Developing a cancer drug without Big Pharma: this hospital shows it can be done
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This statement is a drastic characterization, but you could say “half a dozen PhDs can form reasons to believe they may have found a cure for something”, and the paragraph would end the same.
If you have to pay 200 homeless to take your 0.0001% better than placebo antidepressants in the context of a huge corporation, and maybe redo the trial a few times, I can see how that gets expensive, but I don't see why it's a de facto rule.
But even the big trials it's weird how expensive people say they are. Most other products require a lot of high paid labor to produce, think of a video game studio for example, also without any guarantee it won't flop, and it certainly takes longer to develop than to do a clinical trial.
In most EU countries, the employee receives much less than what they cost the employer. In France, if an employee gets 30K euros, the employer has to provision ~45K Euros.
You can’t just recruit “200 homeless” and have it pass research standards. The homeless population is the most difficult of all to track, maintain accurate records, and even recruit for that matter. You think the homeless just line up for novel drug trials and report back for updates on a strict schedule?
You need good candidates for the trial. You need them to follow up. You need admins to properly track them and ensure it’s at least mostly accurate. Even the best trial candidates won’t follow the protocol correctly.
If you genuinely think the medical and pharma industry don't exploit homeless and other marginalized populations out the wazoo as lab rats. They also only stopped doing it to prisioners when it was made illegal, because that's what they did before. Of course using them has a lot of practical problems, as you outline, other than the much bigger ethical issue.
You managed to miss the whole point of the comment though.
Which is, how is it possible that a multibillion dollar industry, exploiting both the test subjects AS WELL as the researchers in the form of practically free PhD candidates can still claim it's one of the most dificult / expensive endeavours? Where does the money go? When you look, it goes to the bureocrats and to the "bio-investors".
You have to try really hard to make a video game no-one wants[0]. You might not recoup all your investment, but you won't sell zero copies. A drug can have all that money poured in, and nothing come of it.
[0] https://arstechnica.com/gaming/2024/09/two-weeks-after-launc...
The office behemoths involved are optional. Whats missing is tools to scan the body locally for cheap. The rest can be automated or distributed to people with an interest in success (high-level-analysis by the cure developers).
Here are the volunteers: https://www.sciencedirect.com/science/article/pii/S266700542...
All data is not reliable data.
What a profoundly ineffective and broken system we have that this could be uttered as anything other than satire.
Step 2: Offer them the “choice” of possibly receiving care by being medical guinea pigs for those who created the situation that deprived them of medical care in the first place.
A coerced choice is a not a free choice.
That means they have gone all the way to prove it’s safe and effective, and now have to convince the regulators.
Can anyone find the studies?
The correct New England paper about this treatment is here:
https://www.nejm.org/doi/10.1056/NEJMoa2210233
This one is TIL therapy, where you basically take tumor-infiltrating lymphocyte from the patient, stimulate them ex vivo, and put them back.
The reason this is so impressive -- and highlighted by this article -- is that large phase III trials like this have now become so complicated due to various technical, financial, logistic, ethical, and above all regulatory challenges, that they are now mostly done by companies, or at least as joint ventures with companies (and often in jurisdictions with less of these issues, certainly not in the EU like this one). It is very, very impressive to pull off something like this as an academic institution (at least in Europe). What's more, the funding came from KWF (the Dutch cancer foundation), which is actually a public charity that mainly relies on donations.
I’d argue that our current system is broken. There’s no reliable metric of drug effectiveness in any of our pre-clinical models, and thus we end up going into clinical trials quite blind indeed. And more often than not, what drug gets into trials has more to do with ego and politics than actual scientific merit. And the folks involved in these types of activities are (IMO) the most unoriginal types I’ve ever seen.
There’s a lot we can do to improve our drug development process. It really doesn’t need to cost billions to bring a drug to the market. But the odds are stacked against anyone with a contrarian hypothesis and I just figured I’d save my sweat and leave this field instead.
ie totally ignoring existing regulations, pretending they don't apply to you and just hoping you can push through.
In a lot of the 'problems' are the regulations ( which are double edged and tricky to get right ) - and pharma companies are just following the rules.
