4 ms·

I actually wrote my thesis on this. Ovarian is very commonly studied for immunotherapy, but there isn't anything out there outside of the clinical research real

I actually wrote my thesis on this. Ovarian is very commonly studied for immunotherapy, but there isn't anything out there outside of the clinical research realms. The data is pointing more and more to solid cancers being much less responsive to immunotherapy than blood cancers. Unfortunately, I don't have good news for you here. We are probably 30 years away from having an IT medicine that doctors prescribe regularly. And even then, it will be insanely expensive

littlestymaar 2y ago
Since you're knowledgeable in the field, I have a question: what makes immunotherapy more inherently expensive compared to other options?
- pinewurst 2y ago
  Because each patient’s treatment has to be individually created for them.
  - moshun 2y ago
    This seems like a space ripe for intelligent robotics automation. Detailed, precise and laborious requiring years of not decades of technical expertise.
    - becurious 2y ago
      Look at what Cellares is doing. Building a manufacturing cell called the shuttle.
    - cactusfrog 2y ago
      Biochemical engineering exists as a discipline and focused on “scale up” of production problems like these. Robots are involved, but most of the time the process is modified to a more stable one.
  - mahkeiro 2y ago
    They are many different kind of immunotherapies, not all of them have to be patient specific. For cell or vaccine therapies a lot work is currently done to create "off the shelf" treatment which may ease the issue with car-t treatments.
- jsperx 2y ago
  The article has a couple paragraphs about the complexity involved in fabrication and how labor intensive it is: “Maus walked me through some of the steps needed to create CAR-T cells for the trial. We started with the room where the DNA instructions that are added to the T cell’s genome are written. […] We went on to the lentiviral-production room, where technicians create viral vectors carrying this DNA. From there, we moved to the tissue-culture room, where the vector is mixed with normal T cells to create the CAR-T. Finally, we visited the immune-monitoring part of the lab, where lab techs assay blood draws and other samples from patients, looking for proof that the CAR-T cells have made it to their targets.” “Jennifer Wargo, a professor of genomic medicine at MD Anderson, referred to the cost of immunotherapy treatments as ‘financial toxicity.’ The patent for June’s CAR-T therapy for leukemia is owned by Novartis, and the median cost for the treatment is $620,000. Even if drug companies don’t try to profit from these therapies, the process is inherently labor-intensive: T cells have to be removed from the patient’s own blood, genetically altered, then reinfused. It’s difficult to determine where economies of scale might kick in.”
  - littlestymaar 2y ago
    Yeah, but that opens many more questions than it answers: this $620 000 figure cannot come out of labor intensity alone, as it represents the cost of thousands of work hours (literally a dozen of doctor full time for a month, or at least 50 well paid specialized technicians working for an entire month on each patient treatment) yet the process described in the text doesn't seem to match this level of labor.
  - robertlagrant 2y ago
    Half of that second paragraph seems to not belong there. Why rebrand "expensive" as "financial toxicity"? Why is profit bad when companies' losses are fine? It seems very strange.
shiroiushi 2y ago
>We are probably 30 years away from having an IT medicine that doctors prescribe regularly. Given the audience of this site, perhaps "IT" isn't the best acronym to use here.

littlestymaar 2y ago

Since you're knowledgeable in the field, I have a question: what makes immunotherapy more inherently expensive compared to other options?

pinewurst 2y ago
Because each patient’s treatment has to be individually created for them.
- moshun 2y ago
  This seems like a space ripe for intelligent robotics automation. Detailed, precise and laborious requiring years of not decades of technical expertise.
  - becurious 2y ago
    Look at what Cellares is doing. Building a manufacturing cell called the shuttle.
  - cactusfrog 2y ago
    Biochemical engineering exists as a discipline and focused on “scale up” of production problems like these. Robots are involved, but most of the time the process is modified to a more stable one.
- mahkeiro 2y ago
  They are many different kind of immunotherapies, not all of them have to be patient specific. For cell or vaccine therapies a lot work is currently done to create "off the shelf" treatment which may ease the issue with car-t treatments.
jsperx 2y ago
The article has a couple paragraphs about the complexity involved in fabrication and how labor intensive it is: “Maus walked me through some of the steps needed to create CAR-T cells for the trial. We started with the room where the DNA instructions that are added to the T cell’s genome are written. […] We went on to the lentiviral-production room, where technicians create viral vectors carrying this DNA. From there, we moved to the tissue-culture room, where the vector is mixed with normal T cells to create the CAR-T. Finally, we visited the immune-monitoring part of the lab, where lab techs assay blood draws and other samples from patients, looking for proof that the CAR-T cells have made it to their targets.” “Jennifer Wargo, a professor of genomic medicine at MD Anderson, referred to the cost of immunotherapy treatments as ‘financial toxicity.’ The patent for June’s CAR-T therapy for leukemia is owned by Novartis, and the median cost for the treatment is $620,000. Even if drug companies don’t try to profit from these therapies, the process is inherently labor-intensive: T cells have to be removed from the patient’s own blood, genetically altered, then reinfused. It’s difficult to determine where economies of scale might kick in.”
- littlestymaar 2y ago
  Yeah, but that opens many more questions than it answers: this $620 000 figure cannot come out of labor intensity alone, as it represents the cost of thousands of work hours (literally a dozen of doctor full time for a month, or at least 50 well paid specialized technicians working for an entire month on each patient treatment) yet the process described in the text doesn't seem to match this level of labor.
- robertlagrant 2y ago
  Half of that second paragraph seems to not belong there. Why rebrand "expensive" as "financial toxicity"? Why is profit bad when companies' losses are fine? It seems very strange.

shiroiushi 2y ago

>We are probably 30 years away from having an IT medicine that doctors prescribe regularly. Given the audience of this site, perhaps "IT" isn't the best acronym to use here.