[HN Gopher] AstraZeneca unveils successes in treatment of lung c...
___________________________________________________________________
AstraZeneca unveils successes in treatment of lung cancer
Author : cebert
Score : 295 points
Date : 2024-02-19 14:31 UTC (8 hours ago)
(HTM) web link (www.ft.com)
(TXT) w3m dump (www.ft.com)
| cebert wrote:
| https://archive.ph/eNqky
| genman wrote:
| It is about Osimertinib, sold under the brand name Tagrisso.
|
| It works (in "statistically significant and highly clinically
| meaningful" manner) against certain types of lung cancer when
| administered on early stage.
|
| It was provisionally approved after success in phase 1 trial by
| FDA in 2015 and by EMA in 2016.
|
| Side effects:
|
| Very common (greater than 10% of clinical trial subjects) adverse
| effects include diarrhea, stomatitis, rashes, dry or itchy skin,
| infections where finger or toenails abut skin, low platelet
| counts, low leukocyte counts, and low neutrophil counts.
|
| Common (between 1% and 10% of clinical trial subjects) adverse
| effects include interstitial lung disease.
| GenerWork wrote:
| That doesn't sound too bad if it can cause lung cancer to
| regress.
| hef19898 wrote:
| Side effects do not realy sound bad so, as someone who went
| through a light, comparatively, chemo I saw a lot worse with
| other patients. Plus, the alternative is lung cancer in late
| stages. And you sure as hell don't want that!
|
| It is really good to see progress in cancer treatment so!
| hanniabu wrote:
| > It works (in "statistically significant and highly clinically
| meaningful" manner) against certain types of lung cancer when
| administered on early stage.
|
| What is considered early stage? Pre symptoms?
|
| And what type of success rate are we talking here?
| e40 wrote:
| The side effect you didn't mention: mouth sores. It's the only
| one that my wife had (in the first month). So far, no other
| problems, though the chemo started last week (see my comment
| about it, if curious).
| quantumwoke wrote:
| That would probably be from the chemo your wife is on rather
| than the osimertinib. Chemo tends to cause mouth ulcers along
| with hair loss etc.
| e40 wrote:
| No, the chemo started a month after the osimertinib and the
| sores appeared in that first month. The oncologist
| confirmed it was a side effect of it.
| 1letterunixname wrote:
| Hey onco-nosology nerds: Is there a cell-typed unambiguous
| classification system, research, and clinical treatment protocol
| nexus attempting to capture and disseminate information on all
| cancer types in a more precise and organized effort?
| eber wrote:
| I don't know if this is what you mean, but Foundation Medicine
| has a biobank of genomic data (HIPAA) with cancer patients'
| genomic profiles.[1] It's pan-tumor and pan-cancer.
|
| EDIT: if you're looking for more of a "what is the current best
| known treatment plan for xyz" then this might not be what
| you're looking for. The standard of care is very much changing
| very often, I don't know if anyone has a solution for
| disseminating that. foundation medicine also has a patient-
| focused side where you can get your own test and get pointed to
| the treatment for your cancer genomic profile [2]. The
| societies are probably trying the most to get all of that data
| available/up-to-date (for example: the American Cancer Society)
|
| [1] https://www.foundationmedicine.com/service/genomic-data-
| solu...
|
| [2] https://www.foundationmedicine.com/patient/start-with-
| step-o...
| badcppdev wrote:
| More precise and organised than what?
| thallada wrote:
| NCI has the current treatment guidelines for each cancer and is
| updated when new treatment options become available:
| https://www.nccn.org/guidelines/category_1
|
| Unfortunately, these are very clinician-focused and are very
| hard to understand without a medical background. They also
| don't usually cover experimental treatments that are still in
| trials, but in some cases can be extremely helpful. I work on
| an app at Outcomes4Me (https://outcomes4me.com/) that is trying
| to convert the NCI guidelines into an algorithm so that we can
| tell patients in simpler terms what their treatment options are
| based on their specific diagnosis. We also try to find clinical
| trials recruiting for their specific diagnosis. We've done this
| for breast and lung cancer so far.
| someonehere wrote:
| Didn't Cuba have a vaccine for lung cancer? I seem to recall
| seeing one in a documentary (maybe a Michael Moore film?)
