Common Diabetic Drug Fights Cancer Stem Cells 149
SubtleGuest writes "In the latest issue of Cancer Research, a breakthrough study shows that Metformin, a cheap and common diabetic medicine, kills cancer stem cells — the cells postulated to be responsible for tumor resistance and recurrence after chemotherapy (research abstract here). It has been known that diabetics taking Metformin experience lower cancer rates, and now it is apparent why that may be and how it may apply to non-diabetics as well. When combined with Doxorubicin to kill non-stem cancer cells, the results are nothing short of astonishing: total remission in a mouse xenograft model. The results are achieved at levels below the dosage needed for diabetic control, opening many new avenues in cancer treatment and prevention."
I feel jealous (Score:5, Funny)
I wish I was a mouse. Then I'd get all the good cancer treatments.
Re:I feel jealous (Score:4, Insightful)
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No, sementherapy. It's astonishingly bad.
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...so it wasn't good for you?
Fine... (Score:3, Insightful)
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I wish I was a mouse. Then I'd get all the good cancer treatments.
Forgetting of course that the only reason you have cancer in the first place is because you were force fed 300 cigarettes per day. That's what I read anyway . . . and free cigarettes are cool, but that many!?
Re:I feel jealous (Score:5, Interesting)
Many of the mice used in research are transgenic; that is, they're genetically modified in such a way that they're predestined to develop cancer. Others, such as the mouse described in the summary, have tumors implanted in them. When testing a treatment (rather than a cause), exposure to environmental carcinogens to promote development of a tumor is less common.
In any case, be glad you're not a lab mouse. Sometimes even the survivors are killed off at the end of the experiment (though this is becoming less common, particularly in cases where the mice are left in no lasting pain or disability).
Re:I feel jealous (Score:4, Funny)
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Whooooooooooooooooooooosh!!!!!!!!
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mice used in research are transgenic
That is an abomination in the sight of the Lord!
Cancer kills Murinaes, God laughs
Now we know what we are, Sentinel Geeks. (Score:2)
I'm on the lookout for that invisible lab worker.
Clean that kitchen now damnit.
Cruel and unusual punishment (Score:5, Funny)
How metformin affects cancer isn't certain, but one possibility is that it deprives tumor cells of sugar.
It's a slippery slope. If we allow this treatment to go through, what next? Take away their caffeine?
What use is there in victory if we destroy all we stand for?
Re:Cruel and unusual punishment (Score:5, Funny)
It's a slippery slope. If we allow this treatment to go through, what next? Take away their caffeine?
After that we cut off their supply of Robert Smith tunes.
That's right; no Cure for cancer say I.
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Non-human model systems (Score:4, Interesting)
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In addition to these results being only in vitro, here comes a sad reminder of the state of this ehm 'research', it looks like they know little about the mechanisms of cancer, this is the cave man trial and error approach still, lots of animals have to die horrible death for them to dig something up, but fingers crossed they finally drawn the winning ticket in this cancer beating lottery.
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There's a lot of drugs that work but that doctors don't really know why. The money-saving potential is so huge on this my initial reaction is it will face years of FUD and continued testing before any humans are allowed to benefit.
Re:Non-human model systems (Score:5, Insightful)
Re:Non-human model systems (Score:5, Insightful)
Yeah, just like those magic cars everyone just knows "they" have but that the big mean oil companies managed to stop. And all those wonderful herbal remedies to cancer that those "fat cats" don't want us to use and that cure cancer in a mere few weeks.
Paranoia for the win!
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"Then name me five non-exotic diseases for which Big Pharma has provided actual cures. I'll wait."
You mean besides all the ones that antibiotics cures? Or how about rabies if caught soon enough? Granted, I agree with you mostly, as there is no money in producing a cure to something, treatment and suppression of symptoms is where the cash is at. And the big pharms know it.
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Tuberculosis, pneumonia, lyme disease (treatment and vaccine), leprosy, and gonorrhea.
With regard to chronic diseases like arthritis, diabetes, etc. Those diseases are extremely difficult to cure. Most of those diseases are genetic or are the result of age-related damage. Take arthritis for example; it's caused by joint cartilege having been worn away over years, faster than it could heal.
Most chronic diseases ar
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If you aren't being funny, you might want to read up on economics, make some research into business, and the cost of cancer research.
