7 ms·

AstraZeneca unveils successes in treatment of lung cancer

376 points by cebert 3y ago

macolaa 3y ago
I'm 31 years old, I was diagnosed with lung cancer a few months ago and am taking this drug. Although my life expectancy is still very limited at around 2 years this treatment is allowing me to live a fairly normal life for the time I have left. The other treatment options are so much worse, this is just a tablet once a day with fairly mild side effects compared to hours of chemo at the hospital every day for weeks at a time. I'm crying writing this as I just can't say how thankful that this treatment is available, I can't even come close to putting it into words.
cebert 3y ago
https://archive.ph/eNqky https://archive.ph/eNqky
genman 3y ago
It is about Osimertinib, sold under the brand name Tagrisso. It works (in “statistically significant and highly clinically meaningful” manner) against certain types of lung cancer when administered on early stage. It was provisionally approved after success in phase 1 trial by FDA in 2015 and by EMA in 2016. Side effects: Very common (greater than 10% of clinical trial subjects) adverse effects include diarrhea, stomatitis, rashes, dry or itchy skin, infections where finger or toenails abut skin, low platelet counts, low leukocyte counts, and low neutrophil counts. Common (between 1% and 10% of clinical trial subjects) adverse effects include interstitial lung disease.
- GenerWork 3y ago
  That doesn't sound too bad if it can cause lung cancer to regress.
- hef19898 3y ago
  Side effects do not realy sound bad so, as someone who went through a light, comparatively, chemo I saw a lot worse with other patients. Plus, the alternative is lung cancer in late stages. And you sure as hell don't want that! It is really good to see progress in cancer treatment so!
- hanniabu 3y ago
  > It works (in “statistically significant and highly clinically meaningful” manner) against certain types of lung cancer when administered on early stage. What is considered early stage? Pre symptoms? And what type of success rate are we talking here?
  - vharuck 3y ago
    Cancer staging is complex, as one would expect for a wide-ranging category of diseases that follow different courses and cause harm different ways. Stage depends on tumor size, distance of spread, what organs it spread to (lymph nodes are especially worrisome), and how much the tumor cells differ from normal tissue. There is a large manual used by oncologists to record this information, and another large manual for cancer registrars to summarize it. https://www.cancer.org/cancer/diagnosis-staging/staging.html https://www.cancer.org/cancer/diagnosis-staging/staging.html There are simplified categories of early/late stages, usually used in public health statistics. "Early stage" here is in situ (hasn't broken out of the tissue where it first appeared) or localized (hasn't left the primary site/organ). "Late stage" is regional (metastasized to adjacent organs) or distant (metastasized to non-adjacent organs, usually through the bloodstream or lymphatic system). >What is considered early stage? Pre symptoms? Not necessarily. This is generally true for things like kidney cancer, which is really deadly. People don't usually get checked until they have symptoms, which is usually after it's metastasized. But benign tumors can cause symptoms by physically pressing on organs. Benign brain tumors, which can kill, are an extreme example of this.
- e40 3y ago
  The side effect you didn't mention: mouth sores. It's the only one that my wife had (in the first month). So far, no other problems, though the chemo started last week (see my comment about it, if curious).
  - quantumwoke 3y ago
    That would probably be from the chemo your wife is on rather than the osimertinib. Chemo tends to cause mouth ulcers along with hair loss etc.
    - e40 3y ago
      No, the chemo started a month after the osimertinib and the sores appeared in that first month. The oncologist confirmed it was a side effect of it.
1letterunixname 3y ago
Hey onco-nosology nerds: Is there a cell-typed unambiguous classification system, research, and clinical treatment protocol nexus attempting to capture and disseminate information on all cancer types in a more precise and organized effort?
- eber 3y ago
  I don't know if this is what you mean, but Foundation Medicine has a biobank of genomic data (HIPAA) with cancer patients' genomic profiles.[1] It's pan-tumor and pan-cancer. EDIT: if you're looking for more of a "what is the current best known treatment plan for xyz" then this might not be what you're looking for. The standard of care is very much changing very often, I don't know if anyone has a solution for disseminating that. foundation medicine also has a patient-focused side where you can get your own test and get pointed to the treatment for your cancer genomic profile [2]. The societies are probably trying the most to get all of that data available/up-to-date (for example: the American Cancer Society) [1] https://www.foundationmedicine.com/service/genomic-data-solutions https://www.foundationmedicine.com/service/genomic-data-solu... [2] https://www.foundationmedicine.com/patient/start-with-step-one https://www.foundationmedicine.com/patient/start-with-step-o...
- badcppdev 3y ago
  More precise and organised than what?
- thallada 3y ago
  NCI has the current treatment guidelines for each cancer and is updated when new treatment options become available: https://www.nccn.org/guidelines/category_1 https://www.nccn.org/guidelines/category_1 Unfortunately, these are very clinician-focused and are very hard to understand without a medical background. They also don't usually cover experimental treatments that are still in trials, but in some cases can be extremely helpful. I work on an app at Outcomes4Me (https://outcomes4me.com/ https://outcomes4me.com/) that is trying to convert the NCI guidelines into an algorithm so that we can tell patients in simpler terms what their treatment options are based on their specific diagnosis. We also try to find clinical trials recruiting for their specific diagnosis. We've done this for breast and lung cancer so far.
