[HN Gopher] Antibody Drug Conjugates: A frontier in cancer treat...
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       Antibody Drug Conjugates: A frontier in cancer treatment
        
       Author : peerless-app
       Score  : 101 points
       Date   : 2024-10-31 17:35 UTC (1 days ago)
        
 (HTM) web link (www.sagelyhealth.com)
 (TXT) w3m dump (www.sagelyhealth.com)
        
       | Panzer04 wrote:
       | Every little step in fields like this is so encouraging. We keep
       | getting better, but the cancers don't.
       | 
       | Ever more effective cocktails of drugs that target the cancers
       | while minimising harm to everywhere else, the closer we get to
       | attacking cancer cells from so many different directions they
       | simply can't adapt in time and we wipe it out immediately (a
       | cure). One can only hope.
       | 
       | I whether we might see even more investment into research like
       | this as it gets closer to deliver curative, rather than just
       | suppressive outcomes, as well
        
         | mjewkes wrote:
         | CAR-T may have a ~50% cure rate for blood cancers:
         | https://ashpublications.org/blood/article/141/19/2307/494672...
        
           | alexissantos wrote:
           | My uncle underwent CAR-T therapy and the turn around was
           | amazing. He's got a brand new lease on life. We would have
           | lost him without it.
        
             | jjtheblunt wrote:
             | What disease did it address?
        
         | xk_id wrote:
         | > whether we might see even more investment into research
         | 
         | The field would benefit greatly from even a fraction of the
         | investment in the AI and crypto bubbles
        
       | melling wrote:
       | Pfizer acquired Seagen for $43 billion. Seagen has some very
       | promising ADC's in the queue.
       | 
       | https://www.pfizer.com/news/press-release/press-release-deta...
        
         | tptacek wrote:
         | It's weird to think of a _hopeful_ story of a $43Bn
         | acquisition.
        
         | loeg wrote:
         | My dad (retired) spent the back half of his career working on
         | ADCs at Seagen. He's glad ADCs panned out as useful cancer
         | treatments.
        
       | namuol wrote:
       | > The Food and Drug Administration approves new cancer treatments
       | when they are shown in clinical trials to be more effective than
       | the current approved cancer treatment for a given cancer type.
       | The approval comes when the treatment extends lifespan without
       | overly increasing the risks of serious side effects.
       | 
       | This standard just doesn't make sense to me. Every case is
       | different, so why "throw out" a treatment option for only being
       | within the margin of error of efficacy on a general population?
       | It must be incredibly frustrating for patients to know about
       | these treatments...
        
         | cyberax wrote:
         | It's fine to ask for an approval for a part of the population
         | (e.g. people with cancer exhibiting particular markers).
        
         | howlingowl wrote:
         | Never let a customer off the hook too early
        
       | throwawaymaths wrote:
       | The issue with ADCs is you're putting a really giant homing
       | system on a tiny warhead. How many molecules of X does it take to
       | kill a cell? There is one really good warhead candidate, but
       | un?fortunately it's illegal to research
        
         | tcbawo wrote:
         | What candidate are you referring to?
        
           | throwawaymaths wrote:
           | Nope. Don't want to be on surveillance lists, even with an
           | anon account. Was researched in the 80s, before we knew
           | enough about the antibody side to make a good go of it. then
           | dropped for obvious reasons (it didn't work which makes sense
           | in retrospect given the crude conjugation strategy plus the
           | restrictedness of the warhead side). That's all I'll say.
           | 
           | Probably enough info for you to figure it out if you're
           | smart. Don't wind up in jail.
        
             | DigitalPaladin wrote:
             | Are you referring to monoclonal antibodies? For which a
             | Nobel Prize was awarded in 2018, and research has continued
             | since the 80s?
        
               | loeg wrote:
               | No, that's the "homing system" side of this analogy. GP
               | is talking about some sort of poison (chemo), but I don't
               | know which one or what the paranoia is about.
        
               | throwawaymaths wrote:
               | Yeah there's stuff that will get you on lists especially
               | since 9/11. But some of them have been restricted since
               | before that, though de facto unenforceable. Today there
               | is the ability to ingest huge volumes of data. I just
               | don't want to deal with the pain in the ass even if I'm
               | found innocent.
        
             | dekhn wrote:
             | Your paranoia is not justified. merely mentioned potential
             | treatments (even ethically questionable ones) does not get
             | you on any "watchlists".
             | 
             | Just say what it is you're referring to, or don't mention
             | it at all.
        
               | throwawaymaths wrote:
               | I will do this for you. List 20 compounds surveiled by
               | the US government for potential association with
               | terrorist groups in a comment under your account below
               | this comment and I will answer yes/no if it is in the
               | group as a whole.
        
               | dekhn wrote:
               | Merely mentioning illegal/regulated drugs does not get
               | you on a watch list. Answering yes/no to a list does not
               | protect you. I will not continue to engage.
        
       | VyseofArcadia wrote:
       | I remember reading somewhere that doctors are experimenting with
       | (or wanting to) some of these more modern treatments first. Right
       | now they're all "exhaust your other options, and then try the new
       | stuff as a weapon of last resort". The more modern treatments
       | could be more effective if we try them first instead of waiting,
       | but we just don't have the data.
       | 
       | Anyone have a source on this half-recollected fact of mine? I
       | can't find one.
        
         | DigitalPaladin wrote:
         | Anecdotally, I can support this.
         | 
         | A loved one is moving through this pathway now. Its has you
         | said: try all the established drugs first, even if they aren't
         | directly indicated for the cancer diagnosis of the patient,
         | then move on to the more modern and specific treatments once
         | the established medicines have failed.
         | 
         | One problem with that approach is, once the patient has reached
         | the point of several failed treatments, the cancer has possibly
         | become advanced and the patient is worn down by the earlier
         | interventions. In my observation, this confluence makes the
         | newer medicines simultaneously harder for the patient to
         | tolerate but also appear less effective than might've been the
         | case at earlier stages of the disease.
        
       | adamredwoods wrote:
       | My wife, now deceased from MBC, took two ADCs that had the same
       | payload (chemo) but two different antibody signatures. The first
       | one did great for about 3 months. The second one failed, major
       | progression. But the conclusion was still unknown, what
       | information did that give us? Was it the cancer rejecting the
       | antibody or mutating to overcome the chemo effects?
       | 
       | Tools we need (large scale):
       | 
       | - how can we identify when the cancer mutates, what part of the
       | ADC is it rejecting? This information is valuable.
       | 
       | - how do we assign different payloads? Can this be scaled? Do new
       | payload/antibody delivery systems need to go through the FDA each
       | time? How do we streamline this to add a wider net to catch
       | cancer mutations?
        
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       (page generated 2024-11-01 23:01 UTC)