[HN Gopher] A vaccine for pancreatic cancer treatment?
___________________________________________________________________
A vaccine for pancreatic cancer treatment?
Author : dcminter
Score : 156 points
Date : 2023-05-12 16:44 UTC (6 hours ago)
(HTM) web link (www.science.org)
(TXT) w3m dump (www.science.org)
| jrjarrett wrote:
| I love that this is advancing treatment; I was somewhat
| disappointed that apparently, you must HAVE cancer first in order
| to create the vaccine.
|
| If there was a vaccine that prevented this before it happened, I
| would be in line.
| rodoxcasta wrote:
| They focus the immune system on the tumor by teaching it to
| identify some "neoantigens" in the tumor. Turns out that tumors
| express various strange proteins in their cell wall, I suppose
| because of the inherent genetic instability.
|
| Anyone know why this can't be a silver bullet for most tumors?
| Like, a way to target an intrinsic characteristic of cancers that
| in theory could be very effective on most of them.. sounds too
| good to be true. So, what's the catch?
| chrisamiller wrote:
| It's true that the whole problem of cancer therapy is "how do I
| target these cells over here, while avoiding the rest of your
| healthy cells, when they look mostly the same" And you're right
| that this is a really exciting and promising approach!
|
| A partial list of the "catches" at present are
|
| 1) tumors are really good at down-regulating the immune system.
| If they weren't, they would have been cleared already
|
| 2) we're still fairly bad at knowing which of the many
| mutations in a tumor are going to be good neoantigens - that
| is, which ones the immune system will be good at recognizing
| and ramping up against
|
| 3) It's expensive to design personalized therapies for every
| patient, but may be necessary (see some of my other comments
| below)
|
| 4) Tumors aren't single cells, they're collections of them that
| can have different characteristics. Just like with other
| therapies, sometimes immunotherapies kill 99% of the tumor, but
| leave that 1% to come roaring back. (same idea as antibiotic
| resistance)
|
| So yeah, lots of hurdles to overcome, but overall, I'm
| genuinely excited about the rapid progress we're making in the
| area of immunotherapies. It's impossible to overstate the
| effect that sustained research funding has had on the rate of
| advances in this field.
| remote_phone wrote:
| Pancreatic cancer terrifies me and keeps me up at night. It has
| virtually no symptoms until it's too late. My friends dad was
| diagnosed with pancreatic cancer and died 6 weeks later.
|
| Every time a celebrity dies of cancer I always hope that it's not
| pancreatic but the numbers keep increasing. Patrick Swayze, Steve
| Jobs, Alex Trebek, Aretha Franklin, now Jerry Springer.
|
| As someone with type 2 diabetes it's something I worry about very
| often.
| tombert wrote:
| Yeah, I'm right up there with you. My uncle died of pancreatic
| cancer about 15 years ago, and like you said, by the time he
| knew about it, it was way too late.
|
| I wish there were easier ways to check for it early.
| cdelsolar wrote:
| it's still very rare especially for young people. as someone
| with a degree of health anxiety, I sympathize, though.
| gww wrote:
| There are lots of other tumours that are just as deadly as
| pancreatic adenocarcinoma.
|
| Steve Jobs died of a pancreatic neuroendocrine Tumour. It
| should not be grouped with pancreatic adenocarcinoma. The
| former is approximately 7-8% of all pancreatic tumors and has a
| much better prognosis of almost 90% at 5 years if it's caught
| early. In Jobs case it was. Pancreatic adenocarcinoma has a
| dismal prognosis of <10% at 5 years.
|
| Edit. My Pancreatic cancer knowledge is a bit outdated but I
| recall type 2 diabetes being a risk factor for pancreatic
| cancer. I believe in some cases pancreatic cancer can cause
| diabetes because of the damage it does to the pancreas.
| 01100011 wrote:
| Yep. Ex-wife has neuroendocrine carcinoid tumors in her liver
| and pancreas, with the main tumor removed from her lung aroun
| 18-19 years of age.
|
| Unless your tumors are functional(i.e. they are
| neuroendocrine tissue and can secrete hormones) or rapidly
| growing, it's not a very severe disease and there are
| treatments available. After 6 years of monitoring by a
| leading oncologist, she was told she would live a long life
| and die of something else.