someonehere 3y ago
Didn’t Cuba have a vaccine for lung cancer? I seem to recall seeing one in a documentary (maybe a Michael Moore film?)
- alexnewman 3y ago
  My father died of lung cancer. I also ran a failed medical tourism company which sent people to get this treatment in Cuba. More modern versions of the Cuban treatment are now few approved in the USA as immunotherapy. Didn’t save my dad
  - herculity275 3y ago
    So sorry to hear about your dad! > I also ran a failed medical tourism company which sent people to get this treatment in Cuba Why did the company fail? How effective was the treatment?
    - alexnewman 3y ago
      Trump banned it
  - badcppdev 3y ago
    Sorry about your Dad but did it help other people? How many did you send and how many had positive outcomes in terms of prolonged life above the expected outcome?
    - alexnewman 3y ago
      Since I settled with the trump white house I keep my mouth shut on outcomes. I am Happy I did it
    - sudosysgen 3y ago
      You might be interested in the Phase IV trials in Cuba, which were published here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346887/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346887/ There was also a published study by Roswell Park, on a few hundred patients many of which flew out to Cuba to take it, but it's only Phase 1, so no efficacy, only safety and antibody titers : https://www.roswellpark.org/newsroom/201903-safety-analysis-now-complete-roswell-park-moves-forward-expanded-study-cimavax https://www.roswellpark.org/newsroom/201903-safety-analysis-...
pauln99 3y ago
“Statistically significant and highly clinically meaningful” perhaps, but not so much that they can say what that actually means. My understanding is that of all cancer drugs approved by the FDA between 2000-2016 (around 90 drugs), the median life extension was just over 2 months...
- jncfhnb 3y ago
  The distribution skews right on these things. Median probably is not the right way to think about it
  - pauln99 3y ago
    Maybe I've misunderstood, but for the average person that's even worse news, right? Two months was from clinical trials where there's no doubt that the "thumb is on the scale" in a host of ways, creating an exaggerated estimate of efficacy that would be realised in the real world. The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs.
    - icegreentea2 3y ago
      Imagine a toy scenario where a cancer will kill 80% of people with it at exactly 3 years, and all 20% remaining will uh live full lives (so say another 20 years). If you created a drug that shifted the ratio to 60/40, and measured right at the 5 year mark. In a population of 100 untreated people, you'd get like 4080 total months lived (80x36 + 20x60). In a population of 100 treated people, you'd get like 4560 months lived (60x36+40x60). That's only generating an extra 4.8 months of life per person treated. However, you've doubled the number of people alive at the end of trial. Now obviously this is a toy example that's probably a bit exaggerated, but this type of behavior is exactly why median/average life extension is an inadequate measure alone.
    - s1artibartfast 3y ago
      >The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs. I dont think that is true at all. The data is pretty clear that lifespan is significantly increasing. >Over time, the mean overall survival has improved from two months in 1973 to five months in 2015. Regarding long-term survival, a clear rise in 2yS is noted, increasing from 2.6% in 1973 to 12.9% in 2013 (latest year of which 2yS data can be calculated; Figure 1 and Tables 1 and 2), occurring mostly after the mid-1990s. A more modest increase is seen in the 5yS, from 0.7% in 1973 to 3.2% in 2010. >https://www.researchgate.net/publication/348455938_Long-Term_Survival_of_Patients_with_Metastatic_Non-Small-Cell_Lung_Cancer_over_Five_Decades https://www.researchgate.net/publication/348455938_Long-Term...
baq 3y ago
A friend died of lung cancer. Went from mild cough to funeral in about 5 weeks. 40 yo. 2 pre-teen kids. Started to look after my own health a bit more. This is a very welcome development.
- superfunny 3y ago
  I'm really sorry to hear that - cancer is terrible.
- graphe 3y ago
  Any more details? No history?
  - baq 3y ago
    Smoker, was always coughing a bit. His grandfather also died of lung cancer, but he didn’t make the connection until it was too late.
- lowercased 3y ago
  PSA: If you have dependents, or think you might, get some life insurance in place now while you're relatively young. I've had too many friends/colleagues pass away unexpectedly without any (or not remotely enough) life insurance, leaving a spouse and young children behind, inevitably turning to gofundme and similar just to get by.
  - alexey-salmin 3y ago
    I actually tried that but the ones I've found had explicit clauses against cancer and other diseases in fine print. Apparently they only help if you get hit by a car and alike. Probably need to make another pass. (I'm in Europe)
    - lowercased 3y ago
