[HN Gopher] World-first experimental cancer treatment paves way ...
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World-first experimental cancer treatment paves way for clinical
trial
Author : femto
Score : 200 points
Date : 2025-02-27 22:24 UTC (1 days ago)
(HTM) web link (www.wehi.edu.au)
(TXT) w3m dump (www.wehi.edu.au)
| unstyledcontent wrote:
| This is hopeful news for a really tragic cancer.
| j45 wrote:
| Truly hopeful.
| Panzer04 wrote:
| Presumably this is the Richard Scolyer case, if anyone was
| curious.
|
| A brief lookup indicates he could possibly be seeing recurrence;
| hopefully that's not the case but this is something that many
| people have said about his trial. We can't say for sure this
| treatment is going to be broadly effective without more time and
| experiments.
| crispycas12 wrote:
| It's neo-adjuvant (treat prior to surgery) with a three mAbs: Ipi
| + Nivo, which is a well established combo of immunotherapeutics
| for many solid tumors, rounded out with relatlimab which I'm less
| familiar with (LAG-3 inhibition). Neoadjuvant use of
| immunotherapies is established concept and is utilized in
| clinical practice for non-small cell lung cancer and colon
| cancer. This is the first time I've seen a use of 3
| immunotherapies used at once: Ipi + Nivo isn't the most tolerable
| treatment regimen. Other novel aspect is use of neoadjuvant
| therapy in GBM.
| trhway wrote:
| Do they give immunotherapy before, after or instead of chemo?
| Asking because I heard what it is after in some cases and that
| puzzled me as chemo usually hits immune system.
| femto wrote:
| From what I read (in a book written by Scolyer), the
| treatment didn't involve chemo. It was along the lines of: 1.
| immunotherapy 2. Surgery to remove the bulk of the tumour. 3.
| More immunotherapy 4. Radiation therapy 5. A course of
| vaccine customised to the genome of the cancer
| mft_ wrote:
| That was a concern in the early days of development of anti
| PD(L)-1 agents - that chemo and even steroids would harm the
| T-cells you're trying to activate.
|
| Yet there are settings where a deliberate combination of anti
| PD-1 with chemotherapy is the standard of care. And there are
| other types of immunotherapy where a combination with
| chemotherapy is advantageous too.
| mcbain wrote:
| No chemo. The entire idea of this regime is to hit the tumour
| with immuno to get the reaction. They want lots of tumour
| cells and for it to be "treatment naive" - Richard hadn't
| even had corticosteroids, which dampens immune.
|
| Once they primed his system they excised as much as possible
| and kept the immuno going while doing a course of radiation.
|
| Profs Long and Scolyer work with melanoma where chemo is
| rarely used these days.
| jsperx wrote:
| Don't mean to hijack this thread, but I don't think HN has DMs.
| Read some of your comments and as a person with cancer would
| love to pick your brain a little to develop my mental model
| further (and of course wouldn't expect anything for free.) Drop
| me a line at [my HN username] [at] nearby.org if open to
| discussing more. Thanks!
| sokols wrote:
| This might be related with the case of Richard Scolyer, the
| Australian pathologist diagnosed with Glioblastoma. He was
| receiving some kind of experimental treatment for it.
| crispycas12 wrote:
| I believe he got just got either Ipilimumab and Nivolumab as a
| combo therapy or Pembrolizumab. He's a researcher who focuses
| on neo-adjuvant (use therapy before resection) therapy in
| melanomas. It was a good gamble to try the same paradigm in
| Glioblastomas
| mcbain wrote:
| https://www.nature.com/articles/s41591-025-03512-1
|
| Ipi/nivo/relatlimab and then a peptide vaccine that they
| haven't written up yet.
| femto wrote:
| Thanks for the link to the paper. I notice that the
| abstract has a link to the page for the upcoming trial:
|
| https://clinicaltrials.gov/study/NCT06816927
|
| It will be interesting to follow its progress.
| fragmede wrote:
| It's not a generic novel treatment against any and all cancers,
| as much as the headline would lead you to conclude.
| crispycas12 wrote:
| You're mostly correct but immunotherapies do work for a many
| different type of cancer. The issue is differences in tumor
| biology plays a major factor. The even bigger caveat is that
| given a sufficient amount of tumor mutational burden (TMB),
| immunotherapies are found to be effective for any solid tumor.
| Granted most patients don't have the sky had TMBs needed for it
| to be effective
| adamredwoods wrote:
| It's triple therapy, which most doctors won't do, which I think
| is one of the future steps to stopping cancer. We should have
| been looking at combination therapy a long time ago. Hopefully
| this will get oncologists to push the envelope a bit more.
| suzumer wrote:
| I thought using multiple therapies for cancer was fairly
| common, or are you referring specifically to immunotherapies?