|
| That doesn't stop me from needing to pay her huge amounts of
| money for alimony, but it is what it is. Steve Jobs died
| because he was an idiot who tried quack therapies.
| jtlienwis wrote:
| You need to think of the cost of this kind of treatment at this
| stage as R&D. If it works thousands of people will benefit, have
| longer lives and contribute back more than the lifesaving
| treatment will cost.
| yieldcrv wrote:
| we can justify having an option for people's self preservation
| instincts without having to make up that fairy tale, more
| elderly humans will probably be a net negative
| chaxor wrote:
| It seems like you're the negative one here. There is nothing
| inherently negative about living longer - just potential to
| have learned far more than others from experience. Any
| biological issues with existing for longer can have
| solutions, for which may be tackled better with more good
| minds put forth to the task.
| yieldcrv wrote:
| nah, people just choose not to read what I wrote
|
| but it is illuminating to see a passionate audience's
| reading comprehension ability
|
| it says treatments and extending life is desirable and
| doesn't need a reason and the reason presented would be a
| waste of energy to debate and quantify while doing so isnt
| even necessary, read it again until it makes sense that way
| t-writescode wrote:
| I downvoted you for this part, fwiw:
|
| > more elderly humans will probably be a net negative
| yieldcrv wrote:
| [flagged]
| uvudshcg wrote:
| You're asserting that "more elderly people is a net
| negative" without giving a supporting argument.
|
| So, I think all the prayer above you is saying they
| disagree. And without you making the effort to support
| your kind of inflammatory statement... it seems perfectly
| reasonable to me that they would not support there point
| other than to say they disagree.
| yieldcrv wrote:
| and my only reason for that assertion is because the
| opposite assertion was not quantified either. I wrote
| "probably" as in "just as probably"
|
| it was to point out the equal likelihood, and the
| unnecessary aspect of bothering
| [deleted]
| spandrew wrote:
| That, or what you said was being a jerk and you got
| called out on it.
| yieldcrv wrote:
| and of the accuracy of the statement?
| UberFly wrote:
| Please explain your "fairy tale" descriptor, I don't
| understand what your are trying to say here.
| killjoywashere wrote:
| I think he's implying that everyone dies, everyone will
| ultimately live through some life arc, and letting people
| survive a fatal illness invariably causes the average age
| of the population to rise and at some point the costs
| outweigh the benefits. So what's the point of a longer arc
| of life?
|
| My personal counterpoint: pancreatic cancers tend to strike
| anywhere in adulthood, so survival could yet lead to many
| years of productive life. Also, having grandparents is
| good, even if they've retired. Maybe especially if they've
| retired.
| Taywee wrote:
| An additional personal counterpoint: I know three very
| productive knowledge workers over the age of 70 who all
| say they'll stop working when they're dead.
|
| My wife and I can only both work because our elderly
| parents take on childcare responsibility for us (because
| paid childcare is very often extremely expensive and very
| often very overcrowded), and our parents teach and enrich
| the lives of our children immeasurably.
|
| Take care of the elderly. Build systems and habits of
| care and compassion that you want to be able to rely upon
| when you get old.
| joshuahedlund wrote:
| I think you are all in agreement; I interpreted the above
| comment as implying the exact opposite - don't make
| economic arguments that people saved will contribute
| more, because elderly people may not actually do that,
| but that doesn't mean it's not worth it on other grounds,
| precisely as you are doing here.
| peteradio wrote:
| So yieldrcv is not arguing against the treatment, just
| saying a better argument should be made for it?
| tux3 wrote:
| I read yieldrcv as saying that people not dying is good
| on its own merit, so we don't need an economic argument.
| The survival instinct is enough justification on its own.
|
| We may not need to contrive some reason why saving lives
| will actually save us money, and therefore saving lives
| is good.
|
| If you need an economic reason to save lives, you will
| have to do incredible gymnastics to justify medical
| treatment for old people, for instance.
|
| So don't do the acrobatics. We can just say that medicine
| is good, actually.
| joshuahedlund wrote:
| yes, jtlienwis is making an economic argument to justify
| the treatment. yieldcrv is arguing that the economic
| argument may be invalid (i.e. it's a "fairy tale" to
| believe the treatment will pay for itself through
| economic activity, but there are non-economic arguments
| to justify treatment (i.e. "we can justify having an
| option for people's self preservation" - the treatment is
| an option for self-preservation and self-preservation can
| be justified on other grounds)
| Taywee wrote:
| I don't think the top level comment was inherently about
| money, though. "Contribute back" can mean non-monetarily,
| or even be implying an indirect monetary gain from them
| contributing non-monetarily to their families.