Also, make SOME effort to understand how science and the scientific community actually work.
It's time to educate yourself, take the tin foil off and join us adults at the big people table.
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Given the success rate of promising cancer treatments, it is a good bet that this won't pan out. That would also be true if it was something the industry could sell for a hundred times that: there's a low success rate for drugs in early stages of testing. If this treatment goes nowhere, we shouldn't assume the industry killed it to make more money, it is much much more likely that the results genuinely showed it didn't work.
I'm not trying to defend big pharma, I'm just saying we should avoid this circular
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Counter claim?
Here's a counter claim for you. In a month, this treatment will turn people into night-raging ZOMBIES!! The next thing you know, Will Smith will have to watch his wife blow up in a helicopter, and then embark on a lonely, multiple-year quest for a cure while hunting deer in Manhattan. Stop the insanity I say!!
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In addition to these results being only in vitro, here comes a sad reminder of the state of this ehm 'research', it looks like they know little about the mechanisms of cancer, this is the cave man trial and error approach still, lots of animals have to die horrible death for them to dig something up, but fingers crossed they finally drawn the winning ticket in this cancer beating lottery.
Considering that the discovery that tumors have stem cells is extremely new and not 100% certain anyway, I'd say it isn't "sad," it's "lucky."
And don't put that just on stem cell research, most drugs out there are discovered through trial and error rather than "Oh hey, you know what would be great for treating this disease? This small molecule."
Re:Non-human model systems (Score:4, Insightful)
"I deleted a file two years ago and defragmented my hard drive. You should be able to get it back for me, right?"
Don't comment on how simple something should be if you have no understanding of the problem.
But isn't prudent to get the cancer cells into some ecosystem or bioreactor, apply various factors and study them there instead of this Nazi like trial and error research involving those animals ?
If this were feasible, we would have started experimenting on human cancers directly as soon as the first petri dishes rolled out.
They claim to be able to sequence much smaller DNA so why not 'sequence' or look into the cancer here.
Sequencing DNA is many, many steps away from having adequate detail regarding the biochemical differences that will manifest in the organism (or cell). We can't even coimpletely simulate a bog-standard conception-to-birth timeline for typical humans, with various genes switching on and off at different locations and times during development. There are tremendous advances taking place in genetics and will be for some time---but we are nowhere near this level of sophistication at present.
Also inside organisms they are able to highlight and target cancer with some agent and see exactly where the cancer cells are using that PET scanner technique, but unable to use the same path to deliver treatment to those areas.
The 'P' in PET scanner stands for positron. If the treatment could home in on positron concetrations then you're golden. I'll tell you what: you get the positron-homing molecules ready and I'll find a way to superglue the medicinal molecules to them. Deal?
It seams to me that this cancer 'industry' is trying to do prolonged and expensive healing, but not to cure.
It only seems that way because you are utterly ignorant of the underlying reality.
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...isn't prudent to get the cancer cells into some ecosystem or bioreactor, apply various factors and study them there instead of this Nazi like trial and error research involving those animals?
I should stop right there. You Godwin'd. Also, Nazis tested on HUMANS, not animals, which was the problem.
Ignoring that, research on anti-cancer drugs usually starts on cultured cancer cells. Once you identify something new that can kill your cells the way you want it to, you need to take it into a whole organism though, to be sure that it will 1. kill only or at least preferentially cancer cells rather than just every cell equally, and 2. to see how inefficient the drug makes it into the cancer cells i
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Re:Non-human model systems (Score:5, Informative)
Translating these results into some meaningful treatment for normal adults is highly likely to face a lot of roadblocks and complexities.
I generally agree with this, but there are two things that raise this above the usual "cures cancer in mice" hype.
The first is that these are xenografts, which means they're dealing with authentic human cancers, which are in general far tougher to kill than cancers in other species (we are tuned up for great longevity for obvious evolutionary reasons, and therefore incredibly cancer resistant compared to most species, meaning the few human cancers that do become malignant are incredibly hard to kill.) A quick look at the paper shows they've used multiple cell lines for the xenographs, which is also good.
The second is that there is already evidence of reduced cancer rates in humans taking this stuff (pancreatic cancer only, and diabetics only, so limited but suggestive data.)
