[HN Gopher] New cancer drug kinder than chemotherapy
___________________________________________________________________
New cancer drug kinder than chemotherapy
Author : pella
Score : 157 points
Date : 2024-01-18 17:54 UTC (5 hours ago)
(HTM) web link (www.bbc.com)
(TXT) w3m dump (www.bbc.com)
| Traubenfuchs wrote:
| From wikipedia:
|
| > When blinatumomab was approved, Amgen announced that the price
| for the drug would be US$178,000 per year, which made it the most
| expensive cancer drug on the market. Merck's pembrolizumab was
| priced at US$150,000 per year when it launched (in September
| 2014).[14] At the time of initial approval, only about 1,000
| patients in the US had an indication for blinatumomab.
|
| I take it they prefer to pump chemotherapy poison ito patients
| for financial reasons?
| ceejayoz wrote:
| It'll be substantially cheaper in the UK.
| teamonkey wrote:
| For those who need it will be free - but not to the health
| service, who do have to pay the sticker price.
| ben_w wrote:
| NHS is approximately a monopsony, which probably has some
| advantages for price negotiation.
| teamonkey wrote:
| A family member has had immunotherapy on the NHS and it
| was disclosed to them (not sure how reliable or accurate
| this is) that a single dose cost the NHS 4 figures. It
| needed several layers of approval for it to be
| administered.
| ben_w wrote:
| For one of the same drugs discussed above by
| Traubenfuchs? If so, unless I've misread the discussion,
| that looks like 12-140 times cheaper depending on which
| drug and exactly where in the 1000-9999 GPB it was?
| wlesieutre wrote:
| Prices in earlier comment are per year, prices the NHS
| paid were per dose. Do we know how many doses per year?
| ben_w wrote:
| Thanks! That means I did misread.
| teamonkey wrote:
| Indeed it was per dose, and IIRC the figure was over
| PS5000. It wasn't intended to be public knowledge, I
| don't think the patient was supposed to be shown it. The
| various supporting chemos ranged from below PS100 to
| about PS250/dose IIRC.
|
| I mention it because in the UK people don't really
| understand that drugs can be really expensive. The
| assumption is that due to the scale of the NHS they're
| heavily discounted or even free, and that the high prices
| mentioned by US folk is due to the unusual healthcare
| situation there.
|
| But there's real money being paid by taxes, as well as
| procedures that determine whether you're worth the
| expenditure.
| ben_w wrote:
| I'm sure some (many) make that kind of mistake, so it is
| worth pointing out.
|
| But also:
|
| > and that the high prices mentioned by US folk is due to
| the unusual healthcare situation there.
|
| Are they wrong? I keep hearing that the US government
| spends more per person on healthcare than the UK
| government, even though the US also has mostly private
| insurance on top of that and the UK mostly doesn't?
| teamonkey wrote:
| Not wrong at all.
|
| The NHS probably does barter discounts. But consider that
| a discount of 50% off $150k/yr would be incredible, yet
| still be a vast amount of money for a single treatment.
| mft_ wrote:
| I understand your cynicism, but let's inject some actual
| data.
|
| The price that the manufacturer charges for a course of
| blinatumomab (in a different indication for adults, not
| that this is especially relevant in this discussion) is
| ~PS56k [0] - so significantly lower than the price quoted
| from the US.
|
| NICE (the organisation which published the document
| referenced) exists to achieve value for money for the NHS
| for higher-priced and specialist treatments. If, following
| a thorough assessment, a medicine does not achieve the
| required value for money standard at the price proposed by
| the manufacturer, they are presented with two options: to
| not have the drug reimbursed in the UK at all, or to lower
| the effective price, so that the drug becomes cost-
| effective.
|
| [0] https://www.nice.org.uk/guidance/ta589/documents/final-
| appra...
| ceejayoz wrote:
| Sticker price varies by country, and national health
| systems can negotiate those prices with quite a bit of
| market power.
|
| https://www.pgpf.org/blog/2022/11/how-much-does-the-
| united-s...