|
| Economics is devilishly difficult to really efficiently
| predict. More reliable lifespans and a larger elderly
| population can affect the total flow of money in ways
| nobody can properly imagine, positively or negatively.
|
| From a younger perspective, the effect of eliminating
| cancers from the equation implies a lot. What is more
| expensive to the world, years of cancer treatments and
| palliative care to somebody in their 70s, or somebody
| living healthily through to 90 years old before dying
| from heart failure? What about the family cost of caring
| for a sick elderly relative?
| yieldcrv wrote:
| correct, I'm not arguing against treatment. fascinating
| how that stirred people here.
| scarmig wrote:
| Another point to indicate that the elderly do contribute
| back: if the elderly were a net negative while we evolved
| (which involved a lot more physical labor than typical
| work does today), there'd be selection pressures against
| the genes that confer longevity. And yet we've evolved in
| a way that the typical person will live long past the age
| of reproductive viability.
|
| Concretely, humans aren't that much smarter than chimps.
| We did reach a point, however, where knowledge can be
| transferred and processed efficiently across individuals
| ("society"). The elderly play a net positive role in
| facilitating and maintaining these knowledge transfer
| networks, particularly to their kin.
| GrinningFool wrote:
| Not OP, but I think the gist was more about not needing to
| justify life-saving treatment in terms of cost-
| effectiveness over someone's life - people just want to
| live as long as possible, and that's OK in spite of the
| 'net negative' of increasing the aging population that it
| can result in.
|
| I think the accuracy of that 'net negative' assumption is
| definitely not a given and that's what most folks are
| reacting to.
| dfsalijvlkj32 wrote:
| [flagged]
| fwungy wrote:
| [flagged]
| jjtheblunt wrote:
| I'm guessing from your tone that your grandmother wasn't
| crippled by poliovirus years before the vaccine. mine was.
|
| to your probable point, it's a disservice that marketing of
| vaccine boosters has clearly made vaccines seem tied to
| corporate profiteering, but there DO exist useful vaccines.
| fwungy wrote:
| The CDC Red Book used to list the chances of a permanent or
| fatal response to polio as being < 0.5%. They took that out a
| while ago when people started citing it.
|
| Oftentimes you find that a bad outcome to an illness,
| especially when rare, is associated with an extenuating
| circumstance. Covid, for example, isn't all that dangerous to
| young people with healthy BMIs. OTOH it is very dangerous to
| the elderly with multiple comorbidities, i.e. people who are
| in danger under any condition and need careful care.
|
| Medicines and vaccines can be wonderful and life saving, but
| speaking as someone who has professionally reviewed trial
| data, they needed to be treated with great care.
|
| The potential for unintended consequences is always high with
| powerful new medications. Techno philia and corporate greed
| can often get in the way of good science.
| JumpCrisscross wrote:
| > _after years of work, BioNTech says that they can get it down
| to less than $100,000 /dose. I'm sure it can be driven down
| further, but this is highly unlikely to ever be cheap. They also
| got an anti-PD-L1 antibody and a four-component chemotherapy
| cocktail (those last two have already been tried in PDAC therapy
| without the vaccine dose, to unimpressive effect). The vaccine
| was administered across nine doses_
|
| Wow, $1mm to save a life. (This math works in the rich world.)
| pastor_bob wrote:
| Perhaps at some point, a 'generic' neoantigen profile vaccine
| can be produced that is somewhat effective. How much variance
| can there be amongst 500,000 cancer patients?
| chrisamiller wrote:
| There is a lot of great work going on thinking about this
| very problem. One common theory goes like this:
|
| There are lots of tumor "driver mutations" that are causative
| and occur in lots and lots of patients. These would make
| great targets for a vaccine like this, in theory.
|
| But - Tumors have to evade the immune system in order to gain
| a foothold. (We have all had many cancerous cells that were
| cleared away without anyone ever knowing!). If a mutation is
| particularly good at activating the immune system, it's
| unlikely to survive long enough to cause cancer. So one of
| the features that a mutation has to have in order to become a
| driver is that it's bad at being recognized by the immune
| system! That means the most common mutations that we'd like
| to target with cheap, mass-produced vaccines may not work
| very well.