The full paper is available at:
http://cancerres.aacrjournals.org/cgi/reprint/69/19/7507 [aacrjournals.org]
and it really is one of the few on the topic that I'd honestly say has results that can fairly be characterized as "dramatic".
You're right: they may lead to another dead end. We've seen a lot of those before. But this looks like solid research and very promising results. Clinical trials on humans are in the works, with patient enrollment starting perhaps as soon as next year.
Re:Non-human model systems (Score:5, Funny)
Hang on a minute, you sound like you know what you're talking about! What are you doing on /.?
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From the looks of things, getting modded up. Now if we could only reserve up-mods to those who knew what they were talking about, we might encourage more actual knowledge here.
Of course, it'd probably also kill slashdot in the process, so please continue as before.
Re:Non-human model systems (Score:4, Informative)
The interesting thing is that it's Metformin... That drug does several things at once (though it's side-effects make it such that you largely don't want it for it's carb-blocking ability...)- diabetics on that med tend to lose weight if they're solely on that one and abide by diet restrictions and are compliant with it. It'd be interesting what comes of the research.
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Won't it's status as an FDA approved drug and the low dosing make for large fast studies?
If I understand correctly the dosage is already at a proven safe level.
Bet it's used off label post chemo inside the week. No harm in any case.
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The recommended dose is 2000 mg per day. Only a few months ago the highest recommended dose was 3000 mg, but as far as insulin takeup is concerned, the extra 1000mg proved only to have marginal gains.
I don't know if the extra 1000 mg would be worthwhile taking as an anti-cancer prophylactic however.
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I thought it was also shown in human data. FTA:
"It has been known that diabetics taking Metformin experience lower cancer rates"
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Correlation is not causation. But it is a reason to look further. So, by all means, take this news with some salt. Just watch your sodium intake, or you'll never live long enough to get a cancer that this correlation may treat.
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I'm diabetic take metformin and had a heart attack 3 months ago (heart attacks are likely for diabetics).
now what am I going to die of? I've already done well not dying of my heart attack 30% of people who have a first heart attack die from it.
Does metformin reduce the incidence of cancer or does diabetes and its complications kill you before cancer arrives?
well with my dodgy heart and sticky blood how unlucky would i have to be to get cancer as well.
Thing is its pretty much self inflicted eating junky foo
RTFA (Score:2)
I know I know, it's Slashdot and we don't do that here. But if you had...
A clinical trial testing metformin alone in early-stage breast-cancer patients, after they have had surgery and chemotherapy to treat their tumors, is being sponsored by the National Cancer Institute of Canada and could begin enrolling patients next year, said Jennifer Ligibel, a breast-cancer doctor at Dana-Farber Cancer Institute, Boston. The idea is to see if metformin is effective in preventing the cancer from recurring. U.S. c
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I'm diabetic... (Score:5, Informative)
... and Metformin was one of the first drugs I tried. Too bad it made me feel HORRIBLE .
Not just all caps horrible, but bold and italic horrible, too. Fever, nausea, chills, cramps, and headache. We even tried ramping up the dose, starting in very small amounts, to no avail. Only afterward did the doctor tell me that a significant fraction of the population has the same reaction.
(I finally broke down and just took insulin and Actos. Works great to control blood sugar. Also works great for gaining weight.)
Re:I'm diabetic... (Score:5, Insightful)
I had cancer and they gave me chemo (then a high-doseage chemo (bone-marrow transplant)). That wasn't a pleasent feelign either.
Still, I doubt Metformin would have had the permenant effects that did.
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Acknowledged. I'm sorry you had to endure that. I hope you kicked its butt.
However, metformin wouldn't be a treatment, but a prophylactic. And it's well-established that few people who will persist in taking something as a preventative course if they do not tolerate it well.
Ideally, they'll learn something from the action of metformin on cancer stem cells and derive a more tolerable drug.
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Perhaps you didn't read the summary, where it says it is used by mixing it in with a standard chemo drug? They only briefly say that maybe it could also be used as a preventative treatment. The big thing was a dramatic increase to the effectiveness of chemotherapy.
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Actually, the study indicates that it would be useful in combination with other chemo. It might also be useful to continue with it after the chemo is discontinued to prevent re-occurrence of the cancer (due to left over stem cells). Further study will be needed to determine how long after it would need to continue but it's quite possible that the answer is shorter than for the rest of the patient's life.