      Yeah, the comment may have been more US-oriented (where I'm living). I do know a couple colleagues who can't get any term life insurance because of some pre-existing medical conditions. That's not good for them, obviously, but for most others, it makes sense to get something early. Years ago, at 35, I got an $800k 20 year term for about $55/month. Close to 20 years later, we have more savings/wealth, so my family would not be in hardship or having to go begging if I died tomorrow. A 15 year $500k policy now costs me $80/month. I recently got that, but may let it lapse in a few years if we don't need that any more. FWIW, my policies don't have any specific denials for certain causes of death (particular disease, etc) but I did have to provide medical records (and I'm not in perfect health).
formercoder 3y ago
My aunt was diagnosed with stage 4 lung cancer and is only alive because of this drug. It’s a marvel of modern medicine.
- declan_roberts 3y ago
  It feels so good to read a comment like this. Thank you for sharing and I’m really happy for you and your family (and modern medicine that makes it all possible).
- jfengel 3y ago
  That is indeed remarkable. Stage 4 lung cancer usually makes you seek out hospice care.
- kthartic 3y ago
  Wow, that's incredible. So wholesome reading a comment like this on HN, makes me more hopeful of the future. Thanks for sharing
- deleted 3y ago
  [deleted]
- e40 3y ago
  My wife was diagnosed in Nov '23. Stage 4. She had a mutation that allowed Tagrisso/osimertinib. There are many mutations, but this one is prevalent in Asian women who have never smoked. There was a trial published just after her diagnosis that showed progression free survival at 2 years of 57% (chemo+osimertinib) vs 41% (osimertinib). https://www.nejm.org/doi/full/10.1056/NEJMoa2306434 https://www.nejm.org/doi/full/10.1056/NEJMoa2306434 She's 6 days into the chemo. There are 4 rounds of pemetrexed+carboplatin and then maintenance carboplatin (forever). Every 21 days. So far, it's been rough, but hopefully her body will adjust and once she's just on carboplatin hopefully her quality of life will be better. She had few side effects from the osimertinib, but the main one was mouth sores. They're gone now, thankfully. Another thing people need to know about this: this diagnosis often comes with regular thoracentesis (removal of fluid from the chest). In this case, it's in the lining of her lung, not lung itself. Advice to anyone in this situation: make all future appointments for thoracentesis, because you don't want to go into the ER/ED to get it done. And, we've stopped allowing residents to practice on her (once it was quite painful). EDIT: Forgot to add: carboplatin crosses the blood-brain barrier, as do the cancer cells. The end state for this cancer, even with the above treatments, is usually tumors in the brain.
dghughes 3y ago
I wish there had been something for IPF which is progressive scarring of lung tissue. My Dad died of it after a long battle. The doctor even said it's worse than lung cancer at least for that there are treatments.
latchkey 3y ago
My mom died from lung cancer. It was going to happen, life long smoker. Dying from LC is a terrible way to go. Your lungs fill with fluid and you slowly drown in your own fluid. The pain meds make you hallucinate terrible thoughts. I wouldn't wish it on anyone. For the benefit of humanity, I hope this treatment works.
- Scubabear68 3y ago
  Same with my dad in the 80s. His descent was horrible to witness, in my case at the age of 21. I’ll never know the truth, but I think his doctor took pity on him, dad died very shortly after a push of morphine.
  - latchkey 3y ago
    Thanks for sharing and sorry to hear that. My mom was only 56 (2004) and I got a call from the hospice very early in the morning. At her request, I had tried to take care of her myself for the couple weeks after her diagnosis, but once the hallucinations started, due to her increasing the pain meds, she started screaming one night and the neighbors called the police thinking I was abusing her. Thankfully, they called a case worker and I was able to get her into hospice pretty shortly after that and then it was just a couple days more at that point. It was pretty traumatic. One of those life events you never forget. RIP mom.
    - Scubabear68 3y ago
      My family tried home care in the terminal stage, but it was too much for my mom and sister. My mom also had some serious mental illnesses, compounding the difficulty we had as a family. The trauma was so great I did not really hit a normal state of emotional and mental stability until I was about 30. I was the only one there as he took his last breath, and it still brings tears when I think about it.
      - arisAlexis 3y ago
        Have you gotten therapy for that trauma?
instagraham 3y ago
> Tagrisso earned $5.8bn in sales in 2023 — 13 per cent of AstraZeneca’s total oncology sales — making it the company’s highest earner. The drug seems to have been approved in 2015-16. If that's the case, why is this announcement of efficacy happening now? A long-term outcome after a short-term tentative approval?
- loeg 3y ago
  It was approved for certain types of cancers and has slowly been approved for more and more types of cancer, basically. > Dec 21, 2020 Approval Tagrisso Approved in the US for the Adjuvant Treatment of Patients with Early-Stage EGFR-Mutated Non-Small Cell Lung Cancer > Apr 18, 2018 Approval FDA Approves Tagrisso (osimertinib) as First-Line Treatment for EGFR-Mutated Non-Small Cell Lung Cancer > Jun 6, 2017 AstraZeneca Presents Tagrisso (osimertinib) Data in Patients with EGFR T790M-Mutation Positive Lung Cancer and Central Nervous System Metastases > Mar 31, 2017 Approval Tagrisso (osimertinib) Receives FDA Full Approval > Nov 13, 2015 Approval FDA Approves Tagrisso (osimertinib) for EGFR T790M Mutation-Positive Non-Small Cell Lung Cancer https://www.drugs.com/history/tagrisso.html https://www.drugs.com/history/tagrisso.html
- yieldcrv 3y ago