|
| There's some evidence on both sides at this point, with lots
| more data being collected, but it's certainly something that
| us folks researching the problem are keenly following!
| inglor_cz wrote:
| To be more precise, the rich world can afford to spend money on
| developing such treatments.
|
| It is entirely possible that 30 years from now, the same
| therapy will cost 1000 USD per dose, with most of the expensive
| stuff automated away.
| screwturner68 wrote:
| The Hep-B vaccine used to cost $100K and now it's about $4000
| (in the US where we get screwed). Honestly a $20K vaccine that
| would protect me from the big killer cancers would be a check
| I'd write in a second and I'm not a rich man.
| ben_w wrote:
| Huh.
|
| I had Twinrix (Hep A+B combo vaccine) at least twice because
| I'd forgotten I'd had it, and only found out later when I put
| my medical notes into a spreadsheet.
|
| Just had to ask and the NHS did it for free.
| pkaye wrote:
| Maybe they meant the Hep-C treatment?
| touisteur wrote:
| Isn't hep-b integrated in the penta/hexa-valent doses for
| kids? (expensive compared to the old boring individual or
| tetravalent ones, but subsidized in France at least, so I
| guess French social security has more negociation power than
| little me? right?).
| chrisamiller wrote:
| This isn't a preventative vaccine like that. It's something
| that has to be developed _after_ you have cancer to target
| your tumor 's specific mutational profile. So mass production
| (just churning out the same thing in bulk) isn't really an
| option! Costs will probably come down eventually, but it's
| going to take research, technology development, and hard work
| to make that happen.
| polishdude20 wrote:
| Is it possible that there is only a relative handful of
| these profiles and we can have these vaccines already on
| hand for each of them?
| ugh123 wrote:
| Do you think it will be that price forever?
| remote_phone wrote:
| For as long as the biotech company can keep it there
| chrisamiller wrote:
| I'm as critical of pharma pricing as the next guy, but this
| really is a case where you're getting a custom vaccine
| design just for you, and the profit margins probably aren't
| very high. I certainly do think it'll come down eventually,
| but there are lots of factors slowing that down.
| mbiondi wrote:
| If it's your life, it might be worth it.
| screwturner68 wrote:
| It's cheaper than cancer, the loss of work and the tens if
| not hundreds of thousands of dollars spent on treatment,
| $100K is totally reasonalble.
| JumpCrisscross wrote:
| > _it might be worth it_
|
| It's absolutely worth it if you can afford it, which the rich
| world can. But personalised medicine forces us to face, in
| stark and dollarised terms, the inequity of healthcare access
| across the world.
| kulahan wrote:
| My plan is to get it via a hospital which accepts public
| funds. This requires them (by law) to offer a payment plan
| that works for my income level.
|
| I'm fine with """paying $1M dollars""" via a monthly bill
| of $50 or whatever until I die and the rest of the debt
| evaporates.
| wing-_-nuts wrote:
| I always wonder if they take assets into account with
| this?
| JumpCrisscross wrote:
| > _requires them (by law) to offer a payment plan that
| works for my income level_
|
| Which is a rich-world perk. (That, to be clear, we
| absolutely should offer our people.)
|
| Side note: do you have a link to more on this law?
| Currently dealing with an uninsured friend for whom we're
| pooling resources for a medical treatment.
| kulahan wrote:
| Certainly - here's the CFPB's page on it:
|
| https://www.consumerfinance.gov/data-research/research-
| repor...
|
| Note that this is for lower-income households
| pkaye wrote:
| Is your friend in the US? If their income is low enough
| they would qualify for expanded Medicaid or ACA subsidy.
| melling wrote:
| Not to worry, it'll be 1000x cheaper in 10 years.
| JumpCrisscross wrote:
| > _it'll be 1000x cheaper in 10 years_
|
| Personalised medicine has high cost floors. The factors
| which would enable a triple order-of-magnitude reduction
| in its cost would sooner realise massive savings
| elsewhere, which means it's unlikely a niche cancer
| treatment would be prioritised.