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You'd probably still need the chemo immediately, but so far, this sounds more like it'd prevent a recurrance over a long period of time.
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Considering that you want to LOSE weight in many cases with Type II (Largely with Type I, you have no choices- you take insulin shots...), gaining weight isn't desirable- I should know, I was on three meds before I carved out the sugars in my diet and lost about 40 pounds. Now I'm under control and merely diet and exercise controlled- and have been for the last 3 plus years.
Gaining weight is typically NOT what someone would want to do if they've got Diabetes. It's actually very harmful for many whom have
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Re:I'm diabetic... (Score:4, Informative)
Did you try the extended release Metformin - for many people that has lesser
side effects than the regular one.
The most common side effect of Metformin is an upset stomach & lots of farting.
But usually that subside after a month or so.
Metformin is really a wonder drug - if possible every diabetic should take it
- It's the one of the few diabetic medication which doesn't make you put on weight.
It usually results in a 3-4 pound weight loss.
- It never causes low blood sugar.
- It's cardioprotective. Diabetics on metformin reduce their chances of getting a heart
attack.
- It's dirt cheap if you take the generic.
- It helps with the Dawn Phenomenon [wikipedia.org]
It help starting with a very low dose of Metformin ER - say Metformin 500 Extended Release
once a day for a couple of weeks to see how it works for you - if you haven't already
tried the ER yet - then you can keep increasing dose - 750, 1000, 1500, 2000 till you find
the maximum dose you can tolerate.
If
Re:I'm diabetic... (Score:4, Informative)
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Everybody's body is different in a variety of little ways. Yours is probably among the small percentage that doesn't take to it.
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Oh! No! Cure for cancer found. (Score:1, Troll)
Our intrepid CEO comes up with a plan. "Let us hire some PR firms to funnel money to our usual shills in the media. Project finding cure for cancer as the major motivation for so many young people to choose medical career and be a general
Re:Oh! No! Cure for cancer found. (Score:5, Insightful)
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I know you're being sarcastic, but I've never understood that argument. If your health insurance subscriber lives a longer and healthier life, aren't you collecting more money from them?
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Cancer is a natural cause. And really, the insurance company prefers you die of old age, because that's the only cause that does not in and of itself cost them anything.
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This is AWESOME for insurance companies.
Charge the same rates and provide cheaper cures?
I'm pretty sure the math works out in their favor.
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SO instead of spending 25K a month to treat someone, the spend 4 dollars a month? and this is bad? People will live longer, and healthier that means the insurance will get premiums longer, and pay out LESS.
Not insurance companies are a nasty bunch of people, so I'm sure they won't lower premiums for this. The CEO will get a BIGGER bonus.
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False.
If people live longer, they have more claims that the insurance company needs to pay. The number of claims outweighs the additional premiums paid when considering the population as a whole.
It's apparently little-known to the general public (judging by comments like yours), but the young subsidize the old and men subsidize women via their insurance policies. Thi
The elephant in the room... (Score:5, Interesting)
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Most likely; there is a theory on cancer that is different from the usual somatic cell cancer theory - check out the Warburg effect ( http://en.wikipedia.org/wiki/Warburg_effect [wikipedia.org] ). But hey, why look for an underlying cause when you can pick your favorite "oncogene" whose mutations aren't necessarily a cause of cancer, but an effect.
When you can't do double blind.... (Score:3, Insightful)
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Expect the price to go up, up, up. (Score:2)
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Or, they could just patent the use of this drug to treat cancer, rather than the drug itself. It's been attempted before, where heart medication that was just about to go generic was suddenly patented as being target to people of African descent. I'm not sure what the end result of that attempt was however.
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Make an attempt to understand how pharmaceutical patents works before looking foolish next time.
Re:Expect the price to go up, up, up. (Score:4, Informative)
http://www.accessmylibrary.com/coms2/summary_0286-11275848_ITM [accessmylibrary.com]
Gee, thanks, I'll definately take that advice next time.
In 1987, the drug's creators had originally obtained a "methods" patent on using the combination of two generic vasodilators (hydralazine and isosorbide dinitrate) that seemed to have a pronounced beneficial effect in treating heart failure.
The methods patent, which expires in 2007, was not race-specific.