| alexnewman wrote:
| My father died of lung cancer. I also ran a failed medical
| tourism company which sent people to get this treatment in
| Cuba. More modern versions of the Cuban treatment are now few
| approved in the USA as immunotherapy. Didn't save my dad
| herculity275 wrote:
| So sorry to hear about your dad!
|
| > I also ran a failed medical tourism company which sent
| people to get this treatment in Cuba
|
| Why did the company fail? How effective was the treatment?
| badcppdev wrote:
| Sorry about your Dad but did it help other people? How many
| did you send and how many had positive outcomes in terms of
| prolonged life above the expected outcome?
| overstay8930 wrote:
| Still in trials in the US/EU, but it's not useful for anyone
| over 60 because the immune system is too weak.
| sva_ wrote:
| For those curious, https://en.wikipedia.org/wiki/CimaVax-EGF
| pauln99 wrote:
| "Statistically significant and highly clinically meaningful"
| perhaps, but not so much that they can say what that actually
| means.
|
| My understanding is that of all cancer drugs approved by the FDA
| between 2000-2016 (around 90 drugs), the median life extension
| was just over 2 months...
| jncfhnb wrote:
| The distribution skews right on these things. Median probably
| is not the right way to think about it
| pauln99 wrote:
| Maybe I've misunderstood, but for the average person that's
| even worse news, right?
|
| Two months was from clinical trials where there's no doubt
| that the "thumb is on the scale" in a host of ways, creating
| an exaggerated estimate of efficacy that would be realised in
| the real world.
|
| The reality is closer to no life extension, with the
| remaining lifespan is spent sicker than you'd have been
| without the drugs.
| icegreentea2 wrote:
| Imagine a toy scenario where a cancer will kill 80% of
| people with it at exactly 3 years, and all 20% remaining
| will uh live full lives (so say another 20 years).
|
| If you created a drug that shifted the ratio to 60/40, and
| measured right at the 5 year mark. In a population of 100
| untreated people, you'd get like 4080 total months lived
| (80x36 + 20x60). In a population of 100 treated people,
| you'd get like 4560 months lived (60x36+40x60).
|
| That's only generating an extra 4.8 months of life per
| person treated. However, you've doubled the number of
| people alive at the end of trial.
|
| Now obviously this is a toy example that's probably a bit
| exaggerated, but this type of behavior is exactly why
| median/average life extension is an inadequate measure
| alone.
| s1artibartfast wrote:
| >The reality is closer to no life extension, with the
| remaining lifespan is spent sicker than you'd have been
| without the drugs.
|
| I dont think that is true at all. The data is pretty clear
| that lifespan is significantly increasing.
|
| >Over time, the mean overall survival has improved from two
| months in 1973 to five months in 2015. Regarding long-term
| survival, a clear rise in 2yS is noted, increasing from
| 2.6% in 1973 to 12.9% in 2013 (latest year of which 2yS
| data can be calculated; Figure 1 and Tables 1 and 2),
| occurring mostly after the mid-1990s. A more modest
| increase is seen in the 5yS, from 0.7% in 1973 to 3.2% in
| 2010.
|
| >https://www.researchgate.net/publication/348455938_Long-
| Term...
| pauln99 wrote:
| I'm sorry, but two months to five months after 50 years
| and hundreds of billions of dollars. That was hardly the
| promise of the "war on cancer"!
| s1artibartfast wrote:
| To be fair, there are other cancers that are essentially
| cured. Lung cancer is a particularly nasty one for a
| number of reasons. It's hard to fight with the laws of
| physics or biology, so I'm curious who promised you
| something else.
|
| In general though, I tend to agree that in the US we
| spend far too much on what essentially boils down to
| performative end of Life Care. If you ask someone if they
| would rather spend $200k for 2 months or leave it to
| their family, I think most people would pick the second
| option. When someone else is paying, they choose the
| first option.
| pauln99 wrote:
| "This year marks the 50th anniversary of the "War on
| Cancer" declared by Richard Nixon, a former President of
| the United States of America. By signing into law the
| National Cancer Act on December 23, 1971, Nixon hoped
| this action to be the landmark legislation taken by his
| administration. Nixon apparently had confidence that
| cancer would be conquered in 5 years."