| a-user-you-like wrote:
| Then give it 50 years, have to start somewhere
| elicash wrote:
| I wouldn't want to burden my family with the debt.
|
| Especially if it might not ultimately work.
|
| That said, I appreciate that costs will go down over time--
| even if only somewhat, if the author is correct.
| xwdv wrote:
| If it doesn't work you get your money back.
|
| The worst case scenario is it works but you die in a car
| crash anyway.
| RobotToaster wrote:
| Stand and deliver, your money or your life.
| hprotagonist wrote:
| i happen to know that this is the lupin express!
| throwaway743 wrote:
| Damn haven't thought of Adam Ant in years. Nice
| a-user-you-like wrote:
| Yeah, best to just not have developed it, or to wait until
| a more equitable country like Norway develops it. Then it
| will be fair.
| carlmr wrote:
| Norway and Germany aren't that different I'd say.
| hprotagonist wrote:
| personalized medicine of this form is one case where at least
| for now the cost makes obvious sense. You're paying like 8 FTE
| PhDs to hand-build you a therapy from your own body. It's not
| even close to automated.
|
| but: if it doesn't work, sometimes you get your money back!
| (novartis has never had to pay out)
|
| https://www.fastcompany.com/40461214/how-novartis-is-defendi...
| stanford_labrat wrote:
| I don't know if 8 PhDs is entirely accurate, biotech teams
| are a thing and usually there are a good mix of non-PhD
| technicians who support an individual project.
| giantg2 wrote:
| I image it like ML teams in tech - the PhDs are building
| the models and the non-PhD are exposing the model,
| jockeying the data, etc.
| chrisamiller wrote:
| You're right that there are a variety of folks working on
| these things, both in academia and industry, but it's
| more complicated than "PhDs do this, others do that". It
| comes down to knowledge, ability, and experience, and the
| best research groups grab onto that wherever they can and
| slot people into the roles that are right for them.
| pmarreck wrote:
| Maybe there's a possible job in helping them automate this?
| failuser wrote:
| That might be a thousand times more expensive. It's not
| software, it's biological processes that are hard to
| automate.
| hanniabu wrote:
| That won't lower costs, only increase profits
| pmarreck wrote:
| That's bullshit, because it can do both. Increasing the
| amount that can be made by 10x could both reduce unit
| costs by 8.5x and increase unit profit by 1.5x. Get outta
| here with your pessimistic external-locus-of-control
| communism
| gtop3 wrote:
| Automation has a tendency to do both increase profits and
| lower costs. This is because as the price decreases the
| market increases. There's 500,000 new cases of pancreatic
| cancer a year in the world. How many of them do you think
| will have access to a One Million Dollar treatment?
|
| This is not to mention how much of this tech could be
| shared with other treatments for other diseases.
| chrisamiller wrote:
| There are lots of folks working on problems surrounding
| automation and reproducibility to enable science in this
| space. One such effort that I contribute to is
| [pVACtools](https://pvactools.readthedocs.io/en/latest/),
| (there are others as well). We do have a small team of
| developers who work in concert with scientists and
| clinicians to build these tools.
| pmarreck wrote:
| How would I apply for a job like that? I've always had a
| strong interest in bio and computers (and physics, and
| psychology, and...)
| hprotagonist wrote:
| safe bet people are working real hard on it; it's just
| like, cell cultures are fussy and biology doesn't care
| about you, so it's very much an uphill fight.
| [deleted]
| scarmig wrote:
| Napkin math: the typical estimate for the statistical economic
| value of a human life (in the US) is $1M-$10M. So if each
| vaccine course can be targeted such that it saves a life with
| 25% likelihood, it's likely a net positive. Future iterations
| and new technologies based on it would hopefully drive the cost
| down further.
| epgui wrote:
| In the US it was on the order of 10M$, not adjusted for
| inflation, a decade or two ago (source: publicly available
| DOT documents).
| tjpnz wrote:
| Presumably even less in countries with socialized medicine
| where the government buys in bulk.
| jdminhbg wrote:
| In this case it looks like probably not, at least in the
| short term, because it's all extremely personalized.
