lot Better at Fighting Cancer Than We Realized

202 points by dnetesn 6y ago

deleted 6y ago
[deleted]
dstick 6y ago
So if I summarize correctly they re-evaluated already “FDA passed” but abandoned substances for anti-cancer workings using new techniques (CRISPR) and got 50 hits. That’s amazing! Would this work in other fields as well?
- gumby 6y ago
  There’s a specific regulatory pathway for this process, section 505(b)(2). It allows you to use the safety data for the approved treatments which can save you a lot of time and money (I have used this route for a drug myself T one of my companies). You still have to prove that your formulation is safe,of course, and prove efficacy for the situation you intend to market it for.
  - dstick 6y ago
    Gotcha, and that makes sense. Seems like a big time saver regardless. Are we talking months or years, that are shaved off?
    - gumby 6y ago
      Typically years. We had a program for a drug that caused bladder cancer in rats. The original mfr had spent a couple of years figuring out that it was specific to rats. I think the current stats are that the average drug time to approval is 14 years.
- iskander 6y ago
  That's a good summary but it's missing the context that these kinds of "hits" will most likely fail clinical trials. Many drugs look good at this stage in preclinical development and almost none of them show both safety (ph1 trial) and efficacy (ph3 trial). There aren't actually that many low hanging therapeutic fruit out there, mostly we have to actually do the work to discover new mechanisms and make new compounds to target them.
  - dstick 6y ago
    It read like that would be different here, using the new method, wouldn’t it? Or did I misunderstand that?
    - iskander 6y ago
      The genes essential for cancer cells to grow in vitro could easily be quite different from those required to establish the tumor micro-environment, invade new tissues and fight off the immune system. They'll have many false negatives from the mismatch in context. Simultaneously, they might have false positives from e.g. differences in layout and density of tumor cells (2D/uniform vs. 3D heterogeneous tumor). And even if they get the right targets, finding drugs with an effective therapeutic index is hard. This might be a useful screening technique...but it's not the first high throughput screening method. They might have some successes, only trials will tell.
deleted 6y ago
[deleted]
trynewideas 6y ago
From a science and pharmaceutical perspective, maybe. As the partner of someone in the US dealing with stage 4 cancer in their 40s, who has two hospitals fighting with each other over whether to keep using a chemo drug that's sent them into anaphylactic shock twice in two rounds of chemo because it's _more convenient_ for the infusion clinic to administer, and all of that currently held up by pre-approval from a relative-to-the-rest-of-US good insurance company that's still already allowed $40,000 of in-network medical bills to hit us in just 5 weeks since diagnosis all after hitting the supposed out-of-pocket max? From a cancer that had been misdiagnosed as an infection, an iron deficiency, and a benign tumor for four months prior, to give it a massive head start? That headline can fuck right and completely off. We might be good at finding new drugs that can fight cancer, but societally we're absolutely shit at fighting this disease.
- drocer88 6y ago
  U.S. cancer treatment is the best in the world. The greatest research, innovation and results[1] happen in America. These are products of American Society. American Society is actually pretty good at fighting this disease. We devote huge resources to preventing, diagnosing and treating and have made great progress. The CAR T-Cell innovations are very promising and American research is making it work. Families often face tragedy but U.S. Medicine is leading the world in this fight. [1] https://worldpopulationreview.com/country-rankings/cancer-survival-rates-by-country https://worldpopulationreview.com/country-rankings/cancer-su... .
  - izacus 6y ago
    From a pure conversational/social/emotional perspective, you maybe shouldn't lecture someone who's actually going through the first hand experience with the disease.
    - drocer88 6y ago
      Most families deal with cancer at some time. Few are unaffected. Maybe we need focus on the hard part of fixing things. We can acknowledge emotions, get moderation of opinions and celebrate empathy but we need measurable results. U.S. Society is delivering on these.
jcims 6y ago