  US approval follows the path of one treatment for one ailment. so if something was useful for 100 ailments, it needs 100 different approvals, and a company willing to attempt doing that what more likely happens is one treatment is denied for the one ailment the company thought they were tackling, and that one treatment is never pursued again so there's a lot of waste in this particular approach to protecting the public. I'm not familiar with other approaches.
  - boppo1 3y ago
    Seems like there's a lot of opportunity with those unused treatments, if you can get the right arrangement of capital. If the company gives up on pursuit, perhaps the'd sell it for less than the R&D cost. Someone could go scoop up 'losers' and find a better way to match them to ailments.
siva7 3y ago
Is there actually some kind of list which shows in a table what kind of cancers are currently treatable by which experimental medicine?
- bosco_mcnasty 3y ago
  clinicaltrials.gov has it all. There's a scraped sqlite database out of a team in israel, i think it's called cdcdb. this summarizes "current clinical experiments". Regarding preclinical, it's a wild west, and nobody really knows if it works or not since it's preclinical by definition. Secondly, the site nccn contains all the treatment algorithms. The treatment algorithms (thousands of sloppy figure pdf pages) are free. They have something more structured (as I understand it, have never seen it) that you have to pay for. These are based on all of the currently available clinical evidence (LOTS of studies). Generally they are along the lines of - subtype your cancer into one of X number of subtypes, treat each subtype with this treatment, and when that fails, move onto this treatment, and when that fails, move onto this treatment, and when that fails, there's no standard but here are you options.
- nradov 3y ago
  By definition no one knows for certain which types of cancer are treatable by experimental drugs. That's why they're still experimental and not yet approved. But this site has a good list of resources for finding clinical trials that might help. https://www.cancer.net/research-and-advocacy/clinical-trials/finding-clinical-trial https://www.cancer.net/research-and-advocacy/clinical-trials...
kkio 3y ago
My father has been taking Tagrisso since he was diagnosed with Stage IV lung cancer in January 2022. It’s been able to give him a relatively normal quality of life I don’t think my family would’ve seen otherwise if he’d gone through chemo and radiation. Just chiming in that I’m super thankful to that these newer treatments are so effective. That said it’s not cheap and he still has to work to keep his insurance… otherwise it’d be ~10k/mo.
- phone8675309 3y ago
  [flagged]
  - olliecornelia 3y ago
    [flagged]
    - phone8675309 3y ago
      What is your problem here? The parent comment was discussing the cost of the medicine, and I was responding to that.
  - nradov 3y ago
    If you're honestly interested in the history of Osimertinib (Tagrisso) then this article has a good overview. It specifies the studies involved so that you can dig into funding sources. Generally for drug development, public funding only covers basic science and maybe early-stage trials. The majority of the expense is in phase 3 clinical trials which pharmaceutical companies pay for. https://doi.org/10.1093/annonc/mdw129 https://doi.org/10.1093/annonc/mdw129
- e40 3y ago
  So glad to hear your father has made it 2 years. I have hopes for my wife (see my recent comment).
- wing-_-nuts 3y ago
  >he still has to work to keep his insurance… otherwise it’d be ~10k/mo. I mean, it'd be covered under the ACA or presumably medicare as well?
deleted 3y ago
[deleted]
adamredwoods 3y ago
According to Wikipedia, it depends on a specific cancer cell mutation, T790M, which could also be a forced mutation from using other EGFR tyrosine kinase inhibitors. This alludes how tricky, and how fast, cancer cells mutate and adapt. >> In people treated with osimertinib, resistance usually develops within approximately 10 months. https://en.wikipedia.org/wiki/Osimertinib https://en.wikipedia.org/wiki/Osimertinib
- zoratu 3y ago
  In my MIL's case it was L858R. T790M also present, effectiveness of drug dramatically increased with presence of both. Osimertinib shrunk the tumor from baseball to golfball, and then her left most lung lobe was surgically removed. She was stage 2 at intake and without metastastis. The drug was not approved for that case in 2021 and she was admitted to an ongoing case study for it.
- rootbear 3y ago
  My sister had the ALK variant of non-small cell lung cancer. The special treatment she got worked until it didn’t, about 16 months. One oncologist said the cancer had likely mutated and the ALK specific therapy was no long effective.
icegreentea2 3y ago
I -think- this is the study referenced https://ascopubs.org/doi/full/10.1200/JCO.22.02186 https://ascopubs.org/doi/full/10.1200/JCO.22.02186
londons_explore 3y ago
I predict that ~30 years from now, someone will take all these drugs that have shown some success in treating some cancer, mix them all together at a low dose, and find the combination works better than any of the components.
- bglazer 3y ago
  This is already done. There are many labs currently looking for "synergistic" combinations of treatments.
jamaicahest 3y ago
Why are the top comments in this thread all personal anecdotes? Is this reddit now?
- ranguna 3y ago
  https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html > Please don't post comments saying that HN is turning into Reddit. It's a semi-noob illusion, as old as the hills.
- wavemode 3y ago
  Since when is it wrong for people who have personal experience with a topic to share personal anecdotes? And what does Reddit have to do with it?
  - jamaicahest 3y ago
    I was under the impression that hacker news was not a place for sharing personal anecdotes, but rather a place for factual debate.

