3 ms·

Nice proof of concept of opening the BBB but I see they didn't mention anything about the chemo improving survival for these patients yet... I guess that will o

by klipt 3y ago

Nice proof of concept of opening the BBB but I see they didn't mention anything about the chemo improving survival for these patients yet... I guess that will only be the next phase of the trial?

wpietri 3y ago
That may be a different and much harder problem. Glioblastoma is an aggressive brain cancer and that diagnosis is basically a death sentence, with a median survival time of something like 15 months. Since these are patients with recurrent glioblastoma, generally this means they've already had brain surgery, radiation, and chemo. At that point, as a recent paper puts it, "treatment options are limited and management of recurrent glioblastoma remains challenging". Which I believe is oncologist for "they're fucked". So my guess is that this is the beginning of a long road of searching for agents and regimens that will be deadly enough to kill the tumor without harming the very similar brain tissue that it's nestled in.
- ngneer 3y ago
  Median survival is just that: half the people have less, half the people have more. Since you are not an oncologist, could you please cite the recent paper in question? That would be helpful for understanding the context in which the statement was made that led to your (insensitive) interpretation.
  - wpietri 3y ago
    Protip: you can find quotes by putting them into Google, which is what I just did: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794906/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794906/ Yes, half the people have less, half more. But even the "more" half is very bad news. 5-year survival is ~4%. My dad made it something like 16 months, although his quality of life was quite poor for most of that; the tumor had already caused some neurological complications, and the surgery kicked off frequent seizures that were debilitating. From what I've read, poor quality of life is typical of aggressive gliomas, even when in nominal remission. And then there's the half who have less; my mom got about 4 months, most of which was taken up with radiation and chemo. Please let me know in the future if I can bring up any of my prose to your sensitivity standards. That's a big concern of mine when writing on the internet.
    - ngneer 3y ago
      I am very sorry for your loss. This is clearly a sensitive and emotional subject for many, thus my comment. I did not mean to offend you, but can see that I have, and apologize for that. I should have known better. Thanks for sharing the link, very helpful to understand the context for your statements regarding poor prognosis, specifically 5-year survival and the various new promising approaches being attempted.
      - fasteo 3y ago
        >>> I did not mean to offend you, but can see that I have, and apologize for that. I should have known better. Reading his first comment, there is no way you would have known about his loss.
        ngneer 3y ago
        Right. I think the "they're fucked" threw me off, because "they" sounds impersonal, as though talking about others without having had the personal experience. However, that very phrase should have alerted me to the fact that anyone who knows as much about the topic and uses strong language is very likely emotionally involved, and therefore it is wiser to tread lightly. This is what I should have known better, and will improve upon for next time.
        wpietri 3y ago
        Sure, but so what? In most of the world's conversations, if somebody talks about a thing, people tend to think, "Oh, maybe they know about the thing." Here on HN, though, and wherever reply guys roam free, you see a lot of the opposite. "I'll just assume I know way more about this than the person I'm going to run my mouth at." I don't think it should be my job to preemptively trot out my credentials every time I whip up a paragraph on something. Especially when, as here, those credentials are not only some of the most painful episodes in my life, but are also guaranteed conversational bombs. Instead, maybe we could have a norm of assuming that people aren't total idiots.
      - datapolitical 3y ago

by klipt 3y ago

Nice proof of concept of opening the BBB but I see they didn't mention anything about the chemo improving survival for these patients yet... I guess that will only be the next phase of the trial?

wpietri 3y ago

That may be a different and much harder problem. Glioblastoma is an aggressive brain cancer and that diagnosis is basically a death sentence, with a median survival time of something like 15 months. Since these are patients with recurrent glioblastoma, generally this means they've already had brain surgery, radiation, and chemo. At that point, as a recent paper puts it, "treatment options are limited and management of recurrent glioblastoma remains challenging". Which I believe is oncologist for "they're fucked". So my guess is that this is the beginning of a long road of searching for agents and regimens that will be deadly enough to kill the tumor without harming the very similar brain tissue that it's nestled in.

ngneer 3y ago
Median survival is just that: half the people have less, half the people have more. Since you are not an oncologist, could you please cite the recent paper in question? That would be helpful for understanding the context in which the statement was made that led to your (insensitive) interpretation.
- wpietri 3y ago
  Protip: you can find quotes by putting them into Google, which is what I just did: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794906/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794906/ Yes, half the people have less, half more. But even the "more" half is very bad news. 5-year survival is ~4%. My dad made it something like 16 months, although his quality of life was quite poor for most of that; the tumor had already caused some neurological complications, and the surgery kicked off frequent seizures that were debilitating. From what I've read, poor quality of life is typical of aggressive gliomas, even when in nominal remission. And then there's the half who have less; my mom got about 4 months, most of which was taken up with radiation and chemo. Please let me know in the future if I can bring up any of my prose to your sensitivity standards. That's a big concern of mine when writing on the internet.
  - ngneer 3y ago
    I am very sorry for your loss. This is clearly a sensitive and emotional subject for many, thus my comment. I did not mean to offend you, but can see that I have, and apologize for that. I should have known better. Thanks for sharing the link, very helpful to understand the context for your statements regarding poor prognosis, specifically 5-year survival and the various new promising approaches being attempted.
    - fasteo 3y ago
      >>> I did not mean to offend you, but can see that I have, and apologize for that. I should have known better. Reading his first comment, there is no way you would have known about his loss.
      - ngneer 3y ago
        Right. I think the "they're fucked" threw me off, because "they" sounds impersonal, as though talking about others without having had the personal experience. However, that very phrase should have alerted me to the fact that anyone who knows as much about the topic and uses strong language is very likely emotionally involved, and therefore it is wiser to tread lightly. This is what I should have known better, and will improve upon for next time.
      - wpietri 3y ago
        Sure, but so what? In most of the world's conversations, if somebody talks about a thing, people tend to think, "Oh, maybe they know about the thing." Here on HN, though, and wherever reply guys roam free, you see a lot of the opposite. "I'll just assume I know way more about this than the person I'm going to run my mouth at." I don't think it should be my job to preemptively trot out my credentials every time I whip up a paragraph on something. Especially when, as here, those credentials are not only some of the most painful episodes in my life, but are also guaranteed conversational bombs. Instead, maybe we could have a norm of assuming that people aren't total idiots.
    - datapolitical 3y ago