I think governments might be less lax in letting there be a new wildwest in drug development.
What makes it difficult is the word “prove”
It turns out it’s obscenely hard to make a drug that’s good, and even harder to prove that it’s good.
So how do you do that ethically? How do you justify taking off something that you know works to some extent and try something completely new or worse placebo? ie don't you have to construct the trial in the context of existing treatments etc?
These are the kind of challenges that makes drug development slow - in the end you don't do one trial, but a series of trials, slowly building confidence and making the case.
Often that's what takes the time during the clinical phase.
Of course it would be much faster to go straight to a big trial that would show how well your treatment works in conditions optimal to it - however that kind of 'move-fast break-things' approach involves potentially breaking things which happen to be people.
Regulation just reflects the cautious 'first do no harm' philosophy.
Now let's be honest - big pharma will simultaneous complain about regulation and the cost of development, and at the same time know it creates barriers to entry - there is always some frustration about the slowest of regulatory authorities to adopt new methods - however you wouldn't want your regulatory to be gungho.
Just to be clear, most drug trials for anything where we have an effective treatment are not “new drug vs placebo”, but instead “new drug vs standard of care”. Thus the goal being to prove it’s better than what already exists.
If the standard of care is already good and you don't need a placebo - then you have another problem - you probably are going to have to do quite a big trial to get the stats to show a significant difference, and you are going to find it harder to persuade people to participate with an experimental treatment if there already is a fairly good treatment.
The whole point about the challenges with clinical trials is that it's not an intellectual exercise in designing the perfect experiment and 'just doing it'.
It's about persuading yourself, the regulators, the doctors and ultimately the patients that it's something you should try - and before you've done your first trial you don't have any human data to show it's safe and effective - all a bit chicken and egg - the solution is often to move slowly in stages.
We can't do any of that for drugs that affect emotions and consciousness because we're barely in the stone age of our understanding of the brain and the technology we have to affect it.
The sole reason Uber pulled off what they did, is there's no national authority governing taxi style services for all states and cities, it's a state and local effort. So Uber counted on navigating around zillions of slow local governments long enough to get big, and it worked very well. You can't do that in prescription drugs, the feds have a big hammer and can (and will) use it anytime they like.
Stop trying to venerate the taxi industry, they’re horrible.
My experience of taxi companies in the UK is that they are generally safe, reliable and operate based on reputation.
My experience of taxi's in the US is that they appear to be often operated by desperate people living on the edge of existence.
Except they did the same mistake anyone who comes up with this disruption plan commits (including Google with Calico, or Zuck with CZI) - they recruit existing academics to do the disruption. Unfortunately this just fails miserably because they’re culturally corrupted to think of standard dogmas (like there can never be a single cure for cancer). I remember a time when other such dogmas existed (remember how it was considered impossible to de-differentiate somatic cells?).
The other mistake tech bros make in biology is they think they can make any cool idea work if they are smart enough. Because this is actually true in tech. But biology is restricted by laws of nature. If a drug doesn’t work, it can’t be made to work. There’s no room for wishful thinking.
Third mistake I see often is individual bias towards fields that they come from. Someone who has an RNA background will only try to use RNA to solve everything, likewise with antibodies, or imaging, etc. The current research funding system incentivizes such thinking and it becomes entrenched in anyone already in this field. There’s never a thought of “which is the exact technology and approach I should use to solve this problem independent of what I’m an expert at?” So a lot of projects are doomed from the start.
As long as you’re cognizant of these three facts, I think it’s very possible to disrupt this field.
Bat "normal" might be. Of course, now we are crossing the threshold from medicine to bio-augmentation.
There won't be any magic for cancer. It's just going to be slow grind to solve one hard problem after another.
Also, you seem to be very pessimistic. Many interventions in the history of medicine, like washing hands or the first vaccine against smallpox, were almost "magical" in their efficiency: they addressed a lot of problems through a relatively trivial intervention.
It is likely that a lot of this low-hanging fruit has been picked up, but you insinuate that there isn't any low-hanging fruit to begin with, only an endless slog of attacking hard problems. That is way too negative.