|
| > According to a 2021 study by the RAND Corporation, a non-
| profit global policy think tank, prices of prescription
| drugs in the U.S. are 2.4 times higher than the average
| prices of nine other nations (Austria, Australia, Belgium,
| Canada, Germany, Japan, Sweden, Switzerland and the United
| Kingdom). That higher cost is largely related to brand-name
| drugs, which are 4.9 times more expensive in the U.S. than
| in those countries. In fact, brand-name drugs are
| responsible for 84 percent of total drug costs in the
| United States despite accounting for only 8 percent of
| drugs dispensed.
|
| The US is _just_ starting to negotiate pricing, beginning
| with ten specific drugs. Until 2022, it was _illegal_ for
| Medicare to do so.
|
| https://www.hhs.gov/about/news/2023/10/03/biden-harris-
| admin...
| teamonkey wrote:
| Literally, yes. On the NHS, they will exhaust cheaper solutions
| that have a fair probability of working before trying more
| expensive ones. Age, long term prognosis, whether they have
| dependents, and some other factors are also considered.
| Traubenfuchs wrote:
| > dependants
|
| You mean ones life is valued more if one has children?
| teamonkey wrote:
| If you have young children that depend on you, yes.
| copperx wrote:
| Do they look up records? Is this ethical? Does this also
| happen in the US or other countries?
| dekhn wrote:
| There's an entire subfield dedicated to calculating life
| values for making difficult decisions.
| https://en.wikipedia.org/wiki/Value_of_life
|
| I don't recall seeing having children as a variable in that
| valuation, it's typically more about how many years of work
| you continue to do, cast back into current dollars
| ("present value lifetime earnings", see https://escholarshi
| p.org/content/qt82d0550k/qt82d0550k.pdf?t...) and
| normalized for base rates.
| BobaFloutist wrote:
| I mean, yeah. Of course it is.
| copperx wrote:
| No, I wouldn't say a life with dependents has more value.
| However, I do think it should be prioritized over those
| without dependents.
|
| But that has nothing to do with inherent value.
| andy_xor_andrew wrote:
| dumb question... is it _purely_ the demand that makes it this
| expensive? The "you need this or you die" aspect? Or is the
| cost of research and manufacturing for this stuff so
| astronomical that it warrants such a high price?
|
| I almost don't want to even know... if I find out it costs only
| ~$5 to develop a dose, and they're charging $200k to dying
| people... ugh
| seventytwo wrote:
| The research, development, approval process, and production
| all absolutely cost money that needs to be recouped from the
| sale, but we shouldn't ever forget the _reason_ why the
| company exists: to make profit.
| wahnfrieden wrote:
| In other words, no it is not only supply and demand - it's
| the desire to maximize profit as far as the market will
| bear
| daedrdev wrote:
| Or like the other response to your parent comment said,
| it could cost a ton to make, which lowers the number of
| people who can get it, driving costs even higher due to
| low volume.
| konschubert wrote:
| You also need to pay for all the other research projects
| that did NOT yield a successful drug.
| throwup238 wrote:
| There is zero chance it costs $5 per dose because
| blinatumomab is a bi-specific T cell engager which is a
| monoclonal antibody made by extracting it from a cloned white
| blood cell created from recombinant DNA. The yield for this
| process is extremely low and it's really complicated in the
| best of times. The cost of the pipette tips and other
| consumables used by the lab automation alone probably costs
| more.
|
| The flip side is that it treats a rare form of leukemia so
| the market isn't very big and since they can't lower the
| price enough to compete with chemo, they have to actually
| charge _more_ to get their money back. For example chemo
| might cost $10k, but their drug costs $10k to make per person
| so if they charged $50k they might not even get enough
| customers to break even. So instead they charge $200k to get
| the most from the patients they _can_ capture like the X% of
| patients who are allergic to the chemo drugs and have no
| choice (Just an example, I don 't know the specifics for
| blinatumomab)
| anatnom wrote:
| I took blinatumomab in 2015 (in my late 20s). It literally
| saved my life. However, the risks of blinatumomab were seen as
| much riskier than chemotherapy. Most notably, blinatumomab has
| a significant risk of triggering a cytokine storm[0], a
| frequently-fatal immune reaction cascade. When starting a cycle
| of blinatumomab, the hospital required that I be inpatient for
| 7 days and they checked my vitals at least once every two
| hours. (This was _miserable_ for my sleep schedule, which is
| already a mess when in the hospital.) My regimen was 7 days in
| the hospital, then 21 days at home constantly connected to the
| pump, then 7 days of recovery time before starting another
| cycle.