| kohbo wrote:
| I'm not a fan of stuff in very early stages like this being
| posted
| 1970-01-01 wrote:
| Agreed. Good but very early news isn't that interesting. It
| needs at minimum a clinical trial.
| Retric wrote:
| A scheduled clinical trial is fairly late in the process.
|
| It's a specific treatment being evaluated not just some
| pathways discovered in rodents that looks promising.
| femto wrote:
| This one is an unusual case, as the clinical trial is coming
| after the first patient (Scolyer) was treated. It's also
| interesting due to its aspect of "Physician, heal thyself", as
| Scolyer's own research formed the basis of his treatment.
| Scolyer doesn't seem to have been directly involved in his
| treatment, in that it was designed by his collaborator,
| Georgina Long, and executed by another team.
| Cthulhu_ wrote:
| It's always cancer treatments and battery technology that gets
| pushed to the top of tech news sites for some reason but it
| never results in a "this problem is now fixed". Battery tech is
| incremental at best and nowadays may suffer from its own scale,
| that is, billions invested into battery factories set up to
| churn out batteries using a certain technique, which
| disincentivises new techniques.
|
| But with batteries I like to think there's still plenty of
| investor money and healthy competition, so a large scale solid
| state battery plant may yet come to be.
| JohnMD wrote:
| I would like to see a clinical trial with patients who have Stage
| 4 disease being treated with multiple immunotherapies, up to 5 or
| 6 IV and oral immunotherapies. Why are we holding back in a
| population with poor prognosis??
|
| As far as legislation, we should pass "Right to Try" laws.
| Allowing anyone with Stage 3 or 4 to pick an immunotherapy
| regardless of whether it's been approved. We should never allow
| hope to die!
| s1artibartfast wrote:
| Why can't you start a trial and do just that? Doctors have
| discretion up to the practical limit of being sued by their
| patients.
| LadyCailin wrote:
| Or their estate.
| lumost wrote:
| There is a bound on the degree to which terminal patients are
| willing to be human guinea pigs, and a bound on which the data
| is statistically useful to anyone.
|
| I've read many reports of terminal patients who wish that they
| hadn't wasted the last few months of their healthspan searching
| for Hail Mary treatment options. If you were to ask yourself
| what you would do with 1-3 months of healthy life left, would
| you spend it in a hospital on chemo?
| drysine wrote:
| If I had a chance of beating cancer and extending my life by
| a lot, I'd rather die fighting.
| programjames wrote:
| You're currently dying of the "being human" cancer. Are you
| working on or donating to anti-aging research, or do you
| prefer to do other things with your time? It just comes
| down to your discount factor. Based on inflation, it's
| typically about 0.95/year, so you would expect to care
| about ~10% as much for things 50 years in the future. This
| means if you had a ~10% better quality of life _not_
| working on anti-aging, you 're guaranteed to be better off.
| In reality, you should hedge your bets; if everyone spent
| just a little time on the disease, we could cure "being
| human". The same applies to dying fighting cancer. You
| should be willing to do some experimental procedures, but
| not if it eliminates your happiness for the rest of your
| life.
| somenameforme wrote:
| One assumption people making such arguments implicitly
| assume is that such things are possible, which is not a
| given. It could well be that you could have infinite
| money, a billion scientists, and make no progress
| whatsoever. And I'm only referring to cancer there. Anti-
| aging seems even less likely.
|
| I think there's a lot of cognitive dissonance on this
| topic from people like Ray Kurzweil. The overwhelming
| majority of increases in life expectancy over the past
| millennia have come from reductions in childhood
| mortality. It's not like people in the past just hit 40
| years old and randomly keeled over. But rather people
| were quite unlikely to make it out of childhood. If one
| person dies in childhood and the other at 80, you have a
| life expectancy of 40 years old but it's rather
| misleading! In reality the average life expectancy (for
| those that made it out of childhood) has remained pretty
| similar for millennia - around 70 years. [1]
|
| So for instance the Founding Fathers died at an average
| age of 72. John Adams lived to 90, and Sam
| Adams/Jay/Franklin/Madison died in their 80s. The only
| two who died before their 60s were Hamilton, who was
| killed in a duel, and Hancock, who'd had poor health
| throughout most of his life. This is a nice sample
| because you had Founding Fathers as young as 18 (Monroe)
| when the Declaration of Independence was signed, so we're
| certainly not seeing a surviorship bias. They were
| certainly wealthier than average, but all the wealth in
| the world doesn't matter when state of the art healthcare
| was doing things like treating infections by bloodletting
| (including by leeches) to get rid of 'bad blood' or
| 'balance the 4 humors.'
|
| [1] - https://aeon.co/ideas/think-everyone-died-young-in-
| ancient-s...