376 points by cebert 3y ago

I'm 31 years old, I was diagnosed with lung cancer a few months ago and am taking this drug. Although my life expectancy is still very limited at around 2 years this treatment is allowing me to live a fairly normal life for the time I have left. The other treatment options are so much worse, this is just a tablet once a day with fairly mild side effects compared to hours of chemo at the hospital every day for weeks at a time. I'm crying writing this as I just can't say how thankful that this treatment is available, I can't even come close to putting it into words.

cebert 3y ago

https://archive.ph/eNqky https://archive.ph/eNqky

genman 3y ago

It is about Osimertinib, sold under the brand name Tagrisso. It works (in “statistically significant and highly clinically meaningful” manner) against certain types of lung cancer when administered on early stage. It was provisionally approved after success in phase 1 trial by FDA in 2015 and by EMA in 2016. Side effects: Very common (greater than 10% of clinical trial subjects) adverse effects include diarrhea, stomatitis, rashes, dry or itchy skin, infections where finger or toenails abut skin, low platelet counts, low leukocyte counts, and low neutrophil counts. Common (between 1% and 10% of clinical trial subjects) adverse effects include interstitial lung disease.

GenerWork 3y ago
That doesn't sound too bad if it can cause lung cancer to regress.
hef19898 3y ago
Side effects do not realy sound bad so, as someone who went through a light, comparatively, chemo I saw a lot worse with other patients. Plus, the alternative is lung cancer in late stages. And you sure as hell don't want that! It is really good to see progress in cancer treatment so!
hanniabu 3y ago
> It works (in “statistically significant and highly clinically meaningful” manner) against certain types of lung cancer when administered on early stage. What is considered early stage? Pre symptoms? And what type of success rate are we talking here?
- vharuck 3y ago
  Cancer staging is complex, as one would expect for a wide-ranging category of diseases that follow different courses and cause harm different ways. Stage depends on tumor size, distance of spread, what organs it spread to (lymph nodes are especially worrisome), and how much the tumor cells differ from normal tissue. There is a large manual used by oncologists to record this information, and another large manual for cancer registrars to summarize it. https://www.cancer.org/cancer/diagnosis-staging/staging.html https://www.cancer.org/cancer/diagnosis-staging/staging.html There are simplified categories of early/late stages, usually used in public health statistics. "Early stage" here is in situ (hasn't broken out of the tissue where it first appeared) or localized (hasn't left the primary site/organ). "Late stage" is regional (metastasized to adjacent organs) or distant (metastasized to non-adjacent organs, usually through the bloodstream or lymphatic system). >What is considered early stage? Pre symptoms? Not necessarily. This is generally true for things like kidney cancer, which is really deadly. People don't usually get checked until they have symptoms, which is usually after it's metastasized. But benign tumors can cause symptoms by physically pressing on organs. Benign brain tumors, which can kill, are an extreme example of this.
e40 3y ago
The side effect you didn't mention: mouth sores. It's the only one that my wife had (in the first month). So far, no other problems, though the chemo started last week (see my comment about it, if curious).
- quantumwoke 3y ago
  That would probably be from the chemo your wife is on rather than the osimertinib. Chemo tends to cause mouth ulcers along with hair loss etc.
  - e40 3y ago
    No, the chemo started a month after the osimertinib and the sores appeared in that first month. The oncologist confirmed it was a side effect of it.

1letterunixname 3y ago

Hey onco-nosology nerds: Is there a cell-typed unambiguous classification system, research, and clinical treatment protocol nexus attempting to capture and disseminate information on all cancer types in a more precise and organized effort?

eber 3y ago
I don't know if this is what you mean, but Foundation Medicine has a biobank of genomic data (HIPAA) with cancer patients' genomic profiles.[1] It's pan-tumor and pan-cancer. EDIT: if you're looking for more of a "what is the current best known treatment plan for xyz" then this might not be what you're looking for. The standard of care is very much changing very often, I don't know if anyone has a solution for disseminating that. foundation medicine also has a patient-focused side where you can get your own test and get pointed to the treatment for your cancer genomic profile [2]. The societies are probably trying the most to get all of that data available/up-to-date (for example: the American Cancer Society) [1] https://www.foundationmedicine.com/service/genomic-data-solutions https://www.foundationmedicine.com/service/genomic-data-solu... [2] https://www.foundationmedicine.com/patient/start-with-step-one https://www.foundationmedicine.com/patient/start-with-step-o...
badcppdev 3y ago
More precise and organised than what?
thallada 3y ago
NCI has the current treatment guidelines for each cancer and is updated when new treatment options become available: https://www.nccn.org/guidelines/category_1 https://www.nccn.org/guidelines/category_1 Unfortunately, these are very clinician-focused and are very hard to understand without a medical background. They also don't usually cover experimental treatments that are still in trials, but in some cases can be extremely helpful. I work on an app at Outcomes4Me (https://outcomes4me.com/ https://outcomes4me.com/) that is trying to convert the NCI guidelines into an algorithm so that we can tell patients in simpler terms what their treatment options are based on their specific diagnosis. We also try to find clinical trials recruiting for their specific diagnosis. We've done this for breast and lung cancer so far.