One of the things you've missed is the strong restrictions put on pharma in terms of promoting use of existing drugs beyond the existing approval ( which makes sense ), and the almost complete freedom Doctors have to do what they want - they can just decide to prescribe something off-label if they think it might help.
It can take a very long time for new ideas to become new products - and a lot of that is inertia ( nobody else is doing it ).
Clinical trials are long and expensive, the medical advisory board wants compensation as well. But even startups can theoretically fund new therapies if they and their medial advisory boards get subsidies. It is a lot of risk though because for most drugs or medical devices, the real effectiveness can only be determined later in the trial itself.
For example, memantine has been tested 5 times in ALS. There even no pre-clinical studies that show any positive effect of memantine in animal models. This seems so bizarre to me.
* As for cancer, there are several (many?) ALS variants. The first gene to be associated with ALS was SOD1 G93A allele in 1993. It stayed the only ALS gene known until 2006. That was a curse for research as ALS with SOD1 origin is less than 2% of total cases, and even for SOD1 there are dozens of mutations associated with ALS, some with 6 months of life expectancy, others with 20 years.
* Most commercial animal models are SOD1 G93A mice [0]. The G93A mutation represents roughly only 0.4-1.4% of all ALS cases worldwide, yet it is the most used animal model!
SOD1 G93A ALS models are also the less costly animal models.
* I think another important thing is that ALS starts often in hands (split hand phenomena) and targets skeletal muscles. But humans' nervous system for hands is very special, only shared with other upper primates. Other mammals like mice have an interneuron between the upper and lower motor neuron for hands. We do not, there is a direct connection between upper and lower motor neurons, reflecting the importance of manipulation for humans. Therefore for me, we can't prove with mice at pre-clinical stage, that a drug is efficacious or not (many drugs have some efficacy in animal models, but none in humans).
* Some publications pretend they can use individual cells, fishes, or nematodes as animal models. That's laughable, it's ignoring the importance of anatomy and physiology. We are complex animals, our hormones, our immune system, and our metabolism are important to understanding ALS. The proof of that is that ALS patients who have the best life expectancy have a BMI of 27.
* Other publications pretend to make their own animal models with some chemical, like BMAA, a neurotoxin found in certain cyanobacteria. Those publications smell bad behavior for me.
If you want to buy a mice model of ALS:
[0] https://www.jax.org/jax-mice-and-services/preclinical-resear...
Biology is extremely complex. There's no substitute for actually trying things out on subjects in vivo. For many diseases we don't even know the cause (Alzheimer's for example). Drug companies have all the incentive in the world to improve the system to get better odds; it's not like they want drug discovery to be such a crapshoot.
One of the books of the "Colossus" trilogy (about a computer that takes over the world) had the computer doing this sort of medical experimentation on randomly selected drafted subjects, with the idea of maximizing overall utility. It shows the problem with utility maximization as a goal, similar to the requirement that people give up a healthy kidney if someone else needs a transplant.
And “biology is complex” is the type of truism I hinted at. You can always say that whenever you fail. Biology is complex and Alzheimer’s is the most complex of them all, to be sure, but I hope you’re aware of the. Alzheimer’s cabal allegations that the entire field was mutilated by a bunch of people into believing and pursuing the wrong hypotheses for decades.
And if you pick a single successful example that was discovered in academia, was spun out into a small focussed biotech, and was in a disease area that didn’t require large or multiple studies to make it to market, you’ll have your anecdote to prove your point.
Except… you’d be ignoring the costs of the 90% of drugs that fail in phase 1. You’d be ignoring the huge amount spent on discovery across the industry that never leads to a successful candidate.
Drug discovery and development is difficult because, for all of our clever science, it’s still essentially serendipitous and random. And we’ve not yet figured out how to make a production line out of something that’s random, try as we might. And it’s expensive because of the failures as well as the cost associated with success.
I wonder if the "optimal" theory is portfolio in this case, or if there is a new generation of VC/pharma investors who want a higher probability at a lower return.