|
| At the time I took blinatumomab, I had already had unsuccessful
| treatments with two different chemo regimens. At the hospital
| system I was at, at least one failed chemo regimen was a pre-
| requisite for blinatumomab, as it was only indicated for
| "refractory" or "recurrent" cancers. I assume this is more
| related to the chance of acute death and (at the time) relative
| newness of blinatumomab compared to established chemotherapy
| regimens. (B-cell ALL is sadly very common in children, but
| this fortunately means that there is a LOT of funding research
| into the disease.)
|
| After going through 3 one-month cycles of blinatumomab, it was
| becoming less effective, but I was able to line up a allogenic
| stem cell transplant which has (knock on a thousand woods) kept
| me clean for the 8 years since.
|
| [0] https://en.wikipedia.org/wiki/Cytokine_storm
| pama wrote:
| Amazing story. Thanks for sharing. For all of us who work in
| drug discovery the hope is to hear cases like yours become
| more common and hopefully one day we can push cancer out of
| the range of common causes of death. There is still a ton of
| work to do.
| dogman144 wrote:
| That poison chemo was and is a vast improvement on puberty-
| killing radiation, for instance. It's a spectrum
| mdp2021 wrote:
| Coincidentally, physicist Sabine Hossenfelder published on YT
| just hours ago about a new treatment - "proton flashes".
|
| > _one of the most common ways to treat cancer is radiation
| therapy with x-rays ... You can use these highly energetic
| photons to kill off cancer cells. The difficulty really is ...
| killing the cancer cells without killing the patient - but the
| problem with using x-rays is that you can 't shoot them at tumors
| inside the body without also burning some of the tissue on the
| way to the tumor and behind it... But you can use beams of other
| particles instead and this is where particle physics enters ... A
| beam of protons is far less likely to interact with tissue on
| short distances_
|
| And it is still part of the "kinder" set (protons are "kinder"
| than x-rays).
|
| _New Cancer Treatment With Proton Flashes Goes on Trial_
|
| https://www.youtube.com/watch?v=K515uMQQzV4
| dekhn wrote:
| I downvoted you mainly because Sabine is a font of
| misinformation in areas outside her direct expertise.
|
| Particle beams for cancer therapy aren't new; shortly after the
| invention of the cyclotrone, EO Lawrence did this with neutrons
| in the late 1940s and proton beams were being used successfully
| in the 50's. She leaves out these details and only mentions
| trials from the 1990s.
| blashyrk wrote:
| > I downvoted you mainly because Sabine is a font of
| misinformation in areas outside her direct expertise.
|
| Just curious, since I've run into her channel recently and
| found her generally pleasant and informative (minus the
| unfunny jokes part), do you have any specific examples of
| this?
| dekhn wrote:
| https://www.reddit.com/r/AskPhysics/comments/15o0fx7/i_just
| _...
|
| To be fair, her criticism isn't that LIGO itself was fake,
| but it's really hard to tell, from the video and from
| https://backreaction.blogspot.com/2019/09/whats-up-with-
| ligo... If you read that blog, you can see she is using a
| collection of rhetorical techniques to cast down on the
| LIGO results (for example, using the term retraction out of
| context).
|
| But it's mainly her videos about health-related stuff that
| doesn't have good support. She approaches most of these
| things with a "assume a spherical cow" approach, common
| when physics folks try to do biology.
| mdp2021 wrote:
| Thank you for the warning about Dr. Hossenfelder and for the
| information about the technology,
|
| but we have not effected any blind endorsement. Just informed
| of a consistent parallel piece, esp. after the coincidence,
| which may be useful in itself - or just interesting.
| bearjaws wrote:
| I actually worked with MGH on their first proton treatment
| software for non cyberknife proton treatment. Later scaled it
| into AWS so their dosimetrists could iterate on treatment plans
| much faster. The initial treatments were incredibly successful
| and much easier on the patient, but theres no miracle either.
|
| Patients still suffer adverse reactions, and you will have
| margins of error, not to mention you do not have unlimited time
| to develop a treatment plan that is perfect. It's a
| time/efficacy trade off and the goal is to hit as much of the
| cancer as possible, while maintaining a SAFE dose of radiation,
| not a zero dose. What is a safe dose? Well, the more aggressive
| your cancer the higher that number gets too.