I was forced to dive headlong into understanding cancer therapy 2 1/2 years ago. It was obvious at the time that this was the correct direction to head, developing an entire therapeutic ecosystem to give the body every possible advantage and assail the disease with every possible disadvantage in order to get the desired outcome. However, what I saw was a rather bizarre and disturbing fetish in the pharmaceutical and medical communities for ‘monotherapies’. I believe I understand the allure, if you find one thing that works, the proverbial silver bullet, that’s the best case scenario for treatment. It’s also quite obviously the best case for shareholders and investors, but let’s set that aside for now. For the sake of future patients, I do hope that medicine and regulators deprioritize the search for monotherapies and receive the type of analysis represented in this article with open arms. In particular, I hope that the ’standard of care’ is given some flexibility so that doctors are able to adopt low risk adjunct therapies in order to improve outcomes and the amount of data available for continued research and improvement of treatment plans.
- tornato7 6y ago
  I've been impressed by the "therapudic ecosystem" developed for coronavirus in the absence of a 'monotherapy'. The MATH+ treatment is an effective combination of available drugs and vitamins. I hope any future COVID drug is used alongside these options, instead of a "here's an expensive drug, now go home!" Approach that some treatments take.
  - copperx 6y ago
    MATH+ seems to me like throwing everything and the kitchen sink into the disease, which screams “we don’t really know what we’re doing.” I haven’t seen replication efforts, and the doctor who’s peddling it once claimed to cure sepsis with IV vitamin C, an effort that failed to do much when replicated. It doesn’t look like a serious approach.
- iskander 6y ago
  Re: monotherapies. This hasn't been my experience. Almost all chemotherapy regimens are combination cocktails (e.g. R-CHOP, CMF, FOLFIRINOX, &c) And as soon as a drug is shown to be very potent on its own (e.g. aPD1/aPDL1 checkpoint blockade) there's an explosion of trials looking to combine it with every possible other mechanism. However, there is a strong desire to see drugs do something on their own before combining them with something else.
iskander 6y ago
Drug repurposing for cancer is a neat and vaguely plausible idea that's been eating up attention and grant funding for a decade now, without any successes in clinical trials.
- TaupeRanger 6y ago
  Precisely. The title is frankly appalling.
ne01 6y ago
There is a tendency to fight our way out of every problem. But what we truly need is to accept the problem, take responsibility and look for the root cause. That is true “fighting”. But most try to destroy the symptoms so they can continue their path and usually continue the root cause. Of course finding the root cause is not easy and it takes one to study oneself I highly recommend the following book to everyone (including the “healthy”) The 12 Stages of Healing: A Network Approach to Wholeness Book by Donald M. Epstein and Nathaniel Altman
- _jahh 6y ago
  while I'd be the last to say root approach should be discounted (diet, lack of exercise, smokes, and bad sleep contributing more to bad outcomes that just about anything else), I worry that the thinking in this post can be used to judge people who have cancer for their actions when unfortunately the true root cause for many people is actions taken long before they're born because of environmental exposure. So while yes most everyone could benefit from more self study some cancerous situations require vigorous assault on the symptoms, like death.
  - dstick 6y ago
    Agreed, and even then, doesn’t cancer “just happen”? There’s a BRCA2 gene defect in my family (that I’m lucky enough not to have inherited) and that increases the likelyhood of developing breast cancer to 80% for women and prostate cancer to ~20% for men. But to the best of my knowledge, everyone has an innate %, just by virtue of being alive.
- deleted 6y ago
  [deleted]
the-dude 6y ago
I am instantly reminded of Lou Reed's "Magic and Loss". Not easy to listen to the first few times. Learned to appreciate. Much later on I lost a loved one to acute leukemia. At least there was no months long struggle.
tyingq 6y ago
Fair enough, but cancer is a broad term. There are still many cancers where the only treatment is basically poison, irridation and/or butchery/mutilation. Hopefully that improves soon. I'm guessing future history will reflect on how dark all of this was.
29athrowaway 6y ago
Fenbendazole, active ingredient in dog deworming medication, has shown some anti-cancer properties. https://www.nature.com/articles/s41598-018-30158-6 https://www.nature.com/articles/s41598-018-30158-6
pps43 6y ago
Yet there is no visible shift in cause of death distribution. Cancer is still up there, successfully competing with cardiovascular diseases for #1 spot.
- deeg 6y ago
  I don't think that's necessarily a knock against cancer treatments. In the end we all have to die of something and late-life cancer is probably always going to be a leader. I think a better stat would be the average age of those who die of cancer and the survival rates of child cancers.
  - phendrenad2 6y ago
    Yeah I wish people would account for this when making statements. What is the incidence of cancer death in 50-year-olds then vs now.
jitendrac 6y ago