|
| You're right, there are a small handful of unusual
| cancers that we have cures for, and that's great. And
| some small progress has been made overall. But a lot of
| money has been spent, and it has been half a century or
| more, and we don't have much to show for our efforts.
| JumpCrisscross wrote:
| > _we don 't have much to show for our efforts_
|
| This is mind-bogglingly wrong for most cancers. Several
| death sentences have been turned into treatable diseases.
| s1artibartfast wrote:
| Nixon hyped up some legislation 53 years ago, few
| believed the hype, and the hype was clear to the rest
| very shortly thereafter.
|
| You are right that progress is slow and expensive in a
| lot of areas.
|
| It seems you are frustrated or angry about it. What do
| you want people to do? Are we not spending enough on
| research? Are we spending too much?
| jncfhnb wrote:
| You are, again, failing to note that it's a right skewed
| distribution. The mean is not what you care about.
| pauln99 wrote:
| In fairness, I was responding to the first sentence in
| the quote from the article.
|
| It seems relevant, as a patient to ask, on average, how
| much longer will I live if I take this drug?
| s1artibartfast wrote:
| To which, an average is a pretty poor way to convey non-
| normal data.
|
| If you run a year long trial where you flip a coin and
| immediately kill or save people based on the results,
| your average survival will be 6 months
| s1artibartfast wrote:
| To be fair, the Improvement for the tail is pretty Grim
| too. We have 'only' seen 5 year survival improve from
| 0.7% in 1973 to 3.2% in 2010.
|
| I think the skewed distribution is less relevant than the
| sample group. There are limits to what we can expect from
| medicine. We don't have improved survival after
| decapitation, but that doesn't mean surgery has been at a
| standstill.
|
| It would be interesting to look up survival rates for
| earlier stages. I expect the difference would be more
| substantial.
| ndr wrote:
| Sad stats truth: statistical significance does not say much
| about effect size, and it's misinterpreted by ~half articles.
|
| See https://www.nature.com/articles/d41586-019-00857-9 for more
| losvedir wrote:
| That's why the "highly clinically meaningful" part of the
| quote is there.
| AtlasBarfed wrote:
| I think that is a perverse incentive of Medicare so it gets
| covered in treatment.
|
| The may work better, but the drugs only run the studies to that
| threshold.
|
| My mom died of lung cancer like 10 years ago and the
| immunotherapy drugs like keytuda all has those disclaimers.
|
| Her pd1 wasn't a good fit, but some like Jimmy Carter responded
| really well
| s1artibartfast wrote:
| Yes, but this isnt as negative as it sounds.
|
| That 2 months average is often driven by more people alive at
| the end of a 2 year trial.
|
| Also, 16 years of 2 month extensions ends up being quite
| meaningful.
| pauln99 wrote:
| To be clear, those aren't 16 years of accumulating
| improvements. The median life extension - across all 90-odd
| drugs - was two months.
| s1artibartfast wrote:
| I understand that specifically is for stage 4 non small
| cell lung cancer, but I don't think it's appropriate to
| cherry pick a single example. There are other cancers and
| stages we're much more progress has been made.
| arrosenberg wrote:
| Anecdotal, but Keytruda was approved in 2019 when my dad was
| diagnosed. He got 4 extra years (3.8 of which were pretty high
| quality) that I can assure you he would not have gotten without
| it. The progress on lung cancers specifically has advanced
| quite a bit in the last 10 years.
| e40 wrote:
| In this case, the extension is often far longer. See comment by
| @kkio. Our oncologist has people that have been on it for
| years, as well.
| jseliger wrote:
| _My understanding is that of all cancer drugs approved by the
| FDA between 2000-2016 (around 90 drugs), the median life
| extension was just over 2 months..._
|
| An exciting, underrated possibility: therapies in conjunction
| with each other, even if the therapies are initially studied in
| isolation. Single-agent chemo doesn't work for many cancer
| types, but multi-agent chemo often does. The same may be true
| of the small molecules, antibody drug conjugates (ADCs), and
| monoclonal or bispecific antibodies being tested now. I have
| squamous cell carcinoma initially of the tongue, and now of the
| head, neck, and lungs (https://jakeseliger.com/2023/07/22/i-am-
| dying-of-squamous-ce...), and I'm on a clinical trial
| monotherapy at UCSD called MCLA-158 / petosemtamab. But, if I
| live long enough, which isn't super likely but isn't
| impossible, there's a decent shot that the FDA will finally
| approve Moderna's mRNA-4157 personalized vaccine for melanoma--
| hopefully in 2025. If I can get mRNA-4157 off label and combine
| it with pembrolizumab (Keytruda) and petosemtamab (assuming the
| latter is approved, too), that combo may be much more potent
| than any of the three in isolation, and I've already failed
| pembro as a monotherapy and pembro + carboplatin + paclitaxel.