|
| Some patients still receive high dose radiation while on proton
| treatment simply because their cancer is that aggressive,
| typically suffering the same grade 1-2 diarrhea and vomiting as
| any other form of radiation.
|
| Proton treatment is far superior for most cancers, especially
| deeper cancers like colon and prostate.
|
| It's a living example of how tragic a new treatment option is,
| unfortunately proton centers are expensive to build and take
| years. So many people are still passing away from treatable
| disease and having to endure high dose chemotherapy in other
| cases.
| rdedev wrote:
| My theory is that cancer is a precision recall problem. Our
| body has the tools to fight cancer but they need to be
| precise otherwise they would end up attacking normal cells.
| Our cells do not have as much high level view that we do. On
| the other hand if we see a skin cell inside the brain we know
| that's cancer. Hopefully we can build some treatments that
| lets us light up cancer cells and have our own cells take
| care of it. That being said it's easier said than done
| pgalvin wrote:
| On the topic of interesting Physics contributing to new cancer
| therapies, there is also Boron Neutron Capture Therapy
| (https://www.neutrontherapeutics.com/about-bnct/). I gather the
| gist of it is that it builds up boron isotopes around a tumour,
| then bombards it with neutrons that mostly pass through the
| body but interact far more with the boron isotopes. Energetic
| particles are emitted, have a low range, and hopefully kill
| just the cancer cells. Apparently all in less sessions than
| with X-ray or proton therapy.
|
| Disclaimer: I am not a doctor or medical physicist, I'm just
| fortunate enough to briefly use a machine intended for this
| purpose in separate nuclear physics studies. I believe BNCT has
| been done before with reactor sources of neutrons, but for some
| reason not as a standard treatment and there's only one left in
| Taiwan for this purpose. The new development, afaik, is the
| ability to use accelerator neutron sources for this. Would love
| it if anybody knows more!
| rngname22 wrote:
| Is there a way to like emit energy in a narrow beam from a
| bunch of different angles around a central target such that
| they only overlap in the center/target and the frequencies
| resonate in that location in such a way to reach a higher
| frequency past which there is a destructive effect but below
| which is safe and non-destructive?
|
| /knows nothing about physics
| csdvrx wrote:
| Yes, there is beam forming.
|
| Do a websearch about MIMO and beamforming, or ask Bing
| chatgpt to explain it.
| thfuran wrote:
| They're generally delivered sequentially rather than
| simultaneously, but that is standard practice. It means you
| can concentrate the dose in the target area, but constructive
| interference affects only intensity, not frequency. And
| photons will still interact pretty evenly along the whole
| path.
| dekhn wrote:
| https://en.wikipedia.org/wiki/Radiosurgery there is a subtype
| called Gamma Knife which uses a large collection of emitters
| to effectively target a location while keeping other
| locations under a specific radiation threshold.
| meindnoch wrote:
| Let me guess without looking at the video. Is it about the
| Bragg curve?
| i_cannot_hack wrote:
| Worth noting here is that "proton flash therapy" is a new
| therapy, but "proton therapy" is not. Proton therapy is a lot
| more recent than x-ray therapy, but still a conventional
| therapy.
|
| Flash therapy is the part is which just now entering clinical
| trials, where you treat the patient with ultra-high dose rates
| (so you deliver the same dose of radiation, but in maybe 90 ms
| instead of 90 seconds). There are indications that healthy
| cells are better at recovering from the ulra-high dose rate
| than tumor cells are, which means it would have a protective
| effect on healthy tissue, but the mechanism behind it is not
| known. The type of radiation is not specified, it can be
| protons, electrons, x-rays, etc.
|
| So "proton flash therapy" is a Flash therapy that uses protons.
| Other clinical trials are using electrons instead, i.e.
| "electron flash therapy".
|
| Edit: If anyone thinks this is interesting and is looking for
| work in Stockholm, my workplace develops simulation / treatment
| planning tools for radiation therapy (including proton therapy
| and flash therapy) and is currently recruiting C++ and C#
| developers: https://www.raysearchlabs.com/career/
| mjfl wrote:
| Any chemotherapy that damages the immune system should be
| avoided.