someonehere 3y ago

Didn’t Cuba have a vaccine for lung cancer? I seem to recall seeing one in a documentary (maybe a Michael Moore film?)

alexnewman 3y ago
My father died of lung cancer. I also ran a failed medical tourism company which sent people to get this treatment in Cuba. More modern versions of the Cuban treatment are now few approved in the USA as immunotherapy. Didn’t save my dad
- herculity275 3y ago
  So sorry to hear about your dad! > I also ran a failed medical tourism company which sent people to get this treatment in Cuba Why did the company fail? How effective was the treatment?
  - alexnewman 3y ago
    Trump banned it
- badcppdev 3y ago
  Sorry about your Dad but did it help other people? How many did you send and how many had positive outcomes in terms of prolonged life above the expected outcome?
  - alexnewman 3y ago
    Since I settled with the trump white house I keep my mouth shut on outcomes. I am Happy I did it
  - sudosysgen 3y ago
    You might be interested in the Phase IV trials in Cuba, which were published here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346887/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346887/ There was also a published study by Roswell Park, on a few hundred patients many of which flew out to Cuba to take it, but it's only Phase 1, so no efficacy, only safety and antibody titers : https://www.roswellpark.org/newsroom/201903-safety-analysis-now-complete-roswell-park-moves-forward-expanded-study-cimavax https://www.roswellpark.org/newsroom/201903-safety-analysis-...

pauln99 3y ago

“Statistically significant and highly clinically meaningful” perhaps, but not so much that they can say what that actually means. My understanding is that of all cancer drugs approved by the FDA between 2000-2016 (around 90 drugs), the median life extension was just over 2 months...

jncfhnb 3y ago
The distribution skews right on these things. Median probably is not the right way to think about it
- pauln99 3y ago
  Maybe I've misunderstood, but for the average person that's even worse news, right? Two months was from clinical trials where there's no doubt that the "thumb is on the scale" in a host of ways, creating an exaggerated estimate of efficacy that would be realised in the real world. The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs.
  - icegreentea2 3y ago
    Imagine a toy scenario where a cancer will kill 80% of people with it at exactly 3 years, and all 20% remaining will uh live full lives (so say another 20 years). If you created a drug that shifted the ratio to 60/40, and measured right at the 5 year mark. In a population of 100 untreated people, you'd get like 4080 total months lived (80x36 + 20x60). In a population of 100 treated people, you'd get like 4560 months lived (60x36+40x60). That's only generating an extra 4.8 months of life per person treated. However, you've doubled the number of people alive at the end of trial. Now obviously this is a toy example that's probably a bit exaggerated, but this type of behavior is exactly why median/average life extension is an inadequate measure alone.
  - s1artibartfast 3y ago
    >The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs. I dont think that is true at all. The data is pretty clear that lifespan is significantly increasing. >Over time, the mean overall survival has improved from two months in 1973 to five months in 2015. Regarding long-term survival, a clear rise in 2yS is noted, increasing from 2.6% in 1973 to 12.9% in 2013 (latest year of which 2yS data can be calculated; Figure 1 and Tables 1 and 2), occurring mostly after the mid-1990s. A more modest increase is seen in the 5yS, from 0.7% in 1973 to 3.2% in 2010. >https://www.researchgate.net/publication/348455938_Long-Term_Survival_of_Patients_with_Metastatic_Non-Small-Cell_Lung_Cancer_over_Five_Decades https://www.researchgate.net/publication/348455938_Long-Term...

baq 3y ago

A friend died of lung cancer. Went from mild cough to funeral in about 5 weeks. 40 yo. 2 pre-teen kids. Started to look after my own health a bit more. This is a very welcome development.

superfunny 3y ago
I'm really sorry to hear that - cancer is terrible.
graphe 3y ago
Any more details? No history?
- baq 3y ago
  Smoker, was always coughing a bit. His grandfather also died of lung cancer, but he didn’t make the connection until it was too late.
lowercased 3y ago
PSA: If you have dependents, or think you might, get some life insurance in place now while you're relatively young. I've had too many friends/colleagues pass away unexpectedly without any (or not remotely enough) life insurance, leaving a spouse and young children behind, inevitably turning to gofundme and similar just to get by.
- alexey-salmin 3y ago
  I actually tried that but the ones I've found had explicit clauses against cancer and other diseases in fine print. Apparently they only help if you get hit by a car and alike. Probably need to make another pass. (I'm in Europe)
  - lowercased 3y ago
    Yeah, the comment may have been more US-oriented (where I'm living). I do know a couple colleagues who can't get any term life insurance because of some pre-existing medical conditions. That's not good for them, obviously, but for most others, it makes sense to get something early. Years ago, at 35, I got an $800k 20 year term for about $55/month. Close to 20 years later, we have more savings/wealth, so my family would not be in hardship or having to go begging if I died tomorrow. A 15 year $500k policy now costs me $80/month. I recently got that, but may let it lapse in a few years if we don't need that any more. FWIW, my policies don't have any specific denials for certain causes of death (particular disease, etc) but I did have to provide medical records (and I'm not in perfect health).