|
| And if that combo doesn't work, or has some unexpected negative
| effect (including death), well, I'm going to die anyway, and
| the risk seems worthwhile.
|
| As another commenter observed, the median can be skewed by the
| number of people who don't respond; among those who respond to
| a given drug, some don't respond, but some live surprisingly
| long.
| baq wrote:
| A friend died of lung cancer. Went from mild cough to funeral in
| about 5 weeks. 40 yo. 2 pre-teen kids.
|
| Started to look after my own health a bit more.
|
| This is a very welcome development.
| superfunny wrote:
| I'm really sorry to hear that - cancer is terrible.
| graphe wrote:
| Any more details? No history?
| baq wrote:
| Smoker, was always coughing a bit. His grandfather also died
| of lung cancer, but he didn't make the connection until it
| was too late.
| lowercased wrote:
| PSA: If you have dependents, or think you might, get some life
| insurance in place now while you're relatively young. I've had
| too many friends/colleagues pass away unexpectedly without any
| (or not remotely enough) life insurance, leaving a spouse and
| young children behind, inevitably turning to gofundme and
| similar just to get by.
| alexey-salmin wrote:
| I actually tried that but the ones I've found had explicit
| clauses against cancer and other diseases in fine print.
| Apparently they only help if you get hit by a car and alike.
|
| Probably need to make another pass. (I'm in Europe)
| lowercased wrote:
| Yeah, the comment may have been more US-oriented (where I'm
| living). I do know a couple colleagues who can't get any
| term life insurance because of some pre-existing medical
| conditions. That's not good for them, obviously, but for
| most others, it makes sense to get something early. Years
| ago, at 35, I got an $800k 20 year term for about
| $55/month. Close to 20 years later, we have more
| savings/wealth, so my family would not be in hardship or
| having to go begging if I died tomorrow. A 15 year $500k
| policy now costs me $80/month. I recently got that, but may
| let it lapse in a few years if we don't need that any more.
|
| FWIW, my policies don't have any specific denials for
| certain causes of death (particular disease, etc) but I did
| have to provide medical records (and I'm not in perfect
| health).
| evantbyrne wrote:
| Also to hijack this thread: if you or a loved one is/was a
| long-term smoker, take yourself/pressure them to have routine
| cancer testing. Right now, while our liquid biopsy has
| limited availability, for most people that means getting CT
| scans. Lung cancer is very fast moving and survivability is
| directly related to how early it is detected. The
| overwhelming majority of people who are eligible for routine
| CT scans for lung cancer don't ever get them!
| wing-_-nuts wrote:
| Damn it man, here I am reading this at 41 with a mild cough.
| Thanks for that!
| formercoder wrote:
| My aunt was diagnosed with stage 4 lung cancer and is only alive
| because of this drug. It's a marvel of modern medicine.
| declan_roberts wrote:
| It feels so good to read a comment like this. Thank you for
| sharing and I'm really happy for you and your family (and
| modern medicine that makes it all possible).
| jfengel wrote:
| That is indeed remarkable. Stage 4 lung cancer usually makes
| you seek out hospice care.
| kthartic wrote:
| Wow, that's incredible. So wholesome reading a comment like
| this on HN, makes me more hopeful of the future. Thanks for
| sharing
| e40 wrote:
| My wife was diagnosed in Nov '23. Stage 4. She had a mutation
| that allowed Tagrisso/osimertinib. There are many mutations,
| but this one is prevalent in Asian women who have never smoked.
|
| There was a trial published just after her diagnosis that
| showed progression free survival at 2 years of 57%
| (chemo+osimertinib) vs 41% (osimertinib).