As far as I know, Each cancer in a patient is mostly unique. Not all skin cancers or cancer tumor cases are same. they may have same underlying cause of it but not same cancer case. Mostly what treatment do is remove the affected tumor,tissues, if its related to blood plasma or bone-marrow transplant donor blood and bone marrow. Use chemo to weaken all cells of body regardless of its normal functioning or part of cancer. wait for human body to revive on its own immune system and repeat above task if needed. so, to fight the cancer first we must find a way to affordably find the type of cancer with cause case-by-case basis and develop a procedure for custom treatment and drug-delivery to affected part without disturbing whole body functions. From my perspective we are still way behind but in better position then yesterday or decade ago.
- tyingq 6y ago
  Absolutely true. There are many cancers where the only recourse is disfigurement, dangerous irridation, butchery, poison or death. No blame on current doctors and nurses, but our current understanding is brutal. Any real advances are crazy welcome.
TaupeRanger 6y ago
Frankly, the title is absolutely idiotic. This article describes a way of studying drugs that have already been approved by the FDA for other indications as potential cancer drugs. A vast majority of these drugs will fail or do no better than current treatments which involve butchery and poison. The article is basically worthless and I have no idea why it has even a single upvote from this community. None of this has been shown to do anything for patients.
- yesenadam 6y ago
  > The article is basically worthless and I have no idea why it has even a single upvote from this community. People often upvote if the discussion is good. The discussion on this page was very good, I thought, very much worth reading - informative and touching. Thanks all, and good luck.
racecar789 6y ago
There is a firewall that exists between doctors and billing. Or maybe it's blissful ignorance. I have noticed doctors often have no idea what their tests and procedures will cost the patient. Moreover, a doctor's vocal tone often changes when discussing cost. The tone changes from friendly/caring to annoyed/defensive. I don't think the firewall can last forever.
- jimbokun 6y ago
  > I have noticed doctors often have no idea what their tests and procedures will cost the patient. Maybe they don't know the amounts, but they are forced to know a lot about how the billing process works. For example, my company develops a product that helps doctors create documentation in a way that makes it more likely they will get reimbursed by insurance companies with the least amount of hassle and push back. Also, they probably have no idea what it will cost you until the insurance company and hospital fight it out over the price. > The tone changes from friendly/caring to annoyed/defensive. Every doctor is triggered by having to deal with bureaucratic insurance and billing processes that consume their time and keep them from spending more time on treating patients. You are sensing their barely controlled rage at the system. (This is all for the US system, probably not true in most other countries.)
codecamper 6y ago
I'm sorry but re-purposing existing drugs does not sound promising at all. Having computers that can fold the proteins and understand how molecules bind sounds like a much better shot. Figuring out how to do this with quantum computers to really really speed it up would be wonderful.
Gatsky 6y ago
Cancer is the most difficult health problem humans face. It will still be there long after we conquer neurodegeneration, atherosclerosis and diabetes. It is a major failure mode of all multicellular life. Dinosaurs got cancer. Every animal from mice to elephants gets cancer. It is startlingly common in humans. The cellular pathways altered in cancer existed before animals existed. It is an inescapable hangover from our evolutionary origins as unicellular organisms. The only way to beat cancer is to upgrade the human organism to design out anachronistic evolutionary trade offs and prevent cancer development. The way we treat cancer now - the slash, burn, poison, hunt paradigm - is inhumane, expensive, and of limited effectiveness.
_nalply 6y ago
My wife is getting FLOT chemotherapy. She also does: - cannabis - bromelain and acetylcysteine - the next two times longevity fasting mimicking during four days around a chemotherapy administration Cannabis is well known for its medical traits. Bromelain is a meat-digesting enzyme, and a study suggest to combine it with acetylcysteine to reduce the adenocarcinoma. Another study suggests that acetylcysteine protects from neuropathy, a chemotherapy side effect. Fasting is said to switch the body into an energy-saving mode, protecting from chemotherapy, too; something which the tumor cannot so that it experiences the full brunt of the chemotherapy. Longevity fasting mimicking is not fasting but a diet having the same effects as fasting, but I think this is still dangerous. I hope that my wife compensates by eating more when she does not have chemotherapy. Perhaps this is useful to others. Take care!

