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Comment by ekianjo | Hacker News Reader

> but the canine patients lived a median of 139 days, compared with a median survival of 30–60 days typical for dogs with the condition

so you might get an improvement in overall survival but not a cure for GBM

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GBM median survival for humans (according to the article) is 15 months.

If the effect is linear, the boost to survival time in humans would be an additional 19 months. With the death sentence of GBM hanging over your future, an additional year-and-a-half is huge.

It is and it isn't. A year and a half would go by so quickly. But if it were a high-quality year and a half and not spent in a hospital ward, I guess it's better than the alternative.

How about we could let people make that decision for themselves?

I said nothing about making the decision for anyone else.

It's highly non-linear, as you allude to.

For a mother with a young child, getting another 1.5 years can be the difference between the child not knowing their mother and having some memory of her.

For someone with no or adult children, it can be a lot less significant. My dad passed away from cancer when I was 30 and while I certainly would have taken an extra year with him, it wouldn't have changed much.

Nothing like a deadline to make the most of 18 months. I have a 4 and 6 year old and if I were in this situation I'd cherish the hell out of that time. And hope for further improvements in treatment (and a stroke of luck) in the meantime.

You could say the same for 20 years, in the grand scheme of things.

I'm in the camp of having 18months of non painful survival being a massive change, because it buys you time to wait for another therapy later.

It is and it is. My dad died of a GBM in 2022, 17 months after his diagnosis. If he had had another 19 months, I'd have made him breakfast this morning.

I find it much easier to sympathize with people's desire for additional time with terminally-ill loved ones now.

I'm a bit more optimistic. The article specifically mentions that it is too soon to look at efficacy. There could have been a lot going on with these dogs that shortened their lives that was unrelated to the GBM. Optimizing the treatment for dosing, timing, etc and applying it sooner are likely to greatly improve its efficacy.

Very unlikely to be a cure for GBM, but there's often the hope that therapies can stack very well-- both from combined effect against disease and sometimes sensitizing the disease to other therapy. The dogs were not receiving the human standard of care treatment-- who knows what surgery, radiotherapy, immunotherapy, and chemotherapy can do combined.

The dogs were not humans with human cancer, so we shouldn't expect a clean translation of the results

Of course not, and the relevant xkcd, etc. Not our first rodeo here. It's going to take a long time to get gold standard proof that survival is augmented.

It's still exciting news. They're ramping up through phase 1 to phase 2 in humans, and already have evidence of similar immune response in human patients.

this requires individualized treatment based on the description which will make the implementation costly and impractical. They need to extract a piece of the tumor from the brain.

Surgical resection of glioblastoma is usually (not always) one of the first steps in treatment, so you get that "for free".

But yes, I would expect it to be quite costly.

yes but thats only the first step in this case. then they need to prepare the individualized mRNA shot from there. How long it takes and how complex it is is another question.

Yes, most of the promise of mRNA with cancer is the prospect for individualized therapy. But individualized therapy intrinsically means you're going to be a doing a patient-specific manufacturing step.

Sequencing and RNA synthesizing are widely available commercial services at this point, though not cheap.

There's a lot of magic to take mRNA and formulate it to last in the human body and go and do what you want, but it isn't likely to be the costly part of all of this if there's some small volume of people being treated this way.

If any treatment can extend the life of a patient up to 3 times (as was in the canines), that's significant. Some treatments only have a response efficacy of a few months, but you add a few of these together in sequence, and you build a year.

still does not change my conclusion. its a treatment, not a cure.

Yet

Indeed, you have ascertained the the article's topic— big progress in GBM research— and correctly distinguished it from a topic the article wasn't about.

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