| yieldcrv wrote:
| I'm glad there are options in development! Let's hope there are
| parts of this that can be reduced in cost with scale
| jrussino wrote:
| > $100,000/dose
|
| I really wish I could see a transparent breakdown of that
| number. How much of that is the amortized cost of R&D,
| marketing costs, salaries for the executives and management,
| etc? How much of it is actual production costs, and what do
| those look like (raw materials, equipment, labor)? How much of
| it is profit? What else could be baked into that price?
|
| Does anybody here know of any publicly available reports that
| detail cost breakdowns for pharmaceuticals like this?
| peteradio wrote:
| I think you are probably right that this is some sort of
| Hollywood style accounting.
| epgui wrote:
| This is absolutely not surprising. When I was doing my MSc,
| I'd often use up about 5000$ just in single-use plastic
| consumables in a day. There were zero profit incentives
| related to my project, it was pure fundamental research. Wet
| labs are insanely expensive to run.
| chrisamiller wrote:
| That's not far off from the rates for producing custom order
| medical-grade peptides and/or mRNA vaccines, coupled with the
| expertise needed to design, administer, and monitor them.
| It's certainly not a case where they produce it for 100
| dollars and sell it for 100k. The market for this stuff is
| beginning to develop, and I hope that we'll see new
| innovative companies begin to produce them more cheaply.
| treeman79 wrote:
| So the Covid MRNA vaccine requires many boosters and doesn't
| provide protection for long.
|
| What are the odds this will be the same?
| Retric wrote:
| In this specific case boosters are likely unnecessary because
| pancreatic cancer isn't contagious and if it works all the
| persons current cancer cells are dead.
|
| As to the need for boosters, it's more a question what benefit
| a booster provides vs its risks and costs. Frequent measles
| boosters aren't recommended in the US in large part because the
| disease is already rare here. COVID is however still very
| common which changes the exposure risks part of the equation.
|
| This is also why vaccine boosters for measles are recommended
| when you travel to specific countries.
| https://wwwnc.cdc.gov/travel/page/travel-vaccines
| peteradio wrote:
| Covid MRNA vaccines short lived effect was more to do with the
| characteristics of the virus and the way our immune systems
| generally function, IMO.
| fsociety999 wrote:
| I am not entirely sure why you are getting downvoted. It says
| right in the study
|
| > Vaccine-expanded T cells were durable, persisting up to 2
| years despite post-vaccination mFOLFIRINOX treatment
|
| So yes, that seems to suggest you may have to keep going back
| every couple years for more boosters.
| ben_w wrote:
| I'd be fine with spending EUR100 per year on each of ten
| vaccines that each need annual boosting, if that reduced by
| merely 10% my risks from each of the top ten likely causes of
| death and QALY reduction at whatever my age is in any given
| year of my life.
|
| This isn't that cheap, not yet at least, but I think "what's
| the cost?" is a much more important question than "does it need
| boosters?"
| rubicon33 wrote:
| Call me crazy but I am of a firm belief that the cause of almost
| all cancers is viral in nature. It is a combination of a viral
| infection and a failure of the innate immune response to stop the
| virus. I believe we are stopping these viruses all the time in
| our daily life and it is only when our immune system is under
| duress (ex: age, smoking, chemical, etc.) that it fails to stop
| these viruses.
|
| I'm not a virologist, or a medical practitioner, just someone
| who's interested casually in the subject of cancer and viruses.
| epgui wrote:
| I'm a biochemist with a biomedical background. Everything that
| follows is a simplification, but it's truthy.
|
| We understand pretty well what causes cancer in "otherwise
| healthy individuals" (eg.: assuming there aren't particularly
| bad genes involved... which is a whole thing on its own), it's
| not a big mystery. We know with total certainty that "cancer in
| general" is not usually caused by viruses, although some
| viruses are notorious for causing cancer.
|
| What causes cancer is whatever causes tissue injury and
| inflammation, with some probability. This is why smoking causes
| cancer, why drinking alcohol causes cancer, why sunburns cause
| cancer, why ionizing radiation causes cancer... The more
| chronic or frequent the injury/inflammation, the more the odds
| stack up against you. Viruses that cause chronic inflammation
| cause cancer.
|
| (There are also a bunch of things that directly cause mutations
| including some of the above, and those cause cancer too, with
| some probability, if they overwhelm error-correction
| mechanisms.)
| polishdude20 wrote:
| Is it specifically inflammation or rapid cell regeneration
| which inflammation can cause?
