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Medicine Science

If We Can't Kill Cancer, Can We Control It? 140

An anonymous reader sends this excerpt from The New Yorker: In April, [Dr. Eytan Stein] presented his findings to a packed auditorium at the annual meeting of the American Association for Cancer Research, in San Diego. It was the first public airing of the results of AG-221; patients with progressive [acute myelogenous leukemia] had never improved so quickly and definitively. ... The breakthrough is notable in part for the unconventional manner in which the drug attacks its target. There are many kinds of cancer, but treatments have typically combated them in one way only: by attempting to destroy the cancerous cells. Surgery aims to remove the entire growth from the body; chemotherapy drugs are toxic to the cancer cells; radiation generates toxic molecules that break up the cancer cells' DNA and proteins, causing their demise. A more recent approach, immunotherapy, co-opts the body's immune system into attacking and eradicating the tumor. The Agios drug, instead of killing the leukemic cells — immature blood cells gone haywire — coaxes them into maturing into functioning blood cells. Cancerous cells traditionally have been viewed as a lost cause, fit only for destruction. The emerging research on A.M.L. suggests that at least some cancer cells might be redeemable: they still carry their original programming and can be pressed back onto a pathway to health.
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If We Can't Kill Cancer, Can We Control It?

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  • by Anonymous Coward on Sunday September 14, 2014 @04:35AM (#47901019)

    My wife just died of breast cancer this week -- she did not live to be 40 -- so articles and research like this give me hope that, when our child grows up, cancer will not be something that takes people's lives away from them so quickly and so young. This is a site for geeks, so I am sure a lot of people know about the brilliant nobel-prize-winning physicist Richard Feynman [wikipedia.org], and how his wife Arline Greenbaum died of tuberculosis in the 1940s.

    Today of course, tuberculosis is no longer a death sentence the way it was in the mid-20th century, and I think, well before end of this century, cancer will no longer become a death sentence either.

    • by Anonymous Coward on Sunday September 14, 2014 @07:28AM (#47901353)

      Somewhat ironically, we finally seem to be making progress in the fight against cancer at the same time we are losing the fight against bacteria. Take tuberculosis, for example, there are only a few drugs left that work. In fact, the fda just approved a drug bedaquiline [nejm.org] that would have failed its clinical trial had it been practically any other kind of drug. You see, people who were taking it were dying at an alarming rate. It was approved because we don't have any other weapons against multi-drug resistant TB.

      In 2013 in the US more people died of antibiotic resistant bacteria than died of AIDS.

      • by Rich0 ( 548339 ) on Sunday September 14, 2014 @09:43AM (#47902047) Homepage

        In a sense this is a self-regulating problem. If a LOT of people start dying from bacterial infections you'll see new antibiotics developed. The problem today is that there isn't much public funding for antibiotics, and there isn't much demand for new ones. Sure, the few who need them REALLY need them, but stuff like MRSA is still fairly rare. Nobody wants to pay $100k for a 10-day supply of antibiotics.

        The problem is that developing a new antibiotic costs around $100M or so. (Well, it would be more accurate to say that the new antibiotic would cost $10-20M, but to find it you'd have to spend $80M on a bunch of other antibiotics that don't work out.) Whether you believe in patents or not, SOMEBODY has to spend that money if we want a new antibiotic. The market just doesn't exist for that kind of expenditure, so you won't see private companies doing it until the market grows (ie, more people start dying). Governments don't seem to care much about the issue either - any of the first world nations could easily fund this research but they all want somebody else to do it for them so that they can just do compulsory licensing of the resulting products and get them for cheap (well, the US won't do this since they're in bed with Pharma, but they're busy bombing people in Iraq). Tragedy of the commons...

        • Re: (Score:3, Informative)

          by Anonymous Coward

          stuff like MRSA is still fairly rare.

          No. No, it isn't. You're wrong and are disseminating dangerous disinformation.

          I'll go ahead and cite my med school lecture from last week on that, but if you want more feel free to google on your own. I'll throw you a bone from
          http://www.mrsasurvivors.org/s... [mrsasurvivors.org]:

          MRSA infections and colonization has steadily increased over the years and in 1974. 2% of all staph. aureus infections were MRSA, 22% in 1995 and in 2004 it was 64% with an estimate of over 70% of all staph is now MRSA. In the community, it is estimated that 60% of all skin and soft tissue infections that doctors treat are MRSA infections.

