11 ms·
Cure for cancer one step closer after 'spectacular' breakthrough
- msie 11y agoAnother 999 steps to go...
- msie 11y agoDear Downvoter, Am I wrong?
- epistasis 11y agoYou're presumably referring to the 1000 mountains PhD comic (was XKCD). The difference with the immune drugs is that the immune system can recognize ~500 of the 1000 mountains (the most mutated cancers). So by getting around the immune-evasion system, the immune system can clean up most highly-mutated cancers.
- dntrkv 11y agoYour comment was just unnecessary cynicism. http://blog.ycombinator.com/new-hacker-news-guideline http://blog.ycombinator.com/new-hacker-news-guideline "Critical thinking is good; shallow cynicism, on the other hand, adds nothing of value to the community. It is unpleasant to read and detracts from actual work. If you have something important but negative to say, that's fine, but say it in a respectful way." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html "Avoid gratuitous negativity." "Resist commenting about being downvoted. It never does any good, and it makes boring reading."
- jndsn402 11y ago> "...and it makes boring reading." I've always felt that this was wishful thinking on the part of the mods. Discussions about downvotes (or completely legitimate questions as to why something was downvoted) are no more boring than hundreds of other topics discussed here every day.
- Gatsky 11y agoYour tone is misplaced. I'm an oncologist, and with no conflicts of interest I can assure you these drugs are a bona fide breakthrough.
- mdtancsa 11y agoAs a lay person, its hard not to see the word "breakthrough" as essentially meaningless as its so overused. Insulin, and the polio vaccine I can see in that category... But there have been so many drugs like Avastin (which sadly I had personal experience with through my wife's cancer, which were supposed to be breakthroughs.. miracles etc... Yet, when the dust settled and more data beyond the initial company reported data came to light, it extended life expectancy by very little time.... Our oncologist was pretty good about holding expectations in check. But if we went by the company's claims, we would have been sadly disappointed through false hope, as well as the VAST majority of people who took Avastin. Or Erbitux was another. It was offered to my wife as an option... The pharma gloss used all sorts of superlatives, yet for her cancer, it would have given her an extra few weeks based on some of the studies we were able to dig up. For the kind of money spent for (in some cases) really shitty quality of life, $100k might be better spent on improved hospice care and pain control for the person.
- Gatsky 11y agoI agree with you that the word is overused. Avastin is most certainly not a breakthrough, I don't know any oncologist that considers it as such. I think the word is justified in this context however because the rationale behind immunotherapy is very sound, and it seems able to cure a non-negligible proportion of patients with otherwise incurable disease.
- mdtancsa 11y agoIf you google "Avastin breakthrough" (remember, we lay people have far more time with Dr. google), its still touted as this miracle drug, and is even being pushed as a treatment for non colon cancers of which there is little evidence it does anything... And remember, there are oncologists / doctors who lend their name to the company PRs... Its so sad to think someone would spend $20k on a useless drug, when $20k towards supportive treatments would go such a long, long way for quality of life :( I know there are genuine big steps forward. The cancer that killed Terry Fox for example is so treatable now. And there are good and effective drugs out there, and some that are bullshit. But from the perspective out here, its difficult, sometimes very difficult to tell the real breakthroughs from marketing hype.
- tosseraccount 11y agoSome people with a particular mutation profile get to live a few months longer. For $100,000.00 I guess the upsides are it does appear to be more than a month or two and the side effects are manageable.
- tluyben2 11y agoWell worth the $100k I would say.
- daveloyall 11y agoPretty sure that I speak for most humans when I say that a $100k medical treatment might as well be a $100m treatment. There's some quote like "any quantitative value is qualitative at sufficient scale". $10,000 is the most expensive thing I've ever purchased--and I'm still paying it off.
- carbocation 11y ago"Quantity has a quality all of its own." Attributed to Stalin but perhaps a misattribution.
- mb_72 11y agoI am no expert, but I am guessing like with most things the newest medical technology starts of at it's most expensive point, then decreases over time (as economy of scale or improvements in production efficiency kicks in). So if this treatment is 100k now, but 10k in 5 years and 1k in 10 years (just postulating) it makes it very affordable for people 10 years down the track. Once governments add the treatment to their pharmaceutical benefits programs the cost at that time could be close to zero for a lot more people. Of course we all want the best treatment Right Now, and sadly some people will die who cannot afford a certain medical procedure or medication, but this still seems like a discovery and advance worth thinking positively about.
- unclebucknasty 11y ago
- tptacek 11y agoQuick notes: * It's almost 60% of advanced melanoma patients * Advanced melanoma is difficult to treat * Small-seeming improvements in lifespans for late-stage cancer patients can be very significant, given the lethality of late-stage cancer * One of the two drugs, Nivolumab, also recently demonstrated effectiveness against advanced lung cancer --- another difficult-to-treat cancer Reddit AskScience is probably a good place to watch for updates on this.