|
| https://www.nejm.org/doi/full/10.1056/NEJMoa2306434
|
| She's 6 days into the chemo. There are 4 rounds of
| pemetrexed+carboplatin and then maintenance carboplatin
| (forever). Every 21 days.
|
| So far, it's been rough, but hopefully her body will adjust and
| once she's just on carboplatin hopefully her quality of life
| will be better.
|
| She had few side effects from the osimertinib, but the main one
| was mouth sores. They're gone now, thankfully.
|
| Another thing people need to know about this: this diagnosis
| often comes with regular thoracentesis (removal of fluid from
| the chest). In this case, it's in the lining of her lung, not
| lung itself.
|
| Advice to anyone in this situation: make all future
| appointments for thoracentesis, because you don't want to go
| into the ER/ED to get it done. And, we've stopped allowing
| residents to practice on her (once it was quite painful).
|
| EDIT:
|
| Forgot to add: carboplatin crosses the blood-brain barrier, as
| do the cancer cells. The end state for this cancer, even with
| the above treatments, is usually tumors in the brain.
| LambdaComplex wrote:
| > this one is prevalent in Asian women who have never smoked.
|
| Does that mean the rate is lower for Asian women who _do_
| smoke?
| hgomersall wrote:
| My understanding, though not by any means an expert, is
| that lung cancer that non smokers tend to get is different
| to that which smokers tend to get.
| e40 wrote:
| This is my understanding.
| s1artibartfast wrote:
| I think they just mean that the incidence is much higher in
| that group than would otherwise be expected.
|
| Not all lung cancers are related to smoking, but I'm not
| aware of any where smoking decreases incidence or is
| protective.
| Balgair wrote:
| Hey, best of luck to you both. I've been there with close
| family members and cancer. It's no fun at all. Easily the
| hardest thing I've ever had to do in my life was just to care
| and watch.
|
| Make sure to grab family and friends to help out. _The want
| to help out_ , most of the time, at least. I know it's hard
| to ask, but make sure to do it anyways.
|
| And yeah, standard generic advice to take care of yourself
| too. I hated that advice, as there just was never any time to
| do so. One thing that helped was to schedule that 'me' time
| in and make others aware of it. If you put it on the
| schedule, you'll have a better chance of taking it.
|
| Two tips with MDs:
|
| 1) Carry and use a notebook in all MD interactions. Just a
| simple journal is all. Time, medications given, dosages, MD
| administering, etc. It's a good back up to have, sure, but
| you'll likely never use it. The real power is when MDs see
| you writing things down. They take you more seriously and
| they take themselves more seriously. I think they think that
| you'll sue now and have some proof. But who knows.
|
| 2) If you're in for a long term treatment (1+ nights) put a
| big bowl of candy outside the door. Nurses etc. will stop by
| more often to check up on things and generally seem to like
| you more. Consider putting cigarettes in there too, depending
| on if your nurses smoke. Then they will _really_ like you and
| go above and beyond.
|
| Again, best of luck to you both.
|
| _FUCK cancer_.
| e40 wrote:
| Thanks. Appreciate the tips.
| evaneykelen wrote:
| I wish her and you all the strength in the world.
| sizzle wrote:
| Can you refuse allowing residents to practice on you or your
| loved ones for better quality of care?
| s1artibartfast wrote:
| Sure, you can generally refuse any medical care in the US.
| With respect to residents, It can be as simple as asking
| and picking the right doctor for your procedure. Their
| credentials are generally public.
| e40 wrote:
| Yes, you can, and the doctors we talked to said it would
| not negatively impact them.
| agumonkey wrote:
| It's a great sight to see people outliving research protocols.
|
| Best wishes.
| hereme888 wrote:
| Would you be willing to share a few more details for me to
| understand? It would help me talk more concretely with my
| colleagues.
|
| So she had stage 4 lung cancer.
|
| "Is alive only because of this drug":
|
| - Was her life expectancy obviously prolonged? If so, by how
| much has she exceeded it so far?
|
| - Has the cancer progressed more slowly, halted, or regressed?
|
| Thanks.