Soon thereafter the patent owners applied for a new race-specific methods patent to use the generic combination to treat heart failure in African-American patients.
If my knowledge of pharmecetical patents is so out of whack as to be foolish, that doesn't say a lot for the lawyers, judges, and patent inspectors involved in this case.
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$10 for a month's supply of Metformin in my case.
I'd know.
I (am supposed to) take 2500mg daily.
Still pretty cheap, though.
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Some time ago, there was a drug manufactured for the treatment of sheep (a fatal digestive problem or something similar), which was marketed at $5 per head of sheep, since this was all farmers could afford. Then some medical research discovered that the same medical compound worked on humans as well. This was marketed at $50,000 per person, since that was all insurance companies could afford. After all, how much is a human life worth?
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The drug was Levamisole and Ergamisol [google.co.uk]
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Probably not. Cancer is less common than dia-beet-us, the price will go up a little, but I don't think it'll be that drastic. Especially if there's a generic.
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Don't care if it does, because I get mine from the VA, and I doubt they're going to charge more. And, I might add, sooner or later they'll admit that my Type II is related to the time I spent in Tonkin Gulf back in '72 (Agent Orange, anyone?) making it Service Connected, and all my meds and testing supplies will be free
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It's been out long enough that generics are available, no company will be able to get a stranglehold on supplies and jack up the price.
Is medical advancement stagnating? (Score:4, Interesting)
Is this a patent problem?
A legal one?
It's starting to seem like we've all but halted the advance of medicine while we try to extract as much profit from each new discovery as possible, nevermind that real people are dying in the meantime. How long is it before this drug treatment is avaliable? 2025?
Again, I have little grasp of medicine, so maybe I'm being paranoid. Can anyone give greater perspective on my concern?
Re:Is medical advancement stagnating? (Score:5, Informative)
The frequency with which potential treatments are announced has increased, and the number of existing, effective treatments has increased (both of these pretty much work since whenever).
So you see more noise about things that might work, and those things face a higher bar when actually tested out, thus there are more failures.
If you step back and look at survival rates for various cancers, they have gone up significantly, even in just the last 10 years (some of this may simply be due to increased awareness of carcinogens, but some of it is likely to be due to better treatments).
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And the increase in speed at which treatments have been coming out have also resulted in many more errors and mistakes. Call it corporate greed, but it amounts to the same thing. Sometimes, it's better to take things slowly.
Of course, I firmly believe in a midpoint, where a drug doesn't get released to the general public, but if a consenting individual wants it, can get it, perhaps at a discount or for free. Sort of like an extended clinical trial.
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Doctors that know about these kinds of "possible" treatments will find ways to give it to you. At which point you become a human ginny-pig but not part of any kind of clinical trial. If it works for you or doesn't the data may never make it into research documentation. If you die from the treatment or just die anyway the doctor is unlikely to ever tell anyone what he did. That would open him to loosing his license, law suits and possible jail time.
We could just try lots of stuff on people. "here try this
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Good news here if the results are really that good, since it's already approved for some use, it can be prescribed off-label as the doctor sees fit.
Since it's cheap, it won't get squashed by HMOs refusing to pay for off-label prescriptions.
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Re:Is medical advancement stagnating? (Score:4, Informative)
It's available now. Doctors in the U.S. are allowed to prescribe medication for off-label uses if it's approved for any use, so you might be able to get a prescription metformin for anti-cancer use this afternoon if you make a few calls. There may be a more general problem, but this is not a good illustration of it.
Re:Is medical advancement stagnating? (Score:5, Interesting)
At that point, you still have to move on and make sure that it doesn't kill humans(inordinately often, that is, risks are worth it if the disease, or the current best care has worse risks) which takes time and careful testing, and that it actually has the effect desired in humans, more time and testing, and finally roll out.
Drug companies are, undoubtedly, willing to behave downright evilly when it is in their interests. In this case, though, their interests are largely aligned in favor of the swiftest deployment possible. Every day you are working on a drug and unable to sell it, you are losing money on that drug. If your competitor has a drug and you introduce a new one that does the same thing or better, you'll gain some market share. Even if the existing drug is your drug, its patent protections are ticking away, and you really want to have something new ready to go before they expire. You could try just sitting on a new drug, and milking the old one; but, if you patent the new one, its patent protections will also be ticking away, so you'd be insane not to start selling it, and if you don't patent, somebody else might.
