Somebody has to pay for the trial. Drugs are expensive and the amount needed to dose a single person is orders of magnitude more than mice. So who funds the study?
If it's the government or philanthropic fund, you have to put in a grant and show that it's competitive in terms of preliminary results etc.
If it's the drug companies, you have to deal with lots of complicated things with combination therapies. Drug companies don't like their drug paired with other drugs that aren't in their portfolio. They also need to see a way to make a profit on it, which means they need to evaluate whether this is the most likely successful trial, assess bang for buck etc.
If you want to go compassionate use, then you need to get the pharma to donate the drugs or insurance to cover it. This is spain, so I guess insurance is just the government since they have universal healthcare. I have no idea how that works but I am guessing it doesn't move fast.
For all the folks complaining about "it's only in mice! things never work in humans!" -- I work at MSK and we definitely have seen success treating PDAC in humans: https://www.nature.com/articles/s41586-023-06063-y
"Why don't I see these treatments hitting the general public?" Because trials like these are phase I/II. Then you need a phase III that takes a long time to recruit a large cohort and has overall survival as an end point so you need a long time to measure the actual outcome you care about. And most trials fail in phase III because the surrogate end points used in phase II studies, like progression free survival (ie how long did patients go before their disease advanced in screens), are not necessarily great predictors of improved overall survival.
Specifically for cancer vaccines, this paper was a driving force behind MSK establishing a cancer vaccine center to scale up these personalized neoantigen mRNA vaccines. It's very very difficult to do and extremely expensive right now.
Somewhere between $500K and $2M for an mRNA vax is my guesstimate. You don't have to hypothesize about what the rich might do, though. The co-founder of GitLab was diagnosed with osteosarcoma a few years ago. He relapsed, leaving him without any standard of care treatments. He's spent the last couple of years throwing loads of time, effort, and of course money at lots of experimental treatments: https://osteosarc.com/ -- even released all the data gathered on his tumor over timepoints.
Memorial Sloan Kettering, one of the NCI(National Cancer Institute)-Designated Cancer Centers. If you're getting treated for cancer, the NCI-Designated Cancer Centers are usually your best bet.
right-click, search Google: "MSK most commonly refers to Memorial Sloan Kettering Cancer Center, a world-renowned institution for cancer treatment and research"
PI at a cancer center here. These two ideas are not mutually exclusive. Cancer is indeed not 1 disease but many countless ones. At the same time, cancer diagnoses are based on site of origin and histology (how it looks under a microscope). But often what drives a cell of one tissue toward pathogenesis is the same mutation or other molecular malfunction as a cell of another tissue type. In those cases, we can develop drugs that target that specific component and it may work across both cancer types.
Unfortunately, there are countless ways things can go wrong in cells. There are also rarely drugs that truly span a large swath of cancer types effectively. That's because even though two cancers from different sites may have the same driver, how they respond to treatments can differ. The difference in cell state may allow one of the two cancers to adapt to the treatment, such as by activating an alternative growth pathway, whereas the other cancer type's cell of origin may not have such an easy road to therapeutic escape.
Also, maybe, the fact that what cancer cells have in common, they tend to also have in common with cells that aren't cancer, and therefore make poor targets for therapies.
That's kinda a defining characteristic of cancer. It's your own cells, so your immune system doesn't recognize it as foreign and take care of it. Just about anything that targets cancer targets the non-cancerous cells it started in. Most chemotherapy boils down to "kill it all and hope the cancer dies before the non-cancer, and leaves enough non-cancer behind to keep you alive". There have been a lot of advances in targeted cancer treatments, but even most of them just selectively target the type of cell (healthy or not) that became cancerous, and do less collateral damage to "innocent" cells. It's incredibly hard to target an individual cancer, and so far impossible to target cancers broadly.
I'm no expert, but I know cancer cells promote adding blood pathways towards them, so it might be that they have an "uneven share" of the nutrients transported to them, and thus die out later than the healthy tissue.