202 points by dnetesn 6y ago

deleted 6y ago

[deleted]

So if I summarize correctly they re-evaluated already “FDA passed” but abandoned substances for anti-cancer workings using new techniques (CRISPR) and got 50 hits. That’s amazing! Would this work in other fields as well?

gumby 6y ago
There’s a specific regulatory pathway for this process, section 505(b)(2). It allows you to use the safety data for the approved treatments which can save you a lot of time and money (I have used this route for a drug myself T one of my companies). You still have to prove that your formulation is safe,of course, and prove efficacy for the situation you intend to market it for.
- dstick 6y ago
  Gotcha, and that makes sense. Seems like a big time saver regardless. Are we talking months or years, that are shaved off?
  - gumby 6y ago
    Typically years. We had a program for a drug that caused bladder cancer in rats. The original mfr had spent a couple of years figuring out that it was specific to rats. I think the current stats are that the average drug time to approval is 14 years.
iskander 6y ago
That's a good summary but it's missing the context that these kinds of "hits" will most likely fail clinical trials. Many drugs look good at this stage in preclinical development and almost none of them show both safety (ph1 trial) and efficacy (ph3 trial). There aren't actually that many low hanging therapeutic fruit out there, mostly we have to actually do the work to discover new mechanisms and make new compounds to target them.
- dstick 6y ago
  It read like that would be different here, using the new method, wouldn’t it? Or did I misunderstand that?
  - iskander 6y ago
    The genes essential for cancer cells to grow in vitro could easily be quite different from those required to establish the tumor micro-environment, invade new tissues and fight off the immune system. They'll have many false negatives from the mismatch in context. Simultaneously, they might have false positives from e.g. differences in layout and density of tumor cells (2D/uniform vs. 3D heterogeneous tumor). And even if they get the right targets, finding drugs with an effective therapeutic index is hard. This might be a useful screening technique...but it's not the first high throughput screening method. They might have some successes, only trials will tell.

deleted 6y ago

[deleted]

trynewideas 6y ago

From a science and pharmaceutical perspective, maybe. As the partner of someone in the US dealing with stage 4 cancer in their 40s, who has two hospitals fighting with each other over whether to keep using a chemo drug that's sent them into anaphylactic shock twice in two rounds of chemo because it's _more convenient_ for the infusion clinic to administer, and all of that currently held up by pre-approval from a relative-to-the-rest-of-US good insurance company that's still already allowed $40,000 of in-network medical bills to hit us in just 5 weeks since diagnosis all after hitting the supposed out-of-pocket max? From a cancer that had been misdiagnosed as an infection, an iron deficiency, and a benign tumor for four months prior, to give it a massive head start? That headline can fuck right and completely off. We might be good at finding new drugs that can fight cancer, but societally we're absolutely shit at fighting this disease.

drocer88 6y ago
U.S. cancer treatment is the best in the world. The greatest research, innovation and results[1] happen in America. These are products of American Society. American Society is actually pretty good at fighting this disease. We devote huge resources to preventing, diagnosing and treating and have made great progress. The CAR T-Cell innovations are very promising and American research is making it work. Families often face tragedy but U.S. Medicine is leading the world in this fight. [1] https://worldpopulationreview.com/country-rankings/cancer-survival-rates-by-country https://worldpopulationreview.com/country-rankings/cancer-su... .
- izacus 6y ago
  From a pure conversational/social/emotional perspective, you maybe shouldn't lecture someone who's actually going through the first hand experience with the disease.
  - drocer88 6y ago
    Most families deal with cancer at some time. Few are unaffected. Maybe we need focus on the hard part of fixing things. We can acknowledge emotions, get moderation of opinions and celebrate empathy but we need measurable results. U.S. Society is delivering on these.