> you’d be ignoring the costs of the 90% of drugs that fail in phase 1
It depends on what you call "bringing a drug to market".
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* Phase I costs little, around $1M during the trial, and involves only a small group of participants (one or two dozen people), so it's not multi-center and it is manageable by a few people at a biotech. The problem is that most phase I trials fail, but this is not an issue of cost, it's an issue of the way it is decided as explained by ramraj07, another commenter.
Too often it is started on a hunch without solid pre-clinical data, sometimes it is because the drug was tested and failed in another disease and the managers "pivoted" to a new disease because then it costs little to try again, sometimes it's just a "weird IP/financial trick" where you combine an existing drug and an unrelated drug. Then you know you have a relatively efficacious drug, no need for toxicity studies and you can patent it.
On the contrary, many trials could be done on drugs with good pre-clinical data, but that does not happen because it would be hard to patent.
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* A phase III costs around $25M for one or two hundred participants during the trial [0]. It lasts 6 months at most.
Some publications cite much higher numbers (~$1G), but this does not make sense as drugs are often developed by biotechs (startups, in other words) with only a few million in their pockets.
Another cost inflationary cause is subcontracting to CROs, as most biotechs do not have the manpower, knowledge and business connections to conduct the trial.
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* Once a drug receives commercialization authorization, a major company usually buys the rights and then starts the marketing phase. This starts with teaching doctors on how to prescribe and administer the drug. It means publishing articles in the mainstream medical press, inviting doctors to conferences and workshops, and paying medical sales representatives.
It is costly, this is probably where are spend the ~$500M but for me, this is not drug development costs, it's just marketing costs.
[0] http://idei.fr/sites/default/files/medias/doc/conf/pha/conf_...
Phase I: a small biotech I know of in oncology has phase I costs in the order of $500,000 per patient; this is a higher-end cost, due to their sites being in the US (more expensive than Europe) and because as a small biotech they're had to outsource virtually every aspect of running the trial. In big pharma, per-patient costs were more like $70-100k per patient, but this was just the pure money paid patient (to the site, and external costs like drug supply and shipping) and ignored the cost of laboratory, clinical, operations, and data management work that was being done in house. All told, it would typically be hard to get even a phase I study completed for less than 10x your estimate, and this is before you consider any additional recruitment needed between dose escalation and phase III.
Phase III: again it depends on many factors, but in big pharma a trial cost of $100-200k per patient was again not unreasonable, and typical phase III trials where you're comparing to a meaningful established medicine are larger than 100-200 patients. A biotech I know of is unable to run a phase III for a promising drug without finding a partner to support the majority of the cost (which is >100m EUR in oncology) and they're not wasting money.
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A less anecdotal approach is to consider the total R&D costs of companies across a given timescale, and divide by the number of successes. It's a pretty old reference too, but Matthew Herper did this in 2013. [0] Yes, there were some outliers with low costs, but you'd have to understand the details for context. The typical costs were in the hunderes of millions to billions per successful drug.
[0] https://www.forbes.com/sites/matthewherper/2013/08/11/the-co...
Yet you seem to have assumed I’m oblivious to the reality when I’ve already pressed I’ve been in the deep end and am aware.
I’ve already given an explanation on why I don’t agree with “its still serendipitous and random” - the people working on it are not smart enough and are more interested in stoking egos and careers than doing real science, even if they’re capable of doing so.
“90% of the drugs fail in phase I” - why are you telling me that when I’ve already given an explanation on why that is so - we don’t have good preclinical models that correlate with drug effectiveness - is it that you didn’t understand what I wrote, or are also neck deep in this cultural quagmire you refuse to acknowledge it?
Maybe the one area we would significantly disagree is that I don't think it's simply that "the people working on it are not smart enough and are more interested in stoking egos and careers than doing real science".