| epgui wrote:
| In short, both, via a variety of mechanisms.
| biotechbio wrote:
| This is not true. Some cancers are caused by viruses. Many
| oncogenes were initially discovered in viruses. But the
| majority of tumors are definitely not caused by viruses.
|
| This was a hypothesis in the field for a number of years, and
| has been disproven. If you want a good overview of the history
| of cancer, I recommend "The Emperor of All Maladies" by
| Siddhartha Mukherjee.
| panabee wrote:
| where we agree:
|
| * not all cancers are caused by viruses.
|
| * only some cancers are caused by viruses.
|
| where we disagree:
|
| * that science has proven the majority of tumors are
| definitely not caused by viruses.
|
| could you kindly share a few of the studies disproving the
| majority case? in particular, i'm interested in the sample
| size and diversity powering these refutations.
|
| to clarify, i'm not saying you're wrong. simply seeking to
| learn more.
|
| my research has uncovered misleading conclusions based on
| studies with flawed methodology/logic. for example, this
| study [0] states, "epstein-barr virus plays no role in the
| tumorigenesis of small-cell carcinoma of the lung." based on
| a sample size of 23.
|
| [0] https://pubmed.ncbi.nlm.nih.gov/14752524
| biotechbio wrote:
| Sure, a 2020 study from the Pan-Cancer Analysis of Whole
| Genomes (PCAWG) Consortium, looking for viral evidence in
| thousands of tumor genomes and transcriptomes[0]. Part of a
| massive, cross-institutional effort.
|
| "Searching large pan-cancer genome and whole-transcriptome
| datasets enabled the identification of a high percentage of
| virus-associated cases (16%)".
|
| Far from majority.
|
| [0] https://www.nature.com/articles/s41588-019-0558-9
| panabee wrote:
| thanks for sharing. will dig into the methods.
|
| based on ebv studies i have read (happy to share if you
| want), some papers use flawed methodologies for viral
| detection (e.g., checking for limited set of viral
| proteins).
|
| to reiterate, we mostly agree, except i adopt a more
| restrained stance: the conclusion supported by science is
| that viral causation is provable in some cancers -- but
| not a majority.
|
| which is a subtle, but crucial difference, from
| concluding that viruses do not cause a majority of
| cancers (much higher bar IMO).
|
| for instance, past studies may have used flawed detection
| methods or extrapolated from unrepresentative samples
| like the lung cancer study shared earlier.
| epgui wrote:
| This is not really controversial. The majority of cancers
| in humans are not caused by viruses.
| chrisamiller wrote:
| You're going to want to start with the PCAWG consortium,
| who looked very closely at viral involvement across a host
| of cancers. Their numbers:
|
| Cohort: 2,658 cancers across 38 tumor types Findings:
| Overall, 23 virus genera were detected across 356 patients
| with cancer (13%)
|
| You can read all of the details here:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076016/
|
| I'm not saying that there aren't other mechanisms
| (sustained inflammation, etc) that might contribute to the
| aetiology of some other cancers, even without clear viral
| integrations, but we can state pretty strongly that many
| cancers are not directly caused by cancer.
| panabee wrote:
| thank you for sharing, will dig into this.
| coldcode wrote:
| Second that, its a great book.
| rubicon33 wrote:
| Thanks, I'll check that out. Bought it on Kindle and will
| give it a read.
| Maursault wrote:
| Clumsy headline. It's a vaccine that inoculates against
| pancreatic cancer. It wouldn't inoculate against the treatment
| for pancreatic cancer, because why would anyone want to develop a
| vaccine that prevents a cancer treatment from working? Headline
| vaguely reminds me of _Brain Candy_ , 1996.[1]
|
| [1] https://www.youtube.com/watch?v=xAn-mdS-otE&t=0m15s
| georgeburdell wrote:
| Vaccine seems like the wrong term as I think of it as
| preventative. Perhaps there is no precise term for a treatment
| that uses the immune system to fight an existing disease in the
| body
| nappingbat wrote:
| There are two types of vaccines: prophylactic (to prevent or
| ameliorate the effects of a future infection by a pathogen) and
| therapeutic (to fight a disease that has already occurred, such
| as cancer).
| stronglikedan wrote:
| [flagged]
| pmarreck wrote:
| [flagged]
| nathan_compton wrote:
| Hardly. One typically receives a rabies vaccine (for example)
| _after_ infection.