| formercoder wrote:
| I'm not completely read in to all the details but she told me
| prior to this drug her diagnoses was a "death sentence." The
| lung cancer had metastasized throughout her bones. The
| indication was sudden lower body paralysis caused by a spinal
| tumor. She had spinal fusion surgery as well. I understand
| because it's stage 4 she will never be in "remission" but it
| has regressed significantly.
| hereme888 wrote:
| Thanks for sharing. At such an advanced stage and
| aggressive metastasis, for it to have regressed at all...
| wow. She must have been in so much pain.
| Spooky23 wrote:
| My wife had stage 4 melanoma. Prior to the newish
| immunotherapies about 5 years ago, it was a death sentence --
| 6-9 months life expectancy from diagnosis. Now, it's 60-70% 5
| year survival rate. Unfortunately my wife wasn't one of them.
|
| In general, these types of cancers spew mets and spread
| quickly. Many are resistant to chemo, go to the brain (chemo
| cannot help there) and only respond to high focused radiation
| like SRS or proton beam.
|
| Immunotherapies essentially suppress checkpoints that cancer
| cells use to avoid immune response and/or cause your body to
| target specific checkpoints. I can't read FT.com, but I
| believe it's talking about a targeted therapy that allows
| your body to control the cancer.
|
| There's alot of research happening around things like
| immunotherapy combined with custom versions of Moderna and
| other vaccines that will significantly improve treatment and
| save people going through what my wife went through. It's a
| good time.
| hereme888 wrote:
| Sorry to hear about your wife. Yes, once those melanomas go
| deep enough in the skin, they spread everywhere like a
| plague.
|
| I know there's even researchers creating AI-assisted
| treatment regimes that match specific mutations, other
| aspects of people's DNA, and all the immunotherapy drugs,
| in order to mix and match the best possible solution.
| Ongoing research and not yet widely available.
|
| I look forward to learning more about the newer
| developments.
| dghughes wrote:
| I wish there had been something for IPF which is progressive
| scarring of lung tissue. My Dad died of it after a long battle.
| The doctor even said it's worse than lung cancer at least for
| that there are treatments.
| latchkey wrote:
| My mom died from lung cancer. It was going to happen, life long
| smoker.
|
| Dying from LC is a terrible way to go. Your lungs fill with fluid
| and you slowly drown in your own fluid. The pain meds make you
| hallucinate terrible thoughts. I wouldn't wish it on anyone.
|
| For the benefit of humanity, I hope this treatment works.
| Scubabear68 wrote:
| Same with my dad in the 80s. His descent was horrible to
| witness, in my case at the age of 21. I'll never know the
| truth, but I think his doctor took pity on him, dad died very
| shortly after a push of morphine.
| latchkey wrote:
| Thanks for sharing and sorry to hear that.
|
| My mom was only 56 (2004) and I got a call from the hospice
| very early in the morning.
|
| At her request, I had tried to take care of her myself for
| the couple weeks after her diagnosis, but once the
| hallucinations started, due to her increasing the pain meds,
| she started screaming one night and the neighbors called the
| police thinking I was abusing her.
|
| Thankfully, they called a case worker and I was able to get
| her into hospice pretty shortly after that and then it was
| just a couple days more at that point.
|
| It was pretty traumatic. One of those life events you never
| forget. RIP mom.
| Scubabear68 wrote:
| My family tried home care in the terminal stage, but it was
| too much for my mom and sister. My mom also had some
| serious mental illnesses, compounding the difficulty we had
| as a family. The trauma was so great I did not really hit a
| normal state of emotional and mental stability until I was
| about 30.
|
| I was the only one there as he took his last breath, and it
| still brings tears when I think about it.
| arisAlexis wrote:
| Have you gotten therapy for that trauma?
| Xenoamorphous wrote:
| I'll never understand how in this day and age we still allow
| people to die suffering this way.
|
| How come we are ok with euthanasia for pets but not people?
| samus wrote:
| It is allowed in some places. The problem is it's a
| terrible slippery slope which has been used to get rid of
| people whose lives were considered to not be worth living.
| Mo3 wrote:
| "We" don't. Here in NL euthanasia is freely available if
| needed.
| nicoburns wrote:
| > How come we are ok with euthanasia for pets but not
| people?