| SpaceNoodled wrote:
| It can be preferable to having your body slowly town apart by
| its own immune system.
| kepoly wrote:
| As I sit here getting chemo for B-Cell ALL, most of us don't
| have any other option, it's chemo or death.
| Kognito wrote:
| From one internet stranger to another, I wish you a speedy
| recovery friend!
| navigate8310 wrote:
| I hope for your speedy recovery. Be strong.
| bearjaws wrote:
| Theres a field of auto-immune disorders, where patients suffer
| from their own immune system. I believe they would disagree
| with you.
| sgift wrote:
| Yeah okay. I could have chosen to die instead. Think that would
| have been better?
| josefresco wrote:
| My own immune system is attacking my joints. Without treatment
| I'll be disabled within 10 years. What's your advice doc?
| narrator wrote:
| Most cancer papers in the literature: "We found a new way to kill
| cells. Maybe it will kill cancer cells better than normal cells!"
| mmaunder wrote:
| We need to see a much faster ramp in the pace of innovation in
| this space. We're eeking out tiny wins over decades, like
| Rituximab and this agent. Feels like there's an ossification of
| this entire sector that happened years ago and there's no sense
| of urgency - just businesses as usual with the occasional modest
| win to show. 80 years since chemo was discovered, our most
| successful treatment across the board continues to be poison that
| kills fast growing cells faster than it kills the host. We are
| oncological troglodytes.
| echelon wrote:
| Molecular solutions are punch card science.
|
| I really want to do whole-body clonal work. Our bodies and
| genes are machines, yet we still haven't put them to work.
| We're plastering over the breaks with crude tools that feel
| like modern day bloodletting. The blast radius in the
| transduction pathways is huge and imprecise.
|
| I've written extensively about this topic on HN. Give me a
| minute and I'll dig up some references.
|
| Edit:
|
| https://news.ycombinator.com/item?id=35321368
|
| https://news.ycombinator.com/item?id=32379247
|
| https://news.ycombinator.com/item?id=30407908
| slibhb wrote:
| We're nowhere near "head transplants" or "creating braindead
| clones" (not to mention keeping them alive and healthy for
| decades). This is science fiction.
|
| Actual cancer treatments are moving forward at a good pace.
| Immunotherapies are a good example. Cancer treatment is an
| example of medical research working well.
| Apocryphon wrote:
| Yeah, if we're going to talk sci-fi, at least nanomachines
| are much less ghoulish than the implications of legalized
| human cloning.
| Ralfp wrote:
| This is not only a morally ambiguous sci-fi, it also skips on
| issue that we have no 100% proof way to make sure the blood
| used in the procedures you proposed will not contain cancer
| cells that will then invade the transplanted organ.
|
| Not to mention issue of patient being weakened by, say, organ
| failure, to even survive such procedure.
| CyberDildonics wrote:
| Your comments are basically "what if we had clones guys, why
| has no one thought of this?"
|
| You didn't "write extensively", you put science fiction plots
| ideas that have already been done a dozen times into
| comments.
|
| I'm going to go out on a limb and say that execution might be
| a bigger factor than ideas here.
| echelon wrote:
| You remain possibly my single biggest critic on HN,
| CyberDildonics.
|
| I originally posted a follow-up message, but I revealed to
| much of the path gradient to build this and so I deleted
| it. There are so many low-hanging fruit markets, but I have
| to hold my tongue. It needs the right leadership and angle
| of attack.
|
| I bet my reputation that none of this is science fiction,
| though, and I can't wait to prove you wrong about
| everything you doubt me on. Give me ten years on this one.
| I'll show you.
|
| The Hollywood thread you keep doubting me on is going to be
| extremely obvious in about six months. I really want to see
| you eat your hat on that one. I'm sleeping on the floor
| every night to make it happen, and we're getting there.
| bglazer wrote:
| There are a ton of challenges to better oncology treatments.
| First, as many have noted, cancer is a constellation of
| diseases. Often a single tumor will contain multiple different,
| but related groups of cells. So most treatments will only work
| for a subset of cancers, and then only until the cancer evolves
| to be resistant. So any advance, will be necessarily "modest",
| the reality of the situation is that there will never be a
| silver bullet. The closest we've come is immunotherapies, the
| class of treatment described in the article. These are a
| legitimately incredible advance, completely curing many people
| without the side effects of chemo. That said, theyre limited
| because cancer can evolve to defeat the immune response, and
| occasionally the immune system either under or over-reacts.