jcims 6y ago

I was forced to dive headlong into understanding cancer therapy 2 1/2 years ago. It was obvious at the time that this was the correct direction to head, developing an entire therapeutic ecosystem to give the body every possible advantage and assail the disease with every possible disadvantage in order to get the desired outcome. However, what I saw was a rather bizarre and disturbing fetish in the pharmaceutical and medical communities for ‘monotherapies’. I believe I understand the allure, if you find one thing that works, the proverbial silver bullet, that’s the best case scenario for treatment. It’s also quite obviously the best case for shareholders and investors, but let’s set that aside for now. For the sake of future patients, I do hope that medicine and regulators deprioritize the search for monotherapies and receive the type of analysis represented in this article with open arms. In particular, I hope that the ’standard of care’ is given some flexibility so that doctors are able to adopt low risk adjunct therapies in order to improve outcomes and the amount of data available for continued research and improvement of treatment plans.

tornato7 6y ago
I've been impressed by the "therapudic ecosystem" developed for coronavirus in the absence of a 'monotherapy'. The MATH+ treatment is an effective combination of available drugs and vitamins. I hope any future COVID drug is used alongside these options, instead of a "here's an expensive drug, now go home!" Approach that some treatments take.
- copperx 6y ago
  MATH+ seems to me like throwing everything and the kitchen sink into the disease, which screams “we don’t really know what we’re doing.” I haven’t seen replication efforts, and the doctor who’s peddling it once claimed to cure sepsis with IV vitamin C, an effort that failed to do much when replicated. It doesn’t look like a serious approach.
iskander 6y ago
Re: monotherapies. This hasn't been my experience. Almost all chemotherapy regimens are combination cocktails (e.g. R-CHOP, CMF, FOLFIRINOX, &c) And as soon as a drug is shown to be very potent on its own (e.g. aPD1/aPDL1 checkpoint blockade) there's an explosion of trials looking to combine it with every possible other mechanism. However, there is a strong desire to see drugs do something on their own before combining them with something else.

iskander 6y ago

Drug repurposing for cancer is a neat and vaguely plausible idea that's been eating up attention and grant funding for a decade now, without any successes in clinical trials.

TaupeRanger 6y ago
Precisely. The title is frankly appalling.

ne01 6y ago

There is a tendency to fight our way out of every problem. But what we truly need is to accept the problem, take responsibility and look for the root cause. That is true “fighting”. But most try to destroy the symptoms so they can continue their path and usually continue the root cause. Of course finding the root cause is not easy and it takes one to study oneself I highly recommend the following book to everyone (including the “healthy”) The 12 Stages of Healing: A Network Approach to Wholeness Book by Donald M. Epstein and Nathaniel Altman

_jahh 6y ago
while I'd be the last to say root approach should be discounted (diet, lack of exercise, smokes, and bad sleep contributing more to bad outcomes that just about anything else), I worry that the thinking in this post can be used to judge people who have cancer for their actions when unfortunately the true root cause for many people is actions taken long before they're born because of environmental exposure. So while yes most everyone could benefit from more self study some cancerous situations require vigorous assault on the symptoms, like death.
- dstick 6y ago
  Agreed, and even then, doesn’t cancer “just happen”? There’s a BRCA2 gene defect in my family (that I’m lucky enough not to have inherited) and that increases the likelyhood of developing breast cancer to 80% for women and prostate cancer to ~20% for men. But to the best of my knowledge, everyone has an innate %, just by virtue of being alive.
deleted 6y ago
[deleted]

the-dude 6y ago

I am instantly reminded of Lou Reed's "Magic and Loss". Not easy to listen to the first few times. Learned to appreciate. Much later on I lost a loved one to acute leukemia. At least there was no months long struggle.

tyingq 6y ago

Fair enough, but cancer is a broad term. There are still many cancers where the only treatment is basically poison, irridation and/or butchery/mutilation. Hopefully that improves soon. I'm guessing future history will reflect on how dark all of this was.

29athrowaway 6y ago

Fenbendazole, active ingredient in dog deworming medication, has shown some anti-cancer properties. https://www.nature.com/articles/s41598-018-30158-6 https://www.nature.com/articles/s41598-018-30158-6

pps43 6y ago

Yet there is no visible shift in cause of death distribution. Cancer is still up there, successfully competing with cardiovascular diseases for #1 spot.

deeg 6y ago
I don't think that's necessarily a knock against cancer treatments. In the end we all have to die of something and late-life cancer is probably always going to be a leader. I think a better stat would be the average age of those who die of cancer and the survival rates of child cancers.
- phendrenad2 6y ago
  Yeah I wish people would account for this when making statements. What is the incidence of cancer death in 50-year-olds then vs now.