| tiahura wrote:
| _Perhaps there is no precise term for a treatment that uses the
| immune system to fight an existing disease in the body_
|
| Immunotherapy?
| cesnja wrote:
| Rabies vaccine is also given after infection.
| malfist wrote:
| Tetanus can be too
| up2isomorphism wrote:
| Yeah, every normal US people is paying 10x for the basic medical
| treatment compared to other developed countries in order to fund
| this treatment for the super rich.
| jjtheblunt wrote:
| BioNTech is German, not US.
| dang wrote:
| " _Eschew flamebait. Avoid generic tangents._ "
|
| https://news.ycombinator.com/newsguidelines.html
| temptemptemp111 wrote:
| [dead]
| valine wrote:
| How do we get to the point where this therapy doesn't require a
| team of scientists to manufacture? Is there a future where every
| cancer center has a DNA sequencer and mRNA synthesizer?
| elric wrote:
| Googling the cost of DNA sequencing suggests that "human genome
| sequencing cost decreased from $1 million in 2007, to $1000 in
| 2014". That's pretty amazing.
| voisin wrote:
| It's been 9.5 years since 2014. Wonder how far down it's come
| since then.
| searine wrote:
| Depending on options like depth and quality, a hundred to
| 500 hundred dollars.
| t-writescode wrote:
| Don't forget "Your Insurance Will Totes Pay for It" CEOs
| like the Epi-pen guy.
|
| 500 hundred (50,000) may still be low.
| mikeyouse wrote:
| The $1,000 'cost' was the actual lab cost previously, we're
| now at a point where consumers can buy WGS for under $400,
| so the equivalent supplies/materials cost must be well
| below that;
|
| https://sequencing.com/products/purchase-kit
| Workaccount2 wrote:
| Is there a service that burns your results after giving
| them to you?
|
| I don't need an AI eugenic death squad coming after me in
| 20 years.
| gww wrote:
| With the Novaseq X the cost is approximately $200 a
| genome. One the current challenges is storing the
| hundreds of gigabytes of data per genome.
| ojosilva wrote:
| I found the issue about storage quite interesting, went
| digging and I found this article:
| https://medium.com/precision-medicine/how-big-is-the-
| human-g...
|
| Although the article does not mention it anywhere, I
| thought such repetitive byte sequences could be
| compressed quite well with simple file compression. Went
| digging again. I was wrong, compression of FASTQ genome
| sequence files IS a thing:
| https://en.wikipedia.org/wiki/FASTQ_format#Compression
| touisteur wrote:
| 1TB SD cards are a thing for 150USD now? Maybe two for
| physical redundancy and some Reed-Solomon stuff on each
| card?
| gww wrote:
| I wonder if that would be cheaper in the long term than
| the typical NFS plus off site tape backups and/or cloud
| backup used by the places I have worked. I suspect it
| would become a logistical nightmare to store and keep
| track of thousands of SD cards.
| hkt wrote:
| It'd be pretty amazing to have something like the optical
| storage jukeboxes but for SD cards. Expensive, but
| amazing.
| touisteur wrote:
| I mean we still give DVDs for MRI results here...
|
| Edit: I'd prefer my biostuff data to stay mine and not be
| saved in multitude cloud pinatas...
| epgui wrote:
| Got mine done at 100x coverage (BGI genomics short read)
| for about 1000$ a couple years ago.
|
| (The 1000$ figure you're citing is probably benchmarking
| against 30x coverage, so 1k for 100x is a pretty good
| price.)
| chrisamiller wrote:
| Part of my research involves designing these cancer vaccines.
| There are different delivery mechanisms, but the need to
| synthesize medical-grade peptides or mRNA vaccines is one of
| the major drivers of cost. The sequencing costs are pretty
| minimal at this point, but analysis of that data by a team of
| experts is part of that cost as well. This is still largely
| bespoke stuff that can't quite be standardized because we're
| still figuring out the best approaches, but there are quite a
| lot of people working on it!
| malfist wrote:
| By doing research like this. Universities prove it's viable,
| then companys productionize it, sometimes with incentives from
| the government
| pixl97 wrote:
| Also, how do we get there without effectively creating
| bioweapons lab capable of immense damage in the wrong hands?
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