|
| Also if you think there's no sense of urgency, you haven't
| talked to anyone actually in the field. Do you really think
| oncologists (pediatric oncologists!) aren't eager to cure their
| patients?
| s1artibartfast wrote:
| Plus there is the existing financial incentive. If an
| individual or company comes up with a revolutionary
| treatment, it would be an absolute money printer.
|
| Even historic improvements for large demographics have
| massive returns. Keytruda (major oncology improvement) had
| more than $20 billion sales in 2023.
|
| It is hard to think of a stronger market incentive to improve
| drugs as much as possible.
| mmaunder wrote:
| > Do you really think oncologists (pediatric oncologists!)
| aren't eager to cure their patients?
|
| Don't be bloody ridiculous.
| Log_out_ wrote:
| Why has chemo go through the whole body. Why not ecmo chemo only
| the combat zone?
| bluGill wrote:
| Things like that are done where we can figure out how to get
| the drugs there. Not an easy problem though.
| s1artibartfast wrote:
| Usually the cancer cells are throughout the body, even if the
| tumors themselves have not spread. This is why you might cut
| out a solid tumor, and then give chemo
| rubberband wrote:
| For me, they cut out most of a giant tumor, but couldn't get
| all of it without risking some vital organs. Then I got chemo
| for the rest. Interesting process.
|
| _Usually_ the cancer cells are concentrated where the tumor
| is. One of the first things they may do upon diagnosis of
| cancer is a PET scan (which shows you where cancerous stuff
| is throughout your body).
|
| Life advice for all the young folks: don't get cancer.
| s1artibartfast wrote:
| my understanding is that the word "concentrated" does a lot
| of heavy lifting, and modern thought is that most cancers
| started spreading cells all over the body, even at very
| early stages.
|
| metastatic cancer is a numbers game. for example. at stage
| 0-1, you might still have millions of cancer cells
| throughout your body, and there is a good chance your
| immune system can clean them up. At stages 2 or 3 there
| might be trillions of non-local cancer cells, with a
| proportionally greater chance of propagation.
| Johnny555 wrote:
| When my dog had a subcutaneous form of cancer, one treatment
| discussed was local injection of a chemotherapy agent in the
| tumor area along with electrochemotherapy to help make the
| tumor more susceptible to the chemo treatment.
|
| We opted for surgical removal instead.
|
| https://en.wikipedia.org/wiki/Electrochemotherapy
| bglazer wrote:
| Antibody drug conjugates are one attempt at doing this.
| Basically attach chemotherapy drugs to molecules (antibodies)
| that bind only to proteins on cancer cells
| smileysteve wrote:
| In particular, this is a treatment for leukemia; a blood
| cancer.
| rubberband wrote:
| There's "topical" chemo for some stuff, but it's uncommon. Most
| chemo is either in pill form, or (as was for me) delivered
| intravenously. So it goes through the whole body.
|
| Radiation therapy can target specific areas. It's still used
| instead of chemo in some cases.
| Johnny555 wrote:
| I'm hoping that immune therapies for cancer continue to improve.
| My dog got an experimental immunotherapy for his Hemangiosarcoma
| tumor (which is incurable). Due to the advanced state of the
| tumor (he had to have his spleen removed in emergency surgery due
| to the tumor, plus it had spread to other organs), he was given a
| 2 - 4 month survival time, he's on month 4 now.
|
| There's not enough data to say if the immune therapy is helping
| (he's on traditional low-dose chemo as well), but it seems
| promising. The company (Torigen.com) is focused on animal
| treatment for now, but sees applications for humans in the
| future.
| jackblemming wrote:
| You gave your dog an experimental immunotherapy and emergency
| surgery for.. an expected 2-4 extra months with a presumably
| lower quality of life?
| Johnny555 wrote:
| Well, medical decisions are rarely that clear cut... the
| source of the bleeding spleen was unknown. All we knew is
| that he was bleeding out from his spleen and based on the
| volume of fluid in his abdomen, he wouldn't survive until
| tomorrow. It was "probably" a tumor, but the ultrasound was
| not clear and if it was a tumor, there was a 60% chance it
| was cancer. And we had 30 minutes to decide whether or not to
| take the surgical slot as they couldn't hold it beyond
| then... if we didn't opt for surgery we'd need to euthanize
| the dog.
