[oh_my_goodness]

>a lot of the most difficult to treat cancers are now far more treatable, and in the next 1-5 years clinical trials will tell us which cancers this particular drug works well for,

Can you help disambiguate this? Are there treatments now, or are there potential treatments with trials in 1-5 years?

[epistasis]

The next 1-5 years will tell us which cancers this new drug will work well on, right now it's only been tried in pancreatic cancer when people have failed their first treatment. The new drug from the article, daroxonrasib, has nine trials i see currently, here:

https://clinicaltrials.gov/search?intr=daraxonrasib&viewType...

The first two are the trial that just completed and showed success: people that have pancreatic cancer that failed other treatments, then a "trial" that is meant to give quick access to more people now that it's been shown to work.

Then there's a trial for using it as the first-line treatment for pancreatic cancer, one for lung cancer (NSCLC), and also various combinations with other drugs. I expect we'll see a ton of new trials registered in the coming year. Especially something in combination with colon cancer, because a common drug resistance mechanism in colon cancer is to develop KRAS mutation.

The thing is that we don't really know which cancers it will work well in until we try. And there's limited number of people with cancer that enter clinical trials, and we want to give each person their very best chance at survival, and then there's the massive expense of running the clinical trial itself, so learning happens slowly, one month of survival at a time, or one cancer recurrence at a time, or one death at a time. Patients that take part in clinical trials really are the heroes here. (Especially with the side effects of this new drug, which are horrible. It is a revolutionary drug, but we need to learn how to manage the other things it does as well, and that's going to take time.)

[shevy-java]

But that's not a cure. If they don't take that drug, assuming it works, they still have the original mutation in the cancer cells.

> Patients that take part in clinical trials really are the heroes here.

Are they?

To me personally, putting people into a permanent state of requiring drugs to survive, is not really cure. It's just maximizing income for those selling those drugs. And none of those drugs work exceedingly well; people still die, even if to other disease or frailties. I don't understand this hype in general.

[jmcgough]

I can understand being frustrated and cynical with the pharmaceutical industry, but I have never worked with a single doctor that approaches patient care with the goal of getting them "hooked" on something for life.

The pharmaceutical companies are not the ones making clinical decisions - in this case, it's a shared medical decision between a patient and their oncologist.

Having seen how horrific pancreatic cancer is, how difficult it is to treat, and the decades of slow research done by academic scientists to get to this point, I am elated that we have a tool to give patients more time with their families even if their cancer can't be "cured" with this particular drug.

This may seem unsatisfying, but it's real, measurable progress. KRAS has been known about since the earliest days of cancer research, so it's a true breakthrough to finally have a drug targeting it.

[simulator5g]

Pharmaceutical companies do make clinical decisions, it just isn't called a clinical decision. But they decide what research to pursue, and thereby decide which drugs exist for the doctor to choose.

[jmcgough]

They influence clinical decisions by adding to treatment options, but they do not make clinical decisions. If we believe that a drug's potential risks outweigh its benefits, clinicians will not prescribe it.

[michaelmrose]

Everyone dies. Dying 5 years later is a victory. I would go so far as saying if it was you or someone who you care about you would understand.

https://usafacts.org/articles/how-have-cancer-rates-changed-...

>However, even though the overall number of cases rises as the population grows, fewer people are getting and dying from cancer. Between 2000 and 2021, the incidence rate — or the rate of new cancer cases per 100,000 people — declined by 5.7%, while the annual mortality rate fell by 27.5%.

Cancer is a broad term encompassing many sorts of malfunction and nearly 40% of Americans will be diagnosed with it at some point because if you survive other hazards and maladies cancer is often what gets you.

[oh_my_goodness]

Unfortunately in this particular case people die about 6 months later, not 5 years. See the article.

[michaelmrose]

This is just a failure of understanding. This particular advancement is part of a decades long slog which taken together allows a substantial number of people to live meaningful additional durations every single year. 6 months average by itself means that John got another 3 years even if Jane only got 3 more days.

If I pulled one person out of a burning building it would be newsworthy. Doctors are and have been pulling train loads every day.

[oh_my_goodness]

I support doctors. They're doing great work. I understand that in today's US I probably should have said that explicitly, as many Americans seem to have joined the side of the cancer, viruses, etc., and now oppose doctors (or even blame doctors for the diseases). I'm not one of those irrational people.

I agree that 6 extra months (on average) means some patients get much more time than that. I agree that a statistically significant improvement on the survival rate for this terrible cancer is a very promising result longer term.

My disagreement was much narrower than that. I disagree that 6 extra months is equivalent to 5 extra years. I disagree that people living an extra 6 months on average is equivalent to one person living 3 extra years and one person living 3 extra days. I think 3 days and 3 years average out to about 1.5 years, not to 6 months.

Think of me as a living fossil who takes it for granted that everyone appreciates how much medicine improves our lives.

[jamesrcole]

it's unfortunate that they live an extra 6 months???

[oh_my_goodness]

In my comment I pointed out that "5 years" was a bit of an exaggeration compared to the results in the article (6 months). That seemed unfortunate to me. To me 5 years seems much better than 6 months.

[try_the_bass]

Wow, this is such a wildly pessimistic and cynical take. Are you okay?

> But that's not a cure. If they don't take that drug, assuming it works, they still have the original mutation in the cancer cells.

The person you're replying to called this out specifically:

> and also various combinations with other drugs.

Why do you think they try it in combination with other drugs? You might be right that this drug alone might not be a cure, but if it inhibits cancer growth, then it empowers other drugs to work more effectively.

> people still die

So what... We do nothing, then? This is your complaint? That we can't be immortal, so why bother trying to cure anything?

I don't understand your type in general.

[Spooky23]

My wife died of aggressive melanoma. Immunotherapy would likely have helped her if not for some complications that delayed it.

Today, only 4 years later, there are two therapies, one RNA based and one CART that would have been usable in her situation. She’d be alive today most likely.

Frankly, you have no idea what you’re talking about as you spew toxic bullshit. 5 year survival would meant being there for her son through high school. That survival rate was 65% in 2022 and closer to 80% now in recent trials.

Normally I’d scroll on, but in these degenerate days it is important to counter bullshit before it becomes policy.

[memonkey]

I think the meaning is that because we can see success with KRAS mutation of pancreatic cancer, we can now begin clinical trials for other cancers that may have KRAS mutation (colorectal, lung) and see if there is success there. If there is success in treating other cancers during clinical trials, it could be fast tracked through FDA to be more generally available and then become part of the national treatment option (ideally in 1-5 years after clinical trials).