          Also, FYI, the current cost to bring a new drug to market is $~1 billion. Plenty of cites trivially available on google for that, too.

          • by Rich0 ( 548339 )

            The cost to develop a drug is actually a matter of considerable debate. I'll agree that $100M is a lower-end figure for it. Most of the cost depends on how many failed candidates you factor into the calculations. The cost to actually develop a successful drug is probably $50M or so. The problem is that for every one of those you have many failures, but most of those tend to be abandoned before the full $50M gets spent.

            My point is just that MRSA isn't commonplace enough to be a priority for private inves

          • It doesn't cost anywhere close to that to bring a new drug to market try more like 43 million, but actually a lot less.

            http://www.pharmamyths.net/fil... [pharmamyths.net]

        • You are an Idiot!
          If a LOT of people start dying from bacterial infections you'll see new antibiotics developed.
          How do you think that should/could work? Oh, it is like software development: requiremt, a stuff that kills bacteria. Solution: take this. Done.
          Moron!
          The problem today is that there isn't much public funding for antibiotics, and there isn't much demand for new ones.
          The demand is huge, but finding one that "works different" than all the ones before, hence the bacteria are not immune is nearly imp

          • by Rich0 ( 548339 )

            When I talk to the average person on the street in the US, they talk about ISIS. They might even talk about the NSA. They don't talk about MRSA.

            The demand SHOULD be huge, but the reality is that it isn't.

            This article [usatoday.com] suggests that we only JUST started spending $30M per year on antibiotic research. At that pace it seems like it would take years to come up with a viable drug, and that is only if the NSF/NIH spend some of the money on actual development and not just blue-sky research, which they rarely do.

            • Antibiotics are usually found by accident.
              It is pretty difficult to make a systematic search.
              However I have no idea how much actually is spent directly for antibiotics research.
              I guess to tackle MRSAs a new antibioticum is not enough. I assume phages could perhaps help, but finding or 'crafting' one that attacks exactly that specific bacterium might be similar hard.

        • by u38cg ( 607297 )
          Wrong. Antibiotics as a chemical class are pretty much played out. There is plenty of funding for research - big pharma would love a MRSA killer. The substances simply don't exist.
          • by Rich0 ( 548339 )

            I don't really see any evidence for substantial spending on antibiotic R&D. If you can point to some kind of citation for this I'm certainly curious.

            Antibiotics aren't really a chemical class either, since there are many mechanisms of action. A chemical class would be something like beta-lactam antibiotics, etc. I suspect that particular class is mostly played-out, but there are potentially as many mechanisms for attacking bacteria as there are unique metabolic pathways in bacteria.

            I don't mean to tr

            • by u38cg ( 607297 )
              Sorry, I meant that the spending capability is there if the financial case justifies it.

              And no, there aren't massive swathes of potential avenues of attack. There are only the pathways that bacteria don't share with humans where the drug has no other toxic effect. There will be new antibiotics - no question - but its questionable whether there will ever be another sulphonamide or penicillin.

      • However it is well known how to prevent that bacteria become "multiple resistant" against antibiotics.
        Nevertheless the US does nothing against it ... e.g. forbidding antibiotics in animal breeding (just one thing).

    • by ncc74656 ( 45571 ) *

      My wife just died of breast cancer this week -- she did not live to be 40 -- so articles and research like this give me hope that, when our child grows up, cancer will not be something that takes people's lives away from them so quickly and so young.

