
‘Trojan horse’ drug treated British patients with six different forms of cancer - sdan
https://www.thelondoneconomic.com/lifestyle/revolutionary-trojan-horse-drug-has-successfully-treated-british-patients-with-six-different-forms-of-cancer/07/02/
======
mft_
I'm hoping here that HN isn't going to be _too_ taken in by a good PR strategy
from the biotechs who are supporting the clinical trials here (Seattle
Genetics and Genmab - see here:
[https://www.clinicaltrials.gov/ct2/show/NCT03485209](https://www.clinicaltrials.gov/ct2/show/NCT03485209))

I mean, it's interesting data, and any step forwards in treating cancers
(especially solid tumours) is great... but this isn't especially novel. Toxin-
bearing antibodies like this have been worked on now for years; indeed, there
are examples which have successfully made it all the way through large phase
III trials and onto the market, which takes many years.

e.g.
[https://www.medicines.org.uk/emc/product/2859](https://www.medicines.org.uk/emc/product/2859)
and
[https://www.medicines.org.uk/emc/product/9537/smpc](https://www.medicines.org.uk/emc/product/9537/smpc)

~~~
true_religion
Not novel isn't the same thing as not news. As a tech site, we read lots of
articles about new JavaScript libraries reimplementing techniques discovered
in the 60s.

Can we not have one breathless article about an incremental improvement in
cancer drugs without everyone in the know scoffing about how it is not
revolutionary?

~~~
cat199
> Can we not have one breathless article about an incremental improvement in
> cancer drugs without everyone in the know scoffing about how it is not
> revolutionary?

this will probably happen about the same time that the headlines stop
presenting incremental things as revolutionary..

------
a_imho
_The price has not yet been set. This will be worked out based on the success
of the drug, the number of cancers it treats and what individual markets can
bear._

Why is it not based on the cost of the treatment?

~~~
gregcrv
From
[https://en.m.wikipedia.org/wiki/Prescription_costs](https://en.m.wikipedia.org/wiki/Prescription_costs)

“A study has placed the amount spent on drug marketing at 2-19 times that on
drug research”

~~~
JoeAltmaier
Wow drug research must be really cheap! To judge by the cretinous late-night
ads for junk medicine. They can't have cost much to throw together...

~~~
merpnderp
I’ve always assumed the vast amount of marketing is the armies of incredibly
high paid door to door salesmen who always seem to be visiting your doctor
with some new pitch to reward them for prescribing their pet drug.

------
clort
Its an interesting article.. I have questions!

This antibody binds to 'tissue factor' which are present at high levels on the
surface of many cancer cells. Are these tissue factor present in significant
proportions on other types of cell? (Reading later it suggests that side
effects can include nose bleeds which I wonder if that means that nasal tissue
also contains this)

The figures that they show; obviously it is a small cohort anyway and these
people were otherwise considered untreatable but do we know what percentage of
(eg) ovarian cancer would otherwise find that their tumors were either
shrinking or had stopped growing? It would be important to compare that
against the 14% they saw..

The mechanism of action is good, I am not able to say if it is novel (the name
they use for the technique relates to an incident ~4000 years ago); do we have
leads on other particular circumstances which may be useful to do this? (eg
prostate cancer was not affected.. presumably because it has no tissue factor
on its surface? could it identifiable by any other means?)

~~~
twic
> This antibody binds to 'tissue factor' which are present at high levels on
> the surface of many cancer cells. Are these tissue factor present in
> significant proportions on other types of cell?

Tissue factor is expressed on the surface of the cells adjacent to blood
vessels, so it's all over the body.