- Brakenshire 11y agoThe NHS has a site called 'Behind The Headlines' which analyses articles about medical discoveries which appear in the media. It's also worth a look: http://www.nhs.uk/news/2015/06June/Pages/Immunotherapy-drug-combo-could-combat-melanoma.aspx http://www.nhs.uk/news/2015/06June/Pages/Immunotherapy-drug-... Some useful points: > "Severe side effects were seen in 55% of those taking the combination, 27% of the ipilimumab group and 16% of the nivolumab group. The most common of these side effects were diarrhoea and bowel inflammation...Side effects of the drugs were also a considerable problem. After one year, only a relatively small proportion of people in all treatment groups were still taking the drugs. In the combination group people had often stopped taking the drugs because of side effects. It will be important to compare people’s quality of life while taking these different drugs and their combination." ... > "Some of the wide media coverage of this study, arguably moves into the realm of hype. Much of the reporting could give the impression that immunotherapy is a new discovery. In fact it was first used in the late 1980s, and has been used in the treatment of various conditions." ... > Overall, people taking the combination lived longer without the disease progressing (average 11.5 months) compared with either drug alone (average 6.9 months with nivolumab and 2.9 months with ipilimumab). People whose tumour displayed the protein that nivolumab targets (PD-L1), did just as well with nivolumab alone as the combination. The study is ongoing and it’s not yet known whether people taking the combination treatment live longer overall than those taking the individual drugs.
- ksenzee 11y agotldr: They studied two drugs in people with advanced melanoma, and the combination works better than you would expect: median survival for people taking both drugs was almost a year, compared with ~3 months for one of the drugs and ~7 months for the other. It confirms that the newer immunotherapy drugs are great, and save a lot of lives. It's not a new scientific breakthrough, as you might think from reading just the headline.
- eip 11y agoRun From the Cure: http://www.youtube.com/watch?v=0psJhQHk_GI http://www.youtube.com/watch?v=0psJhQHk_GI
- jreed91 11y agoI'm guessing this just controls the tumors and prolongs their life? That is great but most people have serious side effects or the cancer becomes immune to these drugs. But we are headed in the right direction. My father passed away from melanoma a year ago. Since I have a high chance of getting this later in life, I'm happy that we are advancing this quickly.
- leecho0 11y agoI haven't read the paper, but according to the article, "The treatment, known as immunotherapy, uses the body's immune system to attack cancerous cells." Rather than trying to kill the cancerous cells, the drugs allow your body to attack the tumors. To give some background, your own body already tries to kill cancerous cells through cytotoxic t cells. The tumors that get serious are the ones that escape the immune system. However, strengthening the immune system has its own problems, since it can attack your own cells (autoimmune diseases), or cause other problems (like Crohn's disease). So I'd imagine the cancer cells probably won't get immunity to the drugs, but other serious side effects could come from the treatment.
- kolev 11y agoIt's a vicious circle as doesn't the Crohn's disease itself lead to suppressing the immune system?
- Gatsky 11y agoSome context. One of the drugs in the combination Ipillimumab has been used for a while now, and seems to produce long term survival in about 10% of patients with incurable melanoma. Some of these patients seem effectively cured, having survived 7 years or more without any other treatment. It seems likely that combination therapy will produce a better rate of effective cure. This is a pretty big deal, because advanced melanoma is otherwise a disastrous cancer to have. Cost effectiveness... well ipillimumab costs 100k a year for 4 doses, and nivolumab is probably going to cost another 100k at least on top of that, and is generally continued indefinitely, and the medication to turn off overly vigorous immune responses can also be expensive... But this is modern medical science how it should be. These are incredible, life changing drugs. The hype is justified. They are already spreading through many different types of cancer: lung, renal cancer, liver cancer, some breast cancer, some colon cancers. Toxicity is an issue, but this is generally temporary, and the quality of life tradeoff is different when there is the possibility of making the next 7 christmases. Furthermore, you have to balance the toxicity with the symptoms from progressive cancer or old style ineffective chemotherapy.
- coldtea 11y ago>Cost effectiveness... well ipillimumab costs 100k a year for 4 doses, and nivolumab is probably going to cost another 100k at least on top of that, and is generally continued indefinitely, and the medication to turn off overly vigorous immune responses can also be expensive... I cannot imagine a chemical process to create those drugs that justifies the prices mentioned. Is the price at least subsidising the costs of research, or is it an arbitrary price set by the drug company because "it can"?
- eropple 11y agoLittle of column A, little of column B. The research is expensive. But living is effectively priceless. There are solutions to this, and countries that are not mine will probably avail themselves of them sooner or later.
- onewaystreet 11y ago
- carbocation 11y agoThe phrase "cure for cancer" does a disservice in general, and even more clearly so on a site like HN where people generally speak precisely. (This is not intended for the person who posted the article - I know that HN guidelines recommend keeping the original title.) Inevitably side-discussions come up about whether something is truly a cure and then we get into discussions of the wording (I am currently guilty of this). The novel therapies for melanoma are by no means curative in general, but they add a tremendous amount (relative to the overall life expectancy) and should rightly be heralded (and their cost debated).