Honestly, I've had discussions with so many mid-level smart trusted colleagues who always think that the higher-ups are making stupid decisions, and they'd do better. They're right that some of the decisions might be stupid (and you're probably right about "stoking egos and careers") some of the time, but people are promoted, decision-makers come and go, and the decisions (and failure rates) don't really improve. I (think I) see it for what it is, and agree that we lack meaningfully informative pre-clinical models, but I'm also comfortable to acknowledge the weaknesses of the system and be honest that I don't have all of the answers. At the moment, it's a heinously inefficient crap-shoot, but it's the best we've so far come up with.
But, prove me wrong. There are likely countless molecules that have been discarded that have therapeutic benefit waiting to be realised. (I don't mean to sound facetious here but) If you can do better, and are smarter than and will make better decisions than everyone else in the industry, you'll be a billionaire in short order, as this is literally the golden ticket in this industry that everyone else is missing.
I have done my PhD, I need to take a break to actually take care of my family and immigration. I hope to get back to this field at some point, in my own terms, and see if I can succeed. If it works, it works! If not Who cares right! Let's see.
That being said, we're talking about human lives either way so it needs to be thought through and avoid unintended disasters through lack of care.
I work in this field. Doing phase 3 clinical trials costs between $5,000 to $20,000 per patient per year.
This particular drug did a phase 3 with 423 patients for 2 years, so you're looking at a cost of $4M to $16M just for this one trial alone. Then add on top all the CMC (manufacturing) research that needs to happen, the regulatory filing work, etc, etc.
Unless someone has a few hundreds of millions sitting around, you aren't bringing a novel drug to market without external funding.
Drug production is very different from the typical work done in a hospital pharmacy.
https://www.avl.nl/en/preparing-for-your-appointment/departm...
https://www.avl.nl/en/preparing-for-your-appointment/departm...
https://www.nki.nl/research/facilities-platforms/bioanalytic...
They aren't manufacturing any medicines in those pharmacies. They are buying final product and then preparing it for administration.
GLP and GMP certified don't mean they are manufacturing. GLP are lab best practices and GMP is manufacturing, but it covers a lot of ground, so a basic pharmacy can be GMP and all they do is prepare sterile product.
Similarly, in drug development, we’ve long had access to extensive pre-clinical data and measurement tools. However, without predictive models to interpret this data, we will continue to struggle to forecast a drug’s safety and effectiveness in humans.
Interesting coincidence that for the last several decades, the rate of success of a drug advancing from a phase 1 clinical trial to approval is about 10%, which was just about how good we were at forecasting tomorrow’s weather between 1900-1950.
https://www-ftm-nl.translate.goog/artikelen/ruzie-tussen-zie...
This is a massive understatement of the regulatory hurdles at play. I have worked on dossiers that took 200 man-years at 400k per person. This is the development part of pharma R&D. The dossier might be a thousand pages submitted, but that can easily be 100,000+ pages on the backend.
There's a reason that even billion dollar companies crumble and fail under the documentation complexity.
[1]: https://www.usatoday.com/story/news/world/2018/01/09/cuba-ha...
Not 100% sure, because I've only heard about vaccines in preventative contexts before, but based on this description my guess would be that "anything that tells your immune system to Do Stuff" counts as a vaccine. Versus something like Herceptin, which also treats cancer, just with ready-made antibodies that were grown in a lab.
English is not my native tongue so I have some problem to parse your sentence. I prefer the writing in the publication cited above [0] even if it's probably the same meaning:
"CIMAvax-EGF is a therapeutic cancer vaccine composed of human recombinant EGF"
[0] https://aacrjournals.org/clincancerres/article/22/15/3782/79...
Here's the sentence restructured:
... vaccine refers to anything that induces an immune response against a pathogen or disease. Here is how that definition applies in this case: the vaccine causes the immune system to produce anti-EGFR antibodies.
They hire their own chemists, and make their own drugs. This is not complicated.
https://www.cancer.gov/research/key-initiatives/ras/news-eve...
From what I can tell there are several things like this - that have promising anti cancer effects, that just don't really get that much attention because there's not a patent possible.
Really makes me think much less of medical science. Even if you couldn't patent any thing you'd think you could get fame and fortune by devising a useful therapy.
Also IIRC the rewards are oversized compared to the costs, but that doesn't change that the costs are also huge. Does mean I'm generally in favour of getting every government to quadruple public spending on this though. Whatever the current spend is, we can do more.