formercoder 3y ago

My aunt was diagnosed with stage 4 lung cancer and is only alive because of this drug. It’s a marvel of modern medicine.

declan_roberts 3y ago
It feels so good to read a comment like this. Thank you for sharing and I’m really happy for you and your family (and modern medicine that makes it all possible).
jfengel 3y ago
That is indeed remarkable. Stage 4 lung cancer usually makes you seek out hospice care.
kthartic 3y ago
Wow, that's incredible. So wholesome reading a comment like this on HN, makes me more hopeful of the future. Thanks for sharing
deleted 3y ago
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e40 3y ago
My wife was diagnosed in Nov '23. Stage 4. She had a mutation that allowed Tagrisso/osimertinib. There are many mutations, but this one is prevalent in Asian women who have never smoked. There was a trial published just after her diagnosis that showed progression free survival at 2 years of 57% (chemo+osimertinib) vs 41% (osimertinib). https://www.nejm.org/doi/full/10.1056/NEJMoa2306434 https://www.nejm.org/doi/full/10.1056/NEJMoa2306434 She's 6 days into the chemo. There are 4 rounds of pemetrexed+carboplatin and then maintenance carboplatin (forever). Every 21 days. So far, it's been rough, but hopefully her body will adjust and once she's just on carboplatin hopefully her quality of life will be better. She had few side effects from the osimertinib, but the main one was mouth sores. They're gone now, thankfully. Another thing people need to know about this: this diagnosis often comes with regular thoracentesis (removal of fluid from the chest). In this case, it's in the lining of her lung, not lung itself. Advice to anyone in this situation: make all future appointments for thoracentesis, because you don't want to go into the ER/ED to get it done. And, we've stopped allowing residents to practice on her (once it was quite painful). EDIT: Forgot to add: carboplatin crosses the blood-brain barrier, as do the cancer cells. The end state for this cancer, even with the above treatments, is usually tumors in the brain.

dghughes 3y ago

I wish there had been something for IPF which is progressive scarring of lung tissue. My Dad died of it after a long battle. The doctor even said it's worse than lung cancer at least for that there are treatments.

latchkey 3y ago

My mom died from lung cancer. It was going to happen, life long smoker. Dying from LC is a terrible way to go. Your lungs fill with fluid and you slowly drown in your own fluid. The pain meds make you hallucinate terrible thoughts. I wouldn't wish it on anyone. For the benefit of humanity, I hope this treatment works.

Scubabear68 3y ago
Same with my dad in the 80s. His descent was horrible to witness, in my case at the age of 21. I’ll never know the truth, but I think his doctor took pity on him, dad died very shortly after a push of morphine.
- latchkey 3y ago
  Thanks for sharing and sorry to hear that. My mom was only 56 (2004) and I got a call from the hospice very early in the morning. At her request, I had tried to take care of her myself for the couple weeks after her diagnosis, but once the hallucinations started, due to her increasing the pain meds, she started screaming one night and the neighbors called the police thinking I was abusing her. Thankfully, they called a case worker and I was able to get her into hospice pretty shortly after that and then it was just a couple days more at that point. It was pretty traumatic. One of those life events you never forget. RIP mom.
  - Scubabear68 3y ago
    My family tried home care in the terminal stage, but it was too much for my mom and sister. My mom also had some serious mental illnesses, compounding the difficulty we had as a family. The trauma was so great I did not really hit a normal state of emotional and mental stability until I was about 30. I was the only one there as he took his last breath, and it still brings tears when I think about it.
    - arisAlexis 3y ago
      Have you gotten therapy for that trauma?

instagraham 3y ago

> Tagrisso earned $5.8bn in sales in 2023 — 13 per cent of AstraZeneca’s total oncology sales — making it the company’s highest earner. The drug seems to have been approved in 2015-16. If that's the case, why is this announcement of efficacy happening now? A long-term outcome after a short-term tentative approval?

loeg 3y ago
It was approved for certain types of cancers and has slowly been approved for more and more types of cancer, basically. > Dec 21, 2020 Approval Tagrisso Approved in the US for the Adjuvant Treatment of Patients with Early-Stage EGFR-Mutated Non-Small Cell Lung Cancer > Apr 18, 2018 Approval FDA Approves Tagrisso (osimertinib) as First-Line Treatment for EGFR-Mutated Non-Small Cell Lung Cancer > Jun 6, 2017 AstraZeneca Presents Tagrisso (osimertinib) Data in Patients with EGFR T790M-Mutation Positive Lung Cancer and Central Nervous System Metastases > Mar 31, 2017 Approval Tagrisso (osimertinib) Receives FDA Full Approval > Nov 13, 2015 Approval FDA Approves Tagrisso (osimertinib) for EGFR T790M Mutation-Positive Non-Small Cell Lung Cancer https://www.drugs.com/history/tagrisso.html https://www.drugs.com/history/tagrisso.html
yieldcrv 3y ago
US approval follows the path of one treatment for one ailment. so if something was useful for 100 ailments, it needs 100 different approvals, and a company willing to attempt doing that what more likely happens is one treatment is denied for the one ailment the company thought they were tackling, and that one treatment is never pursued again so there's a lot of waste in this particular approach to protecting the public. I'm not familiar with other approaches.
- boppo1 3y ago
  Seems like there's a lot of opportunity with those unused treatments, if you can get the right arrangement of capital. If the company gives up on pursuit, perhaps the'd sell it for less than the R&D cost. Someone could go scoop up 'losers' and find a better way to match them to ailments.