I don't know anything about cells going dormant as a result of fasting. That sounds questionable to me. There's been some research on fasting and cancer, but there haven't been a lot of studies, and results are inconclusive. Some of the ideas sound sensible. Cancer cells are incredibly greedy and slurp up glucose as they constantly divide. The thinking is that you can starve them and slow progression, in conjunction with chemotherapy and other treatments. It's not widely supported or practiced and more study is warranted. It's hard to find real information on it, because the idea that you can miraculously cure cancer and other diseases by changes in diet is embraced by millions of anti-science crackpots, so there's a ton of disinformation and speculation out there.
So what you’re summarizing is that cancer is definitely a single disease with multiple types but there are commonalities. Which makes sense. Which is why I never bought this “we can’t cure it because it’s not one disease”. We can’t cure it because we aren’t smart enough.
> Which is why I never bought this “we can’t cure it because it’s not one disease”.
Really, in an important sense, cancer isn't one disease because cancer isn't a disease at all. It's a mechanical malfunction, kind of like having a cleft palate.
On the other hand, it is more disease-like than most mechanical malfunctions.
Perhaps you have an overly narrow definition of the word disease? Cleft palate is, in my opinion, a congenital disease. A fractured bone is also a disease.
I have a cancer, a basal cell carcinoma. Like other cancers, it's a transformed cell type with dysregulated growth. But, it's likely to be completely excised surgically, unlike pancreatic adenocarcinoma, which would likely kill me in a few months.
> Perhaps you have an overly narrow definition of the word disease?
I'm intentionally highlighting here a definition of 'disease' that is much narrower than the norm, yes.
> A fractured bone is also a disease.
On the other hand, you're trying way too hard to correct that. Nobody considers a broken bone to be a disease. A broken bone in your leg is not fundamentally different from a broken rock outside your leg, and -- more importantly -- this lack of difference is easily understood by everyone.
But while e.g. diabetes is not caused by external agents, it looks from the outside just like other types of problems that are. This leads to both types of problems being called "disease", even though the radical difference in how the problem occurs means that the treatments and ways of thinking that apply to one type are not appropriate for the other type.
Diabetes is purely mechanical, and if you take measures against it, you can suppress its effects. It will never fight back or attempt to circumvent your efforts. Malaria is purely external, and if you take measures against it, it will take countermeasures.
Cancer is an intermediate phenomenon. It is not caused by external agents. But it is alive and may respond to measures taken against it -- it consists of part of yourself 'going rogue' and becoming as malicious as an external agent.
This intermediate status suggests that approaches from either end of the "disease" spectrum might be fruitful. One of the biggest problems we have in dealing with cancer is that we want to treat it as a malign external agent to be removed from the body, as would be appropriate if it were really a disease. But while there are many effective tools to do that for diseases, they all fail badly in a couple of different ways when the "disease" is indistinguishable from the rest of your self.
I think you should maybe come up with a new word. You're heavily overloading terms that have medical definitions with your own meanings, and expounding an alternative philosophy of medicine, which is fine but shouldn't depend on semantics, perhaps.
No, they do what most cancer researchers do, which is wrap the truth around so much bullshit that you can read it however you please. I’m also not an amateur, I spent most of my PhD studying cancer drugs.
Jokes aside, there are a few natural sugar sources without fiber, like sugar cane (it has fiber, but we just spit it). I think we can all agree that eating too much honey or sugar cane juice would be bad for our health.
There's also sugars like inulin (https://en.wikipedia.org/wiki/Inulin), which are actually classified as soluble fiber because we can't digest them, so the bacteria in our digestive system does it for us. Inulin is a prebiotic, so it's actually healthy to eat in moderation.
Inulins just aren't sugars. As you say, they're categorized as soluble fiber. Any definition of sugar that included inulins would include all soluble fibers.
Yeah nature does create sugar with little fiber, but it's not comparable to 1) the amount of high-fiber sources, and 2) the amount of refined industrial sugar.
"Off-Topic: Most stories about politics, or crime, or sports, unless they're evidence of some interesting new phenomenon. Videos of pratfalls or disasters, or cute animal pictures. If they'd cover it on TV news, it's probably off-topic."