If it has benefits then more doctors will start to do it and more data will become available. If not, onto the next thing.
Just looking at a few things there I'm guessing that's a few million dollars at the very least.. and even so you have to look at opportunity cost. Is this the best and most promising path of research for the physicians and researchers? Are there more promising compounds? Etc.
Rarely are these things straightforward and clear cut.
That being said, I recently broke my ankle, and found that the protocols still often include 6 weeks off it, despite modern evidence largely showing zero downsides (and some benefits, especially in terms of early recovery) to weight bearing immediately - Probably costing possibly billions of dollars in lost productivity and unnecessary PT every year.
I probably shouldn't get too high on my horse about random unexplored therapies - plenty of things in medicine that are just done some way because that's how it's always been done.
>> that have promising anti cancer effects
I don't know why people gravitate towards the "simple" remedies for cancer, or pose that money making is a barrier for these remedies. Remember, research costs money! DO the funding yourself if you think there's a miracle cure here. (hint: there's not.)
Sigh. Vitamin C quackery again.
Vitamin C at high doses is cytotoxic, so it works against rapidly dividing cells. Cancer cells also preferentially concentrate vitamin C because they are under oxidative stress.
However, just like with most of other generally cytotoxic treatments, cancer cells quickly evolve resistance to it. And the overall toxicity of vitamin C makes it uninteresting as a treatment.
In the articles linked in this thread, large-dose vitamin C prolonged survival, but didn't clear the cancer. It's exactly what you'd expect from a chemo treatment.
https://www.cancer.gov/news-events/cancer-currents-blog/2015...
- Doctors want the best outcomes for their patients. They’ll use whatever treatment is most effective
- Doctors want the best outcomes for themselves. If they’ve found an effective treatment that others are overlooking then they’ll seek to publish
- Patients want the best outcomes for themselves. If there is an overlooked treatment then they’ll communicate it to their doctor
it’s unlikely for an effective treatment to exist and be ignored by the medical community for decades just because something can’t be patented
However often the work required to prove something is effective is beyond a capacity of a single Doctor. Also in terms of wanting the best outcome for themselves - sometimes that involves not putting their career at risk by trying unproven treatments on patients ( you are focussing on the outcome when it works, not the more likely outcome and consequence of it not working ).
So sure 'miracle' cures are unlikely to lay undiscovered - but most improvements in medicine are incremental, rather than miraculous.
I can't stop you from refusing to read sources - but you should know that you're totally wrong here. I can, and have in this thread, cited multiple high quality sources.
ie how can you have sometime which is both obviously beneficial - backed up by dozens of studies and yet complain about lack of research - if it's so clear then why do we need more research?
I also suspect doctors don't require FDA etc approval if they wanted to prescribe vitamen C - so what's stopping them? Lack of research? But I thought you knew?
Having said all that it is beyond all doubt true that commercial organisations can't afford to spend money on researching drugs with no prospect of return - however I wouldn't characterise that as evil big pharma blocking something - it's simply just that's it's not their role.
That role belongs to organisations either funded directly by the public ( charities ) or indirectly ( taxes ) for the greater good.
Hah sure.
Try this and tell me how the egomanical "gods in white" react.
Go through some stuff the RFK says about vaccines etc... and you'll see that in real life it's the opposite.
Also see my post on the same thread: https://news.ycombinator.com/item?id=42266462
They will often do what make them the most money. Also remember that is doctor is subject to rules and regulations. He risks loosing his license if he does not toe the line. Your average medical student is about half a million dollars in debt when he/she graduates.
> - Doctors want the best outcomes for themselves. If they’ve found an effective treatment that others are overlooking then they’ll seek to publish.
Doctors do want the best outcomes for themselves, but if you manged to become a doctor, it means that you have never learned to question authority. Many doctors believe that what they are taught is Gospel. A doctor or a medical student who questions authority, will either not make it through medical college, or will have a license revoked.
>- Patients want the best outcomes for themselves. If there is an overlooked treatment then they’ll communicate it to their doctor.
