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Comment by entee | Hacker News Reader

Cancer favoring glucose has been known for a very long time, this is called the Warburg Effect:

https://en.wikipedia.org/wiki/Warburg_effect_(oncology)

Interesting new pharmacology for sure, but the end of the article is critical here:

"Additionally, an accompanying commentary by William Katt and colleagues indicated that there are no FDA-approved drugs that target glucose and glutamine metabolism. This is because previous drug candidates proved to be too toxic for use in humans."

It's really hard to go after glucose because it's kind of everywhere. If there's a way to target this compound more specifically, maybe it could be useful. As it stands now, it's very very far from being a viable drug (and it doesn't sound like the authors claim otherwise). Cool science though.

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This is how they detect cancer with a PET scan. They pump some radioactive glucose into your veins first. Tumors absorb it quicker than normal tissue, so they glow brighter on the PET scan.

I worked on this for multiple myeloma. DCA is nice but the concentrations you need for treating people gives them peripheral neuropathy, which isn’t trivial. But fwiw combining DCA with other drugs looks promising.

The issue is that cancer is polyclonal so there is a sub-population that predominantly relies of aerobic glycolysis, but the sub-populations that mostly metabolise glutamine or fatty acids will escape treatment... so you need a bit of a shotgun approach, in combination with traditional anti-cancer agents.

That makes sense. I think most people underappreciate how polyclonal cancer is. Every tumor isn't one cell, it's dozens or hundreds of different types of cell, which makes it extremely hard to cover all the possible escape paths for the cancer overall. As you mention, going with a shotgun approach of different drugs can help, but that's when toxicity becomes a real problem. It's not always possible to just give 2 drugs because one is so toxic on its own so you might kill the patient. One of the theories I've heard about why we've made relatively more progress on cancers in children is that they "heal" better, which means they can actually tolerate higher doses for some of these drugs.

That sounds like fascinating research. Besides chemotoxic agents, do you know what other compounds are being experimented with, in combination with DCA?

A couple of interesting publications on Glioblastoma treatment that might be pointing in the right direction for targeting glucose and glutamine starting with mouse models: https://www.nature.com/articles/s42003-019-0455-x and progressing to human case study: https://www.ncbi.nlm.nih.gov/pubmed/29651419

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