jitendrac 6y ago

As far as I know, Each cancer in a patient is mostly unique. Not all skin cancers or cancer tumor cases are same. they may have same underlying cause of it but not same cancer case. Mostly what treatment do is remove the affected tumor,tissues, if its related to blood plasma or bone-marrow transplant donor blood and bone marrow. Use chemo to weaken all cells of body regardless of its normal functioning or part of cancer. wait for human body to revive on its own immune system and repeat above task if needed. so, to fight the cancer first we must find a way to affordably find the type of cancer with cause case-by-case basis and develop a procedure for custom treatment and drug-delivery to affected part without disturbing whole body functions. From my perspective we are still way behind but in better position then yesterday or decade ago.

tyingq 6y ago
Absolutely true. There are many cancers where the only recourse is disfigurement, dangerous irridation, butchery, poison or death. No blame on current doctors and nurses, but our current understanding is brutal. Any real advances are crazy welcome.

TaupeRanger 6y ago

Frankly, the title is absolutely idiotic. This article describes a way of studying drugs that have already been approved by the FDA for other indications as potential cancer drugs. A vast majority of these drugs will fail or do no better than current treatments which involve butchery and poison. The article is basically worthless and I have no idea why it has even a single upvote from this community. None of this has been shown to do anything for patients.

yesenadam 6y ago
> The article is basically worthless and I have no idea why it has even a single upvote from this community. People often upvote if the discussion is good. The discussion on this page was very good, I thought, very much worth reading - informative and touching. Thanks all, and good luck.

racecar789 6y ago

There is a firewall that exists between doctors and billing. Or maybe it's blissful ignorance. I have noticed doctors often have no idea what their tests and procedures will cost the patient. Moreover, a doctor's vocal tone often changes when discussing cost. The tone changes from friendly/caring to annoyed/defensive. I don't think the firewall can last forever.

jimbokun 6y ago
> I have noticed doctors often have no idea what their tests and procedures will cost the patient. Maybe they don't know the amounts, but they are forced to know a lot about how the billing process works. For example, my company develops a product that helps doctors create documentation in a way that makes it more likely they will get reimbursed by insurance companies with the least amount of hassle and push back. Also, they probably have no idea what it will cost you until the insurance company and hospital fight it out over the price. > The tone changes from friendly/caring to annoyed/defensive. Every doctor is triggered by having to deal with bureaucratic insurance and billing processes that consume their time and keep them from spending more time on treating patients. You are sensing their barely controlled rage at the system. (This is all for the US system, probably not true in most other countries.)

codecamper 6y ago

I'm sorry but re-purposing existing drugs does not sound promising at all. Having computers that can fold the proteins and understand how molecules bind sounds like a much better shot. Figuring out how to do this with quantum computers to really really speed it up would be wonderful.

Gatsky 6y ago

Cancer is the most difficult health problem humans face. It will still be there long after we conquer neurodegeneration, atherosclerosis and diabetes. It is a major failure mode of all multicellular life. Dinosaurs got cancer. Every animal from mice to elephants gets cancer. It is startlingly common in humans. The cellular pathways altered in cancer existed before animals existed. It is an inescapable hangover from our evolutionary origins as unicellular organisms. The only way to beat cancer is to upgrade the human organism to design out anachronistic evolutionary trade offs and prevent cancer development. The way we treat cancer now - the slash, burn, poison, hunt paradigm - is inhumane, expensive, and of limited effectiveness.

_nalply 6y ago

My wife is getting FLOT chemotherapy. She also does: - cannabis - bromelain and acetylcysteine - the next two times longevity fasting mimicking during four days around a chemotherapy administration Cannabis is well known for its medical traits. Bromelain is a meat-digesting enzyme, and a study suggest to combine it with acetylcysteine to reduce the adenocarcinoma. Another study suggests that acetylcysteine protects from neuropathy, a chemotherapy side effect. Fasting is said to switch the body into an energy-saving mode, protecting from chemotherapy, too; something which the tumor cannot so that it experiences the full brunt of the chemotherapy. Longevity fasting mimicking is not fasting but a diet having the same effects as fasting, but I think this is still dangerous. I hope that my wife compensates by eating more when she does not have chemotherapy. Perhaps this is useful to others. Take care!