A patient is generally ridiculed, or ignored by the doctor if he suggests something that he thinks is better.
It goes without saying that there are exceptions both among doctors and patients.
I am baffled by your second paragraph. It is just plainly illogical.
The third paragraph tells me that you ARE possibly from outside the USA, or that you have only seen a few doctors and they were proud or rude. We (personally) have seen private doctors, hospital doctors, country doctors, etc. over 50 years (at least 50-60 different ones). And the preponderance of our evidence shows you are either misinformed, or you are a patient who wants to self prescribe treatments that are medically unsound or 'fringe'. And, yes, those WILL be ignored by any average doctor. But then you could always fly to Mexico and get those useless treatments for low cost...
Some of what you point out is correct: Most doctors are on salary, but they are often (implicitly) required to bring in more business by the organization they work for. If they don't, they risk loosing their license/job on some pretext. In totality what I said overall hold true. These are statements from the renegade doctors themselves. Of course you are going to dismiss them as fringe, quacks etc.
Labeling someone is a fringe and easy way to dismiss them, it does not involve any work. What time have you spend listening to these fringe MDs? What time have you spent examining their patient outcomes/reports? Any yes, it goes without saying one has to be discerning even among the fringe MDs.
It seems that once you exceed a certain level the body just dumps it, making megadoses unviable.
Linus Pauling (of the Nobel Laureate fame) working along with some physicians did do 'rigorous' research on it, and I think had published a book on it. You should be able to check the Linus Pauling Institute and find literature on it. I probably did it over a decade back. Predictably he was ridiculed (IMO wrongfully) for it by people who did a very shoddy job of looking into the nuances.
The last I checked in the US the Riordan clinic offers Vit C for Cancer. There are probably several other practitioners who will not publicize that they treat patients for cancer (and several other chronic conditions) for obvious reasons.
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shepherdjerred writes that this is unlikely because doctors want what is best for their patients and would notice a cure were it available.
This is kind of true. Some doctors do know about and prescribe vitamin c with typical therapy. Here is an umbrella review of hundreds of such cases documenting positive results from using vitamin C.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8812486/
The issue is not whether doctors will prescribe it - I expect anyone could ask their doctor for it. Vitamin C is safe, well tolerated, and shown to mitigate symptoms of chemotherapy. Doctors can and do prescribe it.
The issue is why an apparently promising therapy isn't getting better testing to establish whether or not it is effective despite it being known for decades.
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adamredwoods writes that while his wife was still alive people in her group tried it.
I'd love to know more - especially type of cancer and whether the vitamin c was administered orally (no effect expected) or by IV (depending on type of cancer possible effect expected) and at what dosage.
Here's a randomized controlled trial showing substantial benefits of high dose IV vitamin C for patients with advanced pancreatic cancer - they live longer, the cancer progresses slower, and their quality of life is generally better.
https://pubmed.ncbi.nlm.nih.gov/39369582/
Adam goes on to suggest I should do the funding myself if I think there is a miracle cure here.
There are a couple ideas here. If I or a loved one ever develop cancer - then of course (depending on type of cancer) I would take high dose IV vitamin C, along with similar therapies that are well established as safe and potentially useful.
As far as "Doing the research myself" - honestly, I might. My path would be to construct a website compiling the research, explaining why people with cancer should try this, explaining how you can get your doctor to prescribe it to you (or, since you don't need a prescription to take vitamin c, how you can DIY), and have functionality to support people registering that they are a cancer patient who has decided to take vitamin c (or not) and give updates.
The hope with the website would be that it could compile enough raw data to become compelling to medical professionals.
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Panzer04 asks "if the therapy works if it's as trivial and simple as you say" - why isn't it being done?
Vitamin C is sometimes used. That's why we have hundreds of case studies and, in some cases, randomized controlled trials and other experiments documenting its use and efficacy.
My comments here aren't based on what I say or think - my original source was an article explaining the research on cancer.gov. Vitamin C (again: high dose and IV administered) is known to have potential benefits for cancer patients.
