4 ms·
This sounds really promising. Drug delivery seems like the biggest way to improve existing treatment modalities (improve effectiveness, reduce side effects, etc
by pazimzadeh 3y ago
This sounds really promising. Drug delivery seems like the biggest way to improve existing treatment modalities (improve effectiveness, reduce side effects, etc).
I hope that if this works well, then they can use the same carrier molecule to deliver vaccines specific to other tumor antigens than KRAS? Wouldn’t the approach of targeting lymph nodes also improve non-cancer vaccines too, or other immunotherapies such as immunosuppression in transplant patients which would permit a lower dose?
One thing I still don’t understand though is why immune based therapies in cancer patients are given after chemotherapy, which destroys the immune system.
I understand that once tumors get to a certain size it’s dangerous not to throw our most effective option at them, but it seems like earlier screening + earlier immunotherapy would work better for the general population, and chemo could be used as a last resort. After all you typically don’t wait until someone has a disease to give them a vaccine.
Does anyone know the state of using immunotherapies as first line treatment (even in cancers where chemo “works well” in initial treatment?
- Faaak 3y agoTotally! Some days ago FDA approved a new chemotherapy for PDAC which increases survival time from 9 months to... 11months. Compared to immunotherapy, chemo really looks like an ancient technology. Hope immuno gets even better.
- sydbarrett74 3y agoAgreed. I look forward to the day when chemo is seen like we now see leeching.
- jijji 3y agothey say if the cancer doesn't kill you the chemotherapy will....
- lostapathy 3y agoSooner or later. Chemo drugs are brutal. I was just reading a study the other day that some testicular cancer survivors treated with cisplatin will have measurable, reactive cisplatin in their blood plasma 20 years after treatment. The stuff really is poison.
- sam2426679 3y agoI’m sure there are exceptions, but ime chemoradiation is often still the most effective treatment, statistically. There’s also no such thing as “risk free” immunotherapy, e.g. it can occasionally result in colitis and other unpleasantries.
- pazimzadeh 3y agoWell, chemotherapy destroys/reboots the immune system. So of course, if you always give chemotherapy before immunotherapy, it will keep being the most effective treatment. That is my point. And to qualify for the vast majority of clinical trials you need to have failed existing treatments (chemo) before testing the new stuff. Also, if the immunotherapy gives you colitis, then chemotherapy should shut that down too (it is already used in bad cases of colitis, e.g. methotraxate, cyclophosphamide)
- mcbain 3y agoNo, immuno isn't always a second line treatment. No you don't need to have failed other treatments before being added to a clinical trial. Quite the opposite in many cases - they have entry criteria so that they can be sure any effects (good or bad) can be linked to the trial and not from something else. No if you got colitis from immuno, chemo won't "reset" it, but strong doses of steroids might. (We discontinued my immuno before I got to that point.)
- pazimzadeh 3y ago> No, immuno isn't always a second line treatment. "for the vast majority of clinical trials" is what I said > No you don't need to have failed other treatments before being added to a clinical trial That wasn't my experience when looking for trials for my mom's metastatic cancer, but I hope you're right. > No if you got colitis from immuno, chemo won't "reset" it, but strong doses of steroids might. Two things can be true at once. I didn't say it's curative (neither are steroids), but chemo drugs can be given for severe uncontrolled autoimmune disease, because they are immunosuppressive. > We discontinued my immuno before I got to that point Too bad, I studied it for several years and my mom was a specialist on the adaptive immune system.