Comment by randcraw | Hacker News Reader

Comment by randcraw | Hacker News Reader

If you have cancer, as I may still do (after prostate surgery), PD-1 and PD-L1 immunotherapy simply is NOT a game changer. On average, you live another 6 months, but only if you pass a screening to get the treatment, which most patients fail. So in practice, even with these drugs, the outcome of getting cancer is significant only in a statistical sense. Hardly a breakthrough.

I also happen to work for one of the two pharmas making these drugs, and it PISSES ME OFF no end how much overpromotion this advancement is getting. Fact is, if you have cancer, you're still going to die, at best a year later than if you were on chemo. So the lucky few who pass immuno-screening and then get these drugs will benefit mostly by avoiding chemo, not by living significantly longer, much less getting cured.

Added to its modest actual outcome, the COST of this treatment is insane - profiteering of the worst kind. Charging a dying person $80,000 for an extra 3-6 months of life while promoting the drug as a 'breakthrough' is just plain wrong. It's a violation of the Hippocratic oath. And it's caused me to lose the little bit of my remaining faith in the value of working in this industry.

'As good as it gets' is a pitiful rallying cry when battling cancer, IMHO.

It seems like the PR engine is on overdrive for this drug. And it looks the BBC are spewing it out without giving it any thought at all. Or perhaps the reported was paid?

I'm not saying it has no value, I'm saying that their PR is wildly out of control and it's reflecting on the poor state of journalism more than the efficacy of the drug.

Here is a scathing review of it and the PR engine behind it from the NYT just a month ago, ironically: http://www.nytimes.com/2016/08/09/opinion/cancer-drug-ads-vs...

OPDIVO is another name for nivolumab.

No one should call a cancer treatment drug a 'game changer' unless it literally cures cancer in something like 90% of cases. Otherwise it's spreading false hope and it is actually immoral - if you consider that nearly everybody has been affected by cancer either directly or indirectly.

Actually any drug that cures people with cancer even a small percentage is a game changer. A drug that cured 5% of all cancers would be fantastic given most drugs just delay progression with very bad side effects.

Our metrics are really skewed - we reward companies that develop drugs that increase average life expectancy by a few months in a large percentage of the target population and which cure nobody, not those that cure even if it is only a small percentage of the target populations.

The really bad thing is we are doing almost nothing to develop treatments that prevent cancer in the first place (well nothing gets to the clinic). The three really big advances in cancer treatment in the last 100 years have been the HPV vaccine, Hep B vaccine / anit-Hep C drugs, and antibiotic treatment of Helicobacter (stomach cancer). All of these are preventive treatments that have “cured" millions of cancers.

How would you consider a drug that cures 5% of cancers a "game changer"?

Do you know what a game changer is? Hint: It means the game changes. In this case it would mean that cancer is at least 50% obviated.

The reason it is a game changer in we are now trying to cure not just increase survival. Once you have a method that can cure people with advanced cancers that all other treatments types fail on you have a game changer.

I'd certainly like to think that's the case, although unfortunately it does not seem to be. If you read the article I posted in my initial comment, for example, it seems like this involves value combined with PR BS.

If you think that's not the case and it truly is a game changer please do share why

The immunological drugs really are game changers. Up until now we have had three basic ways of treating cancer: cut, irradiate or poison. These basically never work on advanced cancers, or cancers that come back after initial treatment.

The immunological drugs turn the immune system against the cancer and this approach can cure cancers that are untreatable using other methods. It is still really early days, but the immunological drugs are able to take patients that are weeks from death, and for which everything else has failed, and cure them.

What we really need to know if why it does not work for everyone, but it provides a crack into which we can hammer a wedge.

Indeed the class of immunological drugs look like they could be a game changer at some point in the future.

However the question is around the use of the term for this specific drug right now.

Well this drug is curing people with terminal cancers - something we have not ever been able to do before. Game changer does not have to mean we have perfection, just the previous approach is no longer valid and we are tackling the problem in a new way.

In the field, immunological drugs have given investigators hope that we know that cancer is able to be cured and we now just have to figure out the best way to do it - in the past we really didn’t have an approach that had a chance of making cancer a curable disease. Sure there were some approaches that might work on some cancers or some approaches that would hold the cancer at bay for a time, but nothing that gave hope of general cure.

To put it more succinctly, terminal is no longer terminal.

There may, or may not be, quality of life benefits relative to palliative chemotherapy when dealing with late stage aggressive cancers. Though there isn't 'just one' chemotherapy, in general chemotherapy treatments tend to make the patient sick enough that they must be spaced out to allow the patient time to recover from the treatment.

To me, there does not appear to be anything particularly unique to the treatment economics in regard to the US cancer treatment industry. Unfortunately.

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