Tissue factor's normal role is to trigger blood coagulation - it reacts with
factors in the blood to trigger a coagulation cascade. There is a waterproof
layer of endothelial cells between the adjacent TF-bearing cells and the blood
itself, so this only happens when a blood vessel is breached by mechanical
damage, letting blood come into contact with TF - the resulting coagulation
seals the breach. It's a cool system! Although a bit complicated:

[https://diapharma.com/coagulation/](https://diapharma.com/coagulation/)

I had no idea there was a connection between coagulation and cancer, but
apparently there is - specifically, it's involved in metastasis:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151023/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151023/)

------
anonymfus
The title ("‘Trojan horse’ drug treated British patients with six different
forms of cancer") mislead me into imaging a cocktail of cancer cells as a
treatment.

~~~
philliphaydon
I thought they had 6 different cancers and thought that’s Super unlucky.

------
DrScump
It's interesting that they mention specifically cervical cancer and head/neck
cancers as some of the more successfully treated tumors, given that HPV is now
thought to be a frequent cause of both.

------
rfinney
7 February 2019 Lancet paper on Tisotumab vedotin trial here :
[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045\(18\)30859-3/fulltext)
(entitled: "Tisotumab vedotin in patients with advanced or metastatic solid
tumours (InnovaTV 201): a first-in-human, multicentre, phase 1–2 trial")

 _Tisotumab vedotin is a first-in-human antibody–drug conjugate that is
directed against tissue factor expressed on the cell surface of tumour cells
to deliver a clinically validated toxic payload to tumours. [...] Tisotumab
vedotin is comprised of a fully human monoclonal antibody specific for tissue
factor conjugated to the microtubule-disrupting agent monomethyl auristatin E
(MMAE) via a protease-cleavable valine-citrulline linker. .... The study was
funded by Danish and US biotech companies Genmab and Seattle Genetics_

This Lancet paper references this 2014 Cancer Research paper:
[https://www.ncbi.nlm.nih.gov/pubmed/24371232?dopt=Abstract](https://www.ncbi.nlm.nih.gov/pubmed/24371232?dopt=Abstract)
([http://cancerres.aacrjournals.org/content/74/4/1214.long](http://cancerres.aacrjournals.org/content/74/4/1214.long))
: "An Antibody–Drug Conjugate That Targets Tissue Factor Exhibits Potent
Therapeutic Activity against a Broad Range of Solid Tumors"

Seattle Genetics page on Tisotumab Vedotin :
[http://www.seattlegenetics.com/pipeline/tisotumab-
vedotin](http://www.seattlegenetics.com/pipeline/tisotumab-vedotin)

 _Our [antibody-drug conjugate] technology combines the specificity of
monoclonal antibodies, innovative linker systems, and the cell killing power
of potent cytotoxic agents to treat cancer._

Interestingly, Seattle Genetics stock is down 12% on Friday:
[https://finance.yahoo.com/quote/SGEN](https://finance.yahoo.com/quote/SGEN)
("cuz earnings"). Genmab was up 0.69% :
[https://finance.yahoo.com/quote/GEN.CO](https://finance.yahoo.com/quote/GEN.CO)

------
HNLurker2
Let's stop using the word "cancer" and split it in technical terms:
[https://www.lesswrong.com/posts/hwi8JQjspnMWyWs4g/resist-
the...](https://www.lesswrong.com/posts/hwi8JQjspnMWyWs4g/resist-the-happy-
death-spiral)

------
alex_duf
I have no frame of reference, is 25% ish success rate a good thing?

~~~
projektfu
Success rates in cancer are usually broken down by type of response (complete,
partial, no growth, no response) and stage. It would have been helpful for the
article to say what stage was being treated and compare the response rates in
that stage to the best available treatment. For some cancers, 80-100% rate of
complete response is currently achievable. Some are at 0%.

------
alkonaut
The site seems deliberately designed to break safari when using a built in iOS
content blockers. It’s like it reloads itself until the ads have loaded,
making it impossible to scroll. Does anyone else see this? Is this a thing
now?

~~~
oliwarner
Seemingly. It doesn't hurt their SEO (like ajaxing in the content would) and
"forces" people to turn off blockers. Or clear out.

This sort of dickery just means we'll see a rise in NoScript users, or that
functionality becoming baked in.

~~~
Hendrikto
Way too many advertising strategies are dangerously short sighted. That‘s what
led to the proliferation of ad blockers in the first place.