I wish this ‘guideline’ or any guideline would attempt to even define what the moderation team considers to be ‘political’ because it seems like the community itself cannot agree on a universal-enough term that would apply to the types of discussions where politics and technology may intersect.
- bio startups rise, ag tech startups rise, food startups rise-- everything to do with engineering life.
- second and third tier cities rise in the US while first tier cities ebb. Places like Austin see continued growth, while cities like Baltimore and Cincinnati begin to really revitalize as local market become more important than global markets.
- mobility increases as people are less tied to their jobs/families
- Google slows on the innovation front. FB is increasingly weak as social networking just isn't as profitable anymore. Amazon keeps churning away. Netflix wins best picture at the Oscars.
- AI progress slows. The ML community fragments again. Neurips is no longer where the best ML researchers publish.
- At least one climate protest with over 5M people involved nationally, calling on Congress to act now
- China, mired in internal political upheaval, faces a lost decade. They will either no longer be one of the two biggest economies or they will be on a clear trend down but third place is a long way to fall
- twice as many people consider themselves vegetarian or vegan. Foods for this demographic have gotten much better and more diverse. Consumption of meat is still high, but the trend in 2030 will be clear: the meat industry is shrinking rapidly in the US and Canada. Other nations will lag here, meaning almost all of the innovation will happen in North America
- NYC will have built only two new subway stations
- a third political party will gain at least 5 seats in the House
- there will be a recession. Likely due to housing again. As the boomers die out, their millennial children inherit their suburban homes. Unfortunately they don't want to live in the suburbs and selling the house would pay off their student loan debt. But who is going to buy all these houses?
- political divide in the US heals, but it's not pretty and it all feels chaotic. Political parties weaken in favor of some new form of factions.
- CS undergrad enrollment declines but CS course requirements pervade nearly every STEM field. The common wisdom will now be that interdisciplinary jobs, not vanilla software engineer, are the growth sector, especially in bio/medicine/food/agriculture.
- Medicare age lowered to 50 as a transition toward single payer that will take another decade
- the world has missed its chance to avoid global warming. The schism in the debate will now be about what to do. Radical positions (open borders for mass refugees, a trillion dollar climate change R&D bill) will become more mainstream.
- Cities all over the US will be calling for federal infrastructure to build new train and tran systems, obviating the market demand for autonomous taxis. Uber and Lyft go under. Long haul autonomous vehicles are at 10% of all interstate traffic
- a common political point will be about how the US needs to stop subsidizing corn. As crops becomes more important in this decade (ag tech, rise of vegetarianism, climate change) it will be clear that corn is an over investment but political inertia will not let things change this decade.
- A dominant Canadian tech company will arise that rivals Google/FB or is at least rising rapidly
- towards the end of the decade, robotics is starting to reach the early-success stage. This will have impacts on all sectors as co-working spaces pop up with access to reprogrammable devices that can prototype commercial products. Think: Roomba for X. 2030 is still early days for this, but there's buzz, articles about robo-spaces Wired, etc.
Yes. Exactly this. Building models that assess risks and potential gains. A quant is a catch-all term though, so one person may be working on models that predict some sector of the market and another person could be looking at online allocation algorithms for maximizing risk-adjusted returns.
Twin studies have shown that at least 30% of intelligence is determined by post adoption environment. (This is a lower bound because adopters must meet a minimum bar, limiting the differences in adoption environments.) Add that with prenatal environment, and you could have differences in intelligence distributions across races entirely explained, but again, twin studies aren't enough to show that.
If it's the government or philanthropic fund, you have to put in a grant and show that it's competitive in terms of preliminary results etc.
If it's the drug companies, you have to deal with lots of complicated things with combination therapies. Drug companies don't like their drug paired with other drugs that aren't in their portfolio. They also need to see a way to make a profit on it, which means they need to evaluate whether this is the most likely successful trial, assess bang for buck etc.
If you want to go compassionate use, then you need to get the pharma to donate the drugs or insurance to cover it. This is spain, so I guess insurance is just the government since they have universal healthcare. I have no idea how that works but I am guessing it doesn't move fast.
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