|
| I think because:
|
| - It mostly wasn't an issue we had to deal with until
| recently because we didn't have the medical techniques to
| preserve people's lives so long anyway.
|
| - There are some concerns around people being forced into
| it that require any laws enabling it to be carefully
| designed.
|
| - Religion providing it's usual function of inertia around
| societal customs slowing the change.
|
| Pretty much everyone I know under the age of 60 (and many
| older) support euthanasia for people who have dementia or
| some other unpleasant condition that affects their quality
| of life (self-determined, not forced on people), so I'm
| quietly confident that it will be happen soon.
|
| I'll be pretty mad if it's not available for me if/when I
| get to the point that I want it!
| lr4444lr wrote:
| Because pets are property. There is no concept of consent.
| Human consent to die vs. pathological suicidal ideation is
| a very tricky thing.
| gosub100 wrote:
| It doesn't need to be legal to do it. People commit suicide
| all the time. The government doesn't need to be involved in
| each and every section of our lives, from cradle to grave.
| kevinmchugh wrote:
| Watching my grandfather die with emphysema at age 12 was the
| only anti-smoking message I ever needed
| latchkey wrote:
| Weirdly, my father who has smoked (and drank) daily his
| entire life (now 78), is still alive and kicking. Camel
| unfiltered and a lot of vodka.
|
| I never smoked and I was never a big drinker. But, I stopped
| drinking entirely a couple years ago cause it was just too
| painful to look at him with his current health issues, and
| think to myself that I'm going to end up like he is. No
| thanks, I don't need that poison.
| ianlevesque wrote:
| About 20% of smokers escape that way. Enough for everyone
| to know one, but the odds are still not in your favor.
| instagraham wrote:
| > Tagrisso earned $5.8bn in sales in 2023 -- 13 per cent of
| AstraZeneca's total oncology sales -- making it the company's
| highest earner.
|
| The drug seems to have been approved in 2015-16. If that's the
| case, why is this announcement of efficacy happening now? A long-
| term outcome after a short-term tentative approval?
| loeg wrote:
| It was approved for certain types of cancers and has slowly
| been approved for more and more types of cancer, basically.
|
| > Dec 21, 2020 Approval Tagrisso Approved in the US for the
| Adjuvant Treatment of Patients with Early-Stage EGFR-Mutated
| Non-Small Cell Lung Cancer
|
| > Apr 18, 2018 Approval FDA Approves Tagrisso (osimertinib) as
| First-Line Treatment for EGFR-Mutated Non-Small Cell Lung
| Cancer
|
| > Jun 6, 2017 AstraZeneca Presents Tagrisso (osimertinib) Data
| in Patients with EGFR T790M-Mutation Positive Lung Cancer and
| Central Nervous System Metastases
|
| > Mar 31, 2017 Approval Tagrisso (osimertinib) Receives FDA
| Full Approval
|
| > Nov 13, 2015 Approval FDA Approves Tagrisso (osimertinib) for
| EGFR T790M Mutation-Positive Non-Small Cell Lung Cancer
|
| https://www.drugs.com/history/tagrisso.html
| yieldcrv wrote:
| US approval follows the path of one treatment for one ailment.
|
| so if something was useful for 100 ailments, it needs 100
| different approvals, and a company willing to attempt doing
| that
|
| what more likely happens is one treatment is denied for the one
| ailment the company thought they were tackling, and that one
| treatment is never pursued again
|
| so there's a lot of waste in this particular approach to
| protecting the public. I'm not familiar with other approaches.
| boppo1 wrote:
| Seems like there's a lot of opportunity with those unused
| treatments, if you can get the right arrangement of capital.
| If the company gives up on pursuit, perhaps the'd sell it for
| less than the R&D cost. Someone could go scoop up 'losers'
| and find a better way to match them to ailments.
| s1artibartfast wrote:
| This happens. Drug companies sell off IP and technology
| quite often.
|
| The bottle neck is you need someone with a better use
| hypothesis, and a billion dollars to test that. Drug Trials
| and development are obscenely expensive.
| ackbar03 wrote:
| Why doesn't the company pursue it for other purposes? Sounds
| extremely narrow, as per the comment above. There may be
| related stuff where it works as a treatment depending on the
| endpoint?