siva7 3y ago

Is there actually some kind of list which shows in a table what kind of cancers are currently treatable by which experimental medicine?

bosco_mcnasty 3y ago
clinicaltrials.gov has it all. There's a scraped sqlite database out of a team in israel, i think it's called cdcdb. this summarizes "current clinical experiments". Regarding preclinical, it's a wild west, and nobody really knows if it works or not since it's preclinical by definition. Secondly, the site nccn contains all the treatment algorithms. The treatment algorithms (thousands of sloppy figure pdf pages) are free. They have something more structured (as I understand it, have never seen it) that you have to pay for. These are based on all of the currently available clinical evidence (LOTS of studies). Generally they are along the lines of - subtype your cancer into one of X number of subtypes, treat each subtype with this treatment, and when that fails, move onto this treatment, and when that fails, move onto this treatment, and when that fails, there's no standard but here are you options.
nradov 3y ago
By definition no one knows for certain which types of cancer are treatable by experimental drugs. That's why they're still experimental and not yet approved. But this site has a good list of resources for finding clinical trials that might help. https://www.cancer.net/research-and-advocacy/clinical-trials/finding-clinical-trial https://www.cancer.net/research-and-advocacy/clinical-trials...

kkio 3y ago

My father has been taking Tagrisso since he was diagnosed with Stage IV lung cancer in January 2022. It’s been able to give him a relatively normal quality of life I don’t think my family would’ve seen otherwise if he’d gone through chemo and radiation. Just chiming in that I’m super thankful to that these newer treatments are so effective. That said it’s not cheap and he still has to work to keep his insurance… otherwise it’d be ~10k/mo.

phone8675309 3y ago
[flagged]
- olliecornelia 3y ago
  [flagged]
  - phone8675309 3y ago
    What is your problem here? The parent comment was discussing the cost of the medicine, and I was responding to that.
- nradov 3y ago
  If you're honestly interested in the history of Osimertinib (Tagrisso) then this article has a good overview. It specifies the studies involved so that you can dig into funding sources. Generally for drug development, public funding only covers basic science and maybe early-stage trials. The majority of the expense is in phase 3 clinical trials which pharmaceutical companies pay for. https://doi.org/10.1093/annonc/mdw129 https://doi.org/10.1093/annonc/mdw129
e40 3y ago
So glad to hear your father has made it 2 years. I have hopes for my wife (see my recent comment).
wing-_-nuts 3y ago
>he still has to work to keep his insurance… otherwise it’d be ~10k/mo. I mean, it'd be covered under the ACA or presumably medicare as well?

deleted 3y ago

[deleted]

adamredwoods 3y ago

According to Wikipedia, it depends on a specific cancer cell mutation, T790M, which could also be a forced mutation from using other EGFR tyrosine kinase inhibitors. This alludes how tricky, and how fast, cancer cells mutate and adapt. >> In people treated with osimertinib, resistance usually develops within approximately 10 months. https://en.wikipedia.org/wiki/Osimertinib https://en.wikipedia.org/wiki/Osimertinib

zoratu 3y ago
In my MIL's case it was L858R. T790M also present, effectiveness of drug dramatically increased with presence of both. Osimertinib shrunk the tumor from baseball to golfball, and then her left most lung lobe was surgically removed. She was stage 2 at intake and without metastastis. The drug was not approved for that case in 2021 and she was admitted to an ongoing case study for it.
rootbear 3y ago
My sister had the ALK variant of non-small cell lung cancer. The special treatment she got worked until it didn’t, about 16 months. One oncologist said the cancer had likely mutated and the ALK specific therapy was no long effective.

icegreentea2 3y ago

I -think- this is the study referenced https://ascopubs.org/doi/full/10.1200/JCO.22.02186 https://ascopubs.org/doi/full/10.1200/JCO.22.02186

londons_explore 3y ago

I predict that ~30 years from now, someone will take all these drugs that have shown some success in treating some cancer, mix them all together at a low dose, and find the combination works better than any of the components.

bglazer 3y ago
This is already done. There are many labs currently looking for "synergistic" combinations of treatments.

jamaicahest 3y ago

Why are the top comments in this thread all personal anecdotes? Is this reddit now?

ranguna 3y ago
https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html > Please don't post comments saying that HN is turning into Reddit. It's a semi-noob illusion, as old as the hills.
wavemode 3y ago
Since when is it wrong for people who have personal experience with a topic to share personal anecdotes? And what does Reddit have to do with it?
- jamaicahest 3y ago
  I was under the impression that hacker news was not a place for sharing personal anecdotes, but rather a place for factual debate.