| kelnos wrote:
| Not arguing against your general point that post-
| childhood life expectancy has always been fairly high,
| but I don't think rich aristocrats make for a "nice
| sample" when talking about longevity.
| somenameforme wrote:
| Most of the logic about endless life expectancy take
| improvement in healthcare as the fundamental driving
| factor. And in the past, the wealthy were no better off
| than the impoverished here because you couldn't buy that
| which didn't exist. Germ theory didn't exist, let alone
| antibiotics, even hand washing as a thing before surgery
| didn't yet exist. And what I was alluding to in my
| comment was what happened to George Washington. He died
| at a relatively early age of 67 of a throat infection, or
| of the 5 pints of blood that was taken from him to 'cure'
| that infection leaving portraits of him on his death bed
| as being white as a ghost.
| cogman10 wrote:
| > the wealthy were no better off than the impoverished
| here
|
| Eh, in some ways but not all ways.
|
| The wealthy, for example, were much more likely to
| receive proper levels of nutrition. They could afford to
| eat well balanced meals.
|
| If you are poor, you're living off of whatever you can
| scrounge up or grow.
| askonomm wrote:
| That's why I always think that the _mean_ life expectancy
| is a much more useful metric than _average_. Not sure why
| everybody reports the average everywhere. I have the same
| exact thought when it comes to salaries. Governments and
| the like always publish the _average_, which tells very
| little to the regular person. If anything, it would tell
| the regular person that they must really be very badly
| off if most make more than them, having a negative
| effect. Perhaps that's the desired outcome?
| Earw0rm wrote:
| Mean _is_ average. You perhaps mean median?
|
| Even then though, in e.g. Victorian times, the median
| (50th percentile) gets skewed by horrendously high infant
| mortality.
|
| Looking at the 75th or 80th percentile, or the life
| expectancy for an 18 year old, is a better measure. High
| scores for the 75th can mask deaths due to inequality to
| some extent, but because wealth distributions are _so_
| skewed at the top, the 75th percentile typically looks
| more like an average/poor person than a rich person.
| askonomm wrote:
| I did mean median yes, my bad. Alright, that makes sense
| indeed.
| somenameforme wrote:
| Yeah, even the median life expectancy in the past would
| be getting awful close to something like 2 years old. [1]
| Again running with the Founding Fathers as an interesting
| example, Sam Adams lived until he was 82 and was one of
| 12 children. Yet of all those brothers/sisters, only 3
| lived past the age of 3.
|
| It's this context that I think explains things like
| infant 'exposure' in various cultures over time that we
| can't even imagine today - parents simply leaving their
| child out to the wilds, essentially to die - while
| retaining that cognitive dissonance that perhaps he might
| be found and raised by somebody, as was a frequent
| component in the hero legends, such as with Theseus and
| Perseus.
|
| [1] - https://ourworldindata.org/child-mortality-in-the-
| past
| wahern wrote:
| > Not sure why everybody reports the average everywhere.
|
| Because that's the modern definition of life expectancy:
| the average (mean). Probably because the primary driver
| behind the production of actuarial tables has always been
| for insurance, annuities, and similar purposes. For
| calculating costs and valuations the mean is often a
| better measure because the distribution of deaths isn't
| normal. Though in modern actuarial tables you'll often
| find both.
|
| I would assume popular literature quotes expectancy
| figures from birth because that's the easiest thing to do
| when you're just trying to give a single simple figure.
| But actuarial tables have always been just that--tables.
| Given a person at age X, what's their life expectancy.
| The first row will be from birth, but people with money
| on the line have always understood that number is mostly
| irrelevant. Here's an actuarial table from the 3rd
| century which was built for calculating annuities:
| https://en.wikipedia.org/wiki/Ulpian%27s_life_table
| Interestingly that table seems to use median life
| expectancy.
|
| Actuarial science was a significant driver in the
| development of modern statistics and mathematics,
| especially as the market for financial products exploded
| over the past several centuries. The tables and models
| for life expectancy from 150 years ago were startlingly
| accurate, even in their forecasts of changing life
| expectancies. When Social Security was passed in the
| 1930s the models for how life expectancies would change,
| both from infancy and across all the age brackets, were
| spot on with actual changes up to the 1990s.
| programjames wrote:
| I seem to be much more confident that technology could
| solve the aging problem. Two routes come to mind:
|
| 1. We can already splice up DNA with decent accuracy, so
| it's just a matter of finding _what_ DNA to splice in
| /out to have the desired effects, and then a method to
| apply this to every cell.
|
| 2. We're close to being able to disassemble someone's
| nerves and simulate them with a very high accuracy. So,
| at the very least we could give people new robot bodies.