| s1artibartfast wrote:
| Because it is extremely expensive and complex to pursue
| each each use. At some point of diminishing returns, it
| makes sense to let the medical community lead the process
| of finding and testing uses.
| yieldcrv wrote:
| because there is always lower hanging fruit at that point.
|
| Even if this was the most altruistic, non-profit funded
| goal to solve an obscure ailment, once that inevitably
| fails - and statistically it is inevitably - all capital
| has been expended, your team's reputation has been spent.
| You go to something that has more consensus instead of your
| alchemy concoction nobody's ever head of and wasn't good
| for the one thing you made it for.
| s1artibartfast wrote:
| One other facet to consider is that it is already legal to
| for doctors to the medicine for any of those 100 approvals.
| those trials serve three purposes, 1) to generate high
| quality data to support doctor choice, 2) provide defense for
| medical malpractice suits against doctors, and 3) support
| insurance reimbursement.
|
| Doctors already have discretion to prescribe Tagrisso for the
| common flu. However, a doctor that does so will struggle to
| get insurance to cover it, and will have a harder defense if
| the patient sues.
| siva7 wrote:
| Is there actually some kind of list which shows in a table what
| kind of cancers are currently treatable by which experimental
| medicine?
| nradov wrote:
| By definition no one knows for certain which types of cancer
| are treatable by _experimental_ drugs. That 's why they're
| still experimental and not yet approved. But this site has a
| good list of resources for finding clinical trials that might
| help.
|
| https://www.cancer.net/research-and-advocacy/clinical-trials...
| kkio wrote:
| My father has been taking Tagrisso since he was diagnosed with
| Stage IV lung cancer in January 2022. It's been able to give him
| a relatively normal quality of life I don't think my family
| would've seen otherwise if he'd gone through chemo and radiation.
|
| Just chiming in that I'm super thankful to that these newer
| treatments are so effective.
|
| That said it's not cheap and he still has to work to keep his
| insurance... otherwise it'd be ~10k/mo.
| e40 wrote:
| So glad to hear your father has made it 2 years. I have hopes
| for my wife (see my recent comment).
| phone8675309 wrote:
| I'm glad that Tagrisso has helped your father.
|
| Do we know how much public funding for Tagrisso that
| AstraZeneca mugged from the respective citizens of the
| countries where they operate and how much they're going to sell
| it back to us for?
| nradov wrote:
| If you're honestly interested in the history of Osimertinib
| (Tagrisso) then this article has a good overview. It
| specifies the studies involved so that you can dig into
| funding sources. Generally for drug development, public
| funding only covers basic science and maybe early-stage
| trials. The majority of the expense is in phase 3 clinical
| trials which pharmaceutical companies pay for.
|
| https://doi.org/10.1093/annonc/mdw129
| wing-_-nuts wrote:
| >he still has to work to keep his insurance... otherwise it'd
| be ~10k/mo.
|
| I mean, it'd be covered under the ACA or presumably medicare as
| well?
| adamredwoods wrote:
| According to Wikipedia, it depends on a specific cancer cell
| mutation, T790M, which could also be a forced mutation from using
| other EGFR tyrosine kinase inhibitors. This alludes how tricky,
| and how fast, cancer cells mutate and adapt.
|
| >> In people treated with osimertinib, resistance usually
| develops within approximately 10 months.
|
| https://en.wikipedia.org/wiki/Osimertinib
| zoratu wrote:
| In my MIL's case it was L858R. T790M also present,
| effectiveness of drug dramatically increased with presence of
| both. Osimertinib shrunk the tumor from baseball to golfball,
| and then her left most lung lobe was surgically removed. She
| was stage 2 at intake and without metastastis. The drug was not
| approved for that case in 2021 and she was admitted to an
| ongoing case study for it.
| icegreentea2 wrote:
| I -think- this is the study referenced
| https://ascopubs.org/doi/full/10.1200/JCO.22.02186
| londons_explore wrote:
| I predict that ~30 years from now, someone will take all these
| drugs that have shown some success in treating some cancer, mix
| them all together at a low dose, and find the combination works
| better than any of the components.
| bglazer wrote:
| This is already done. There are many labs currently looking for
| "synergistic" combinations of treatments.
___________________________________________________________________
(page generated 2024-02-19 23:01 UTC)