|
| So the choice was "immediate death or surgery plus a 40%
| chance of returning to normal".
|
| After the biopsy came back and it was Hemangiosarcoma, then
| we opted for the experimental treatment coupled with low-dose
| chemo, which had a low chance of side effects that affect
| quality of life. The experimental vaccine was both to hedge
| our bets (it wouldn't hurt, and it could help, especially if
| he developed side effects to the chemo and we had to stop the
| treatment), and to give the company a little more data on the
| effectiveness of their treatment (even if we had to pay for
| it).
|
| And indeed, he's had a good quality of life - he was fully
| recovered from the splenectomy in a week (though we had to
| keep him movement restricted for another week until the
| stitches came out), and so far he's 100% back to normal,
| showing no side effects from the chemo and his activity
| levels are still back to normal.
| m463 wrote:
| > we had 30 minutes to decide
|
| The older I've gotten the more I've been in these kinds of
| situations.
|
| As a kid you are shielded from stuff, and it catches people
| so... unprepared.
| Johnny555 wrote:
| >As a kid you are shielded from stuff, and it catches
| people so... unprepared.
|
| Yeah, I still remember my dad going in to the hospital
| one weekend for what he thought was heartburn, but mom
| made him go anyway... he didn't come home for 2 weeks
| after being admitted and receiving triple bypass cardiac
| surgery.
|
| In the dog's case, we thought he ate something bad, he
| was a little lethargic but otherwise seemed ok, no fever
| or anything... we almost decided to wait a couple days to
| see if he got over it before taking him to the vet. Even
| the vet seemed shocked when she came back in the room to
| tell us the diagnosis from the ultrasound. We never
| expected to be deciding whether he'd live or die that
| day.
| s1artibartfast wrote:
| Im not familiar with how animal medicene work. When you say
| it was an experimental treatment, does that mean your pet
| participated in a registered study by the manufacturer? If
| so, did the manufacturer pick up the cost? Alternatively,
| do you mean that the treatment was experimental because it
| was off label use, and outside of a study?
| Johnny555 wrote:
| I encourage you to visit their website to learn more as
| I'm just interpreting what our oncologist told us about
| the Torigen vaccine.
|
| It's not part of a funded study so you have to purchase
| the vaccine and agree to let your vet provide followup
| information back to the company.
|
| Our dog's oncologist recommended it and said they've seen
| promising results in other patients, but wouldn't go so
| far as to say that it would prolong his life. The only
| published data I've seen from the company is a safety
| study.
|
| We got the vaccine mostly as a hedge in case the chemo
| didn't work or he had side effects and we had to
| discontinue it, but also to provide data back to the
| company on their vaccine in the hopes that it will help
| other animals or for future human applications.
| odyssey7 wrote:
| Two scenarios for testing experimental cancer therapies for
| dogs. Either you use the experimental therapy to treat
| cancers when they naturally occur in dogs, or you somehow
| give cancer to otherwise healthy dogs and then use the
| therapies to treat the cancer.
| s1artibartfast wrote:
| It isnt the choice that I would make, but what other people
| do with their money is their own business, and the science
| may prove useful.
|
| However, those that call for state funded animal insurance,
| or mandates truly strike me as unhinged.
| dendrite9 wrote:
| The class of drugs are Bi-specific T-cell engagers from what I
| understand. I have a relative going through treatment and the
| possibility of these treatments was raised so I have been reading
| some but I'm not claiming to be an expert. The risk of side
| effects like the Cytokine storm seems to be similar to CAR-T, but
| this type of treatment doesn't require the blood harvesting, cell
| modification, and return for reinfusion. It seems like a better
| (more generic) way of accomplishing something similar.
|
| In the case of the family member in question it sounds like one
| of these therapies are an option after CAR-T treatment currently.
| But it might be a preferable option in the future. I'm not sure
| if that is related to novelty and lack of data or something else.
| google234123 wrote:
| If you otherwise completely healthy, wouldn't you want to still
| keep the chemo therapy (even if it's only a small asditional
| contribution) I'd want the greatest chance of winning
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