|
| Now, it's true that even the wealthiest people in the
| world several hundred years ago had no hope to get either
| of these done. But it seems entirely plausible that if
| everyone came together to work on this _now_ , it could
| be solved in a few decades. I think it isn't happening
| because (1) people's discount factors aren't high enough
| to throw everything to their future; (2) the wealthiest
| people are older, and have the least chance of success;
| (3) it's a coordination problem that most people aren't
| even aware they can coordinate on; (4) a significant
| number of people don't even think it's a problem (because
| of the stories their ancestors told about death maybe not
| being the end). The last two are solvable, but the first
| are just mismatched preferences that you can't really get
| around.
| drysine wrote:
| >donating to anti-aging research
|
| Not as much as I should've. You've made a good point,
| thanks.
| jajko wrote:
| I would not. I would focus on family and friends, leaving
| as little mess to work through for them after my passing
| and making the best out of remaining days. Quality >
| quantity for me, always.
| kelnos wrote:
| There are always thresholds, though.
|
| Would you accept a 10% decrease in the quality of your
| life in exchange for an extra year? I probably would. I
| probably still would if that was a 20% decrease. But I
| probably wouldn't go for that extra year if I had to
| accept a 90% decrease in the quality of my life.
|
| The threshold is a personal decision. There are no right
| or wrong answers. We should even indulge someone who
| _would_ accept that 90% decrease for an extra year. That
| should be their choice, and even if I wouldn 't make it
| myself, that's neither here nor there.
| rsynnott wrote:
| > Would you accept a 10% decrease in the quality of your
| life in exchange for an extra year? I probably would. I
| probably still would if that was a 20% decrease. But I
| probably wouldn't go for that extra year if I had to
| accept a 90% decrease in the quality of my life.
|
| The context is _clinical trials_, tho, so that's not
| generally what's on offer.
| agumonkey wrote:
| I would believe that for many people, simply having a
| chance at fighting would improve the odds.
| deadbabe wrote:
| You are not just fighting for yourself, you are fighting for
| all future generations by helping to contribute toward
| finding a cure, even if you don't benefit it from it. It is a
| noble cause, like going to war to defend your country.
|
| If you only want to contribute toward things if they benefit
| you, then the real cancer is you.
| llamaimperative wrote:
| This is extremely goofy. No one is obligated to try
| experimental drugs to benefit other people. And I work in
| clinical trials!
|
| It is heroic to volunteer oneself into a clinical trial.
|
| In fact, if you feel so strongly about it: you can go do so
| literally right now. I'm happy to help facilitate.
| 1270018080 wrote:
| Of course you would make different choices if you could
| predict the future. But if I only have 1-3 months to live, I
| am going for Hail Mary treatment options to try to extend
| that (because I can't predict the future).
| cancerhacker wrote:
| I'm no longer NED from Stage IV colon cancer (first DX 2014),
| and now it's returned and inoperable. I was given an option
| to add Cetuximab which I'd had previously- but the side
| effects from that were so bad for me that it absolutely isn't
| worth it to me to add a few months, but live in misery.
| robbiep wrote:
| Whilst this would be great, can I just temper this with a
| little understanding of how significant some of the side
| effects of the immunotherapies can be. There are significant
| limits on how much you can stress an already significantly
| stressed body and immunotherapy side effects can be WILD
| dumbledoren wrote:
| It cant be coincidental that this news with a misleading headline
| is being pushed right at the time when a revolutionary Chinese
| drug changed the landscape.
| aj_icracked wrote:
| Out of curiosity, and I'm living under a rock.. which one?
| Nevermark wrote:
| > It cant be coincidental
|
| And yet coincidences happen. So of course it can be.
|
| I suggest avoiding starting any sentences you intend to be
| credible with that phrase. And avoid starting any sequence of
| reasoning you wish to have validity with that type of thinking.
| tanujsh979 wrote:
| This could be groundbreaking I guess! :)
| catoc wrote:
| How is this the "first experimental cancer treatment" ?
|
| It's not. Of course.
|
| It may be the first triple immunotherapy (3 checkpoint
| inhibitors), given in a neo-adjuvant setting, in glioblastoma.
|
| Still cool, less catchy
|
| (Or maybe I don't understand "world-first" ?)
| cryptopian wrote:
| The term "world-first" in this context means that this is the
| first specific cancer treatment of this type:
|
| > It is the first documented use of neoadjuvant triple
| immunotherapy in glioblastoma
|
| If the headline read "world's first" then it would imply what
| you understood
| skybrian wrote:
| We love to debate headlines, don't we? But along those lines,
| it seems like they could just say it's "new" and that would
| be good enough; a headline doesn't need to be any more
| specific.
| baggachipz wrote:
| This is fantastic news, glioma treatment progress was stagnant
| for a long time and is finally starting to pick up steam.
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