      Mine passed a year ago last Saturday of uterine cancer; she was 33. You're probably feeling absolutely gutted right about now. Things will improve slowly, but they will improve. Just yesterday, I was looking through photos for something to illustrate a fund

    • by antdude ( 79039 )

      Sorry to hear that. I had an online friend who died before he reached 40. Same with my grandqueen. Cancer can hit anyone. :(

  • by justcauseisjustthat ( 1150803 ) on Sunday September 14, 2014 @04:42AM (#47901031)
    Anti-CD47 is just entering the first human trials at Stanford, and shows a lot of promise. We really should start seeing declining deaths rates and better quality of life.
  • I feel medical publishing needs to move away from the current paradigm [nature.com] even more than the open-access journals that have been discussed so widely. The company that made this advance, Agios [agios.com] doesn't seem to be a typical "big pharma" company: They are running lean on market cap (350 million in outstanding shares) and big dreams. Imagine a world with a hundred more companies like this could be creating equally innovative solutions. Then realize that the biggest drug company [google.com] has a market cap that could be fund

  • This is a link in case anyone on /. is feeling generous and wants to help someone try to survive their fight against cancer... https://www.givealittle.co.nz/cause/savesally/ [givealittle.co.nz]

  • by Anonymous Coward

    Why not work on prevention? Cancer rates have quadrupled in the last century, thanks to our increasing use of synthetic chemicals in food and environment. Why not try to get rid of the causes instead of finding out what other sort of drugs and chemicals we can add to reverse it?

    • by tomhath ( 637240 )
      How about we do both?
    • by u38cg ( 607297 )
      A large part of the quadrupling is simply increased survival at all ages increasing exposure to cancer inceptions, plus better diagnostics of boring, non-dangerous cancers.
    • Why not try to get rid of the causes instead of finding out what other sort of drugs and chemicals we can add to reverse it?

      We could try it, but I don't think you'd be very happy.

      The #1 cause of cancer is old age. People are dying of cancer in droves because they aren't dying of tuberculosis, or pneumonia, or cholera, or epidemic smallpox, or infected cuts, or any of the other causes of death we've eliminated in the past century.

      DNA copying isn't perfect. It takes, on average, 70 years for enough mutation

  • by ponos ( 122721 ) on Sunday September 14, 2014 @06:47AM (#47901253)

    Let me give you a brief summary of TFA:
    - Some cancers have IDH1, IDH2 mutations that change cellular metabolism
    - This drug is the first targeting the IDH2 enzyme that has been tested in humans
    - 6 out of 7 patients whose disease (leucemia) had the specific IDH2 mutations had "objective response" to the drug, ie the disease burden was reduced. Note, this does not mean cure.

    Now, this is obviously good news, in the same spirit as previous targeted agents like vemurafenib, erlotinib, trastuzumab, crizotinib, especially since it concerns a new aspect of cellular functioning (metabolism). It's too early to say whether the drug will have long lasting impact, but we'll know more after phase II/III trials. It does seem promising.

    For patients with AML or MDS and documented IDH2 mutation, the study (NCT01915498) is still recruiting in several centers around the US and in Paris/France (Institut Gustave-Russy). More information can be found in clinicaltrials.gov (http://www.clinicaltrials.gov/ct2/results?term=NCT01915498&Search=Search).

  • by 140Mandak262Jamuna ( 970587 ) on Sunday September 14, 2014 @08:00AM (#47901513) Journal
    This treatment is meant for one type of cancer, leukemia . That too one type of it affecting about 15% of the patients where the root cause is the lack of one enzyme. Supplying that enzyme corrects the defect.

    We are far from general cure for cancer.

  • This is what they have been looking for: long term drug therapy they can charge whatever they want for. Pay or die. A cure doesn't pay enough. Yes I am cynical.
  • by Cyberax ( 705495 ) on Monday September 15, 2014 @03:38AM (#47906695)
    I really doubt that it's possible to 'reprogram' cancerous cells. They usually have so many mutations (including seriously weird ones, like chromosome fusion or duplication) that it's a wonder they can still fission.
  • My daughter was diagnosed with acute myelogenous leukemia in July of this year. she is currently in her second round of chemotherapy.
    I doubt whether she will be given the opportunity of being part of this research, but I am really glad that there are continuing advancements happening in this field.

    And as a personal point of pride, my son (age 15) was tested, and confirmed as a match for stem cell therapy this weekend ! He agreed without hesitation to help his sister.

  • Is telomerase antagonists. The key to all cancers is that the cells use a substance called telomerase to rebuild the telomeres each time the cell divides. In essence it makes the cells immortal. But block telomerase and the cell just undergoes apoptosis after so many divisions.

To be a kind of moral Unix, he touched the hem of Nature's shift. -- Shelley

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