- nhstanley 11y ago"Cancer" is a word that describes any disease that is the result of uncontrolled growth of your own cells. However, there are so many types of cancer cells and the treatment for each so different that saying we've "cured cancer" is a prime reason why the public doesn't understand or trust these miracle breakthroughs. That being said, these PD-1 inhibitors are a huge breakthrough for any type of cancer that uses this mechanism to evade the immune system. One of the hallmarks of cancer cell growth is their ability to evade the immune system. PD-1 (programmed cell death 1) is a receptor on immune cells like T cells that tells these immune cells to "stand down"/go inactive. Some types of cancer secrete molecules that activate this receptor, inhibiting the immune cells. Drugs like Nivolumab block these receptors, keeping the immune cells active, allowing them to attack cancer cells when they encounter them. Metastisis (cancer cells spreading around the body) is what kills cancer patients, and drug strategies that can keep this from happening are key to keeping people alive. (Re-)activating the immune system against the cancer cells is a great strategy that's had some recent breakthroughs. Another recent breakthrough method, called CAR-T cell therapy (chimeric antigen receptor t-cells) also activates the immune system against cancer. In that case, they take immune cells out of the cancer patients body, use gene therapy to inject genetic material needed by the cells to recognize cancer cells, then grow those cell and re-inject them back to the body. This has been wildly successful in certain types of cancer, like certain leukemias and lymphomas, and may be successful for other types. Here is a nice article that covers these general strategies for those interested: http://www.forbes.com/sites/matthewherper/2015/04/20/immune-system-drugs-melt-tumors-leading-a-cancer-revolution/ http://www.forbes.com/sites/matthewherper/2015/04/20/immune-... There have been a lot of breakthroughs recently. If we keep pushing like this we'll someday soon be fortunate enough to be legitimately surprised when a friend or family member dies of cancer, and many other diseases.
- pinaceae 11y agoas someone who lost a friend last year to skin cancer and has a work colleague with end-stage breast cancer that has spread to her bones - bring it on. as someone working in life sciences - years off, even with FDA fast track. the incentive to reap billions is justified, this is far more important than a fucking social sharing app - it better be more profitable. the best minds should work on a cure for cancer not bullshit timewasters.
- ccvannorman 11y agoIn principle I agree with you, however I doubt it was a scrappy startup team of 3-10 scientists who will be reaping the billions, and I bet it will be incumbent pharmaceutical gargantuans who will earn the bulk of profits.
- snowwindwaves 11y agoAnybody can own part of the gargantuan and enjoy a share of the profit or loss by buying shares on the stock exchange.
- pinaceae 11y ago"scrappy" biotechs are the backbone of pharma innovation. genentech as the best known grandpa in that league. biotech is the other big startup area of the modern economy. full of VCs, unicorns and abysmal failures. but, their blockbuster products actually help people. :)
- datashovel 11y agoMy hunch is, the more greedy the patent holders are, the more likely, and the faster replacement cures will come to market. And if that day comes, I certainly hope one of those replacement cures puts the greedy ones out of business. On a darker note, I think your second comment speaks volumes about the kind of human being you are. I hope one day, years from now, you will take the time to come back to this comment and have the ability to reflect on just how sad your world view was at one point in your life. On a lighter note, I agree that the best minds in the world should work on solving the hard / important problems of the world. With that said, machine learning / artificial intelligence (what alot of those "timewasters" are probably working on) will be what takes the human race to the next level. If you think "finding the cure for cancer" is next level, I am here to tell you we haven't seen anything yet. Machine learning / artificial intelligence is what's going to take us there.
- datashovel 11y agoBased on the linked article from The New England Journal of Medicine would one be able to tell if this is a cure that will be patented by Evil Corp? Or are these researchers publishing these findings as "open source"? I'm presuming the 2 drugs themselves are patented? Otherwise I have a hard time believing 4 doses would cost 100k?
- nazgulnarsil 11y ago>after it's gone, after it's cured once and for all, this bane of human existence, this No. 2 Cause of Death, we will have extended human life a grand total of (drum roll, please) 3.3 years http://asserttrue.blogspot.com/2013/02/taeubers-paradox-and-life-expectancy.html# http://asserttrue.blogspot.com/2013/02/taeubers-paradox-and-...
- andyjohnson0 11y ago...and eliminated a vast amount of suffering.
- summerdown2 11y agoI get your point, and it's a very dramatic and low statistic. But still, just taking the US, if all 320 Million people live for an extra 3.3 years, that's 1 billion total years of life given to people. A lot of books could be written, science done, or life shared with loved ones in that time. Not to mention all the misery and pain removed.
- known 11y agoI prefer a vaccine for cancer prevention;