You'll note, as well, that most of the stories of drug company malfeasance involve playing up the drug's efficacy or playing down its risks, or pushing doctors to switch from old stuff to new stuff, or encouraging them to prescribe existing drugs "off label" for conditions other than the ones they were originally approved to treat. All of those actions suggest pressure in the direction of faster adoption.
Also of note is the fact that disease is really common and tends to strike a broad cross section of people(some diseases more than others, of course. Some are virtually random, some have pretty strong demographic or genetic factors). Odds are very good that a fair number of key players in any big pharma/FDA sandbagging conspiracy(executives, officials, scientist who could blow the whistle) are either themselves sick, or have sick friends/family/pets, or both. An alarming number of people will screw over strangers for money, particularly if they don't have to see it happen, or feel personally responsible; and sociopaths would do the same to friends and family; but the payoff would have to be amazing for them to put themselves at serious risk. If it turns out that key players in medical research are using very different therapies than those that are generally recommended, it would be time to worry. As long as they and their families and friends are using basically the same techniques as everybody else, though, they have a pretty strong human incentive to do their jobs well.
Obviously, I'm not going to claim that there are never instances of sandbagging. I'm sure that there have been circumstances where, for whatever reason, an incentive existed, and I don't find it at all hard to believe that they went ahead and delayed. However, it seems quite unlikely that that is a major influence on medical development as a whole.
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I think it just shows how little we know about (human) biology, seemingly a very complex subject, and how crude our "modern" medicine is.
A little humility and skepticism are in order, but they are lacking in news reports on health/medicine, quoting doctors and researchers as if they are engaged in a literary debate.
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"but doesn't it seem like the discovery of a treatment and the implimentation of a treatment have become abnormally distant from one another? Far beyond what proper testing and trials should mandate? "
no, not really. There are a lot of people researching a lot of potential avenues, most of which will fail at some point along the path.
Just like any science.
"seem like we've all but halted the advance of medicine w"
not at all, we have made huge strides in medicine. The survival rate for Cancer is very high cmo
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cancer stem cells? (Score:1)
metformin treatment will make the inevitable splash in the media along with whatever 'cancer gene' is found next week. will it lead to better treatments? doubtful. look at how well anti-angiogenesis drugs have worked in humans, and how well they worked in mice. in mice
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You haven't kept up. Recent discoveries suggest that cancer arises from mutated/damaged stem cells. Their progeny make up the bulk of the tumor(s) but the bulk of the difficulty in treatment is the stem cells.
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I can see additional genomic instability but EACH cell is different? Seems unlikely. That large a mutation rate would seem to be incompatible with life.
Xenograft? (Score:3, Funny)
Doctor #1: "Is this going to be a stand-up fight, Sir, or another bug-hunt?"
Researcher: "A Xenograph may be involved..."
Doctor #2: "It's a bug hunt."
More metformin news (Score:4, Interesting)
The new study also implicated the protein AMPK, a component of the TOR pathway even further downstream than S6K1, as a key potential drug target. The role of AMPK is especially intriguing because it is activated by metformin, a widely prescribed drug for treating type 2 diabetes. Withers says this means it may be possible in the next few years to design clinical trials that would test metformin's ability to prevent or treat age-related diseases.
Metaformin (Score:1)
Coolness (Score:2)
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Nah, they will "tweek" the chemical formula slightly so they can get a patent, this will reduce the effectiveness of the dosage so they will have to quadruple the dosage of it which will accentuate the nasty side effects.
They will then tout this "new" drug as the new "de-facto" Cancer treatment and it will be just slightly better than chemo in terms of horrible nasty side effects....
They have done this before and they will do it again. Thanks to big Pharma which has its hands in every major country. They
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yes, make the drug far more expensive to produce and then compete with the 4 dollar a month off label brand that's generic. Good luck with that.
the idea of big Pharma controlling this is a joke, unless the people running these companies are stupid. Which they aren't.
"They have done this before and they will do it again. "
cite please.
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http://www.manhattan-institute.org/html/miarticle.htm?id=4442 [manhattan-institute.org]
http://money.cnn.com/2007/03/21/news/companies/drug_patents/index.htm [cnn.com]
That and I personally know a pharmacists who keeps up with all of the latest news concerning this.