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cyberax says "Sigh. Vitamin C quackery again" and then offers a partial explanation of the mechanism for how vitamin C causes cell death in cancer cells - which is better explained in the link I originally provided.
cyberax then claims, without evidence, that cancer cells quickly evolve resistance to it. I don't believe there is any such evidence, having read several papers on this and never seeing it mentioned - nor, by my understanding, is it plausible that cancer cells could fundamentally change how they work to get immunity to this. Perhaps I'm wrong though and cyberax could supply some evidence.
I notice in the replies to cyberax pfdietz says "There is evidence that high doses of antioxidants can make cancer worse" - and then links 2 papers exploring the use of vitamin E as a cancer treatment. Vitamin E, despite sharing quite a few letters with Vitamin C, is a different thing.
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dennis_jeeves2 writes that "Linus Pauling (of the Nobel Laureate fame) working along with some physicians did do 'rigorous' research on it".
This is not correct and explained in the first few paragraphs of my original link. Linus Pauling used orally administered vitamin C which results in weaker blood concentrations and therefore less impact on cancer. The modern method uses IV administered high dose Vitamin C (which I was careful to write in my comment).
While Pauling's method shows little effect in randomized controlled trials, high dose IV Vitamin C does show benefits.
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insane_dreamer writes that "Medical trials to prove its safety in human subjects -- pretty essential -- is a lengthy, multi-stage process that is extremely expensive to carry out."
Pretty meaningless comment. The safety of vitamin C is already well established.
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pjc50 also cites Linus Pauling - which, again, is explained in the first couple paragraphs of the link I originally posted. High dose orally administered vitamin C doesn't work - there are limits on how much you can increase blood concentration through oral administration, so most of the high dose is lost.
That's why, as explained in my original comment/link, the modern protocol uses IV administered vitamin C.
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alphan0n quotes an XKCD strip saying "Bullets can induce cell death in a wide variety of cancers as well."
A bad comment because the tests I've been linked to have been in vivo, and my original link explains why this kills cancer cells and not healthy cells.
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That's my review of the comments. I would characterize them as exceptionally uninformed - which is odd. Why would people feel the need to comment on a subject they don't know about and simultaneously refuse to read the outline I originally linked which answers all the questions and criticisms posted here?
People writing completely half-baked, often deeply ignorant opinions on complex, nuanced subjects out of mostly emotional disdain, but phrasing their responses in such a way as to easily fool someone who doesn't know said subject well that they at all know what they're talking about and are thus arguing rationally.
You may be interested in the VITALITY study out of China from 2022. 400+ people given FOLFOX + Avastin (standard of care, first line for colorectal cancer) vs FOLFOX + Avastin + high dose Vit C.
https://pubmed.ncbi.nlm.nih.gov/35929990/
Roughly showed no change for the overall population, but a significant increase in progression free survival for folks with RAS mutations.
As someone with a stage 4 colorectal cancer with a RAS mutation, this is interesting to me!
Sorry about your diagnosis.
Thanks for sharing. This is an interesting, though somewhat disappointing, paper.
One thing I didn't get while reading it was the specific blood concentration achieved. I noticed they mentioned 12 rounds with 3 infusion days and 1.5g/kg. I'm assuming they injected that amount daily.
I noticed they injected over a period of 3 hours. To my knowledge the half life of vitamin c in blood is only 2 hours. I wonder if the concentration of vitamin c ever got sufficiently high to induce apoptosis.
At IV clinics near me they offer 75g bags of vitamin c on the website that are administered over an hour. I bet you could go back to back and get a higher concentration. In the same trip I wonder if you could get something fun - an IV clinic near me offers a nootropic, methylene blue, might charge you up for a day of studying cancer treatments.
One final idea I've had, not sure how useful it is to you, is that you can an at home ultrasound for a few thousand dollars. You should be able to use it to see your intestines and the tumors growing inside. You could use this to monitor your own treatment - i.e. take daily pictures and examine before and after vitamin c therapy, to see if it does anything.
Best of luck to you. If you want to bounce ideas for DIY cancer treatments off of anyone let me know and we can exchange emails.