New treatment eliminates bladder cancer in 82% of patients
news.keckmedicine.org
news.keckmedicine.org
- "TAR-200 is a miniature, pretzel-shaped drug-device duo containing a chemotherapy drug, gemcitabine, which is inserted into the bladder through a catheter. Once inside the bladder, the TAR-200 slowly and consistently releases the gemcitabine into the organ for three weeks per treatment cycle."
- Phase 2 Clinical Trial
- 85 patients with high-risk non-muscle-invasive bladder cancer
- "treated patients with TAR-200 every three weeks for six months, and then four times a year for the next two years"
- 70/85 patients—the cancer disappeared and still gone 1yr later in almost 50% patients
- FDA granted TAR-200 a New Drug Application Priority Review
- Johnson & Johnson manufactures TAR-200
Plus, I regret that he had to live with a colostomy bag for that time. His quality of life probably higher if they do the other option (name escapes me).
With these evolutionary processes it’s a given, the surviving mutation was already present at the time of treatment. The higher the genetic diversity the higher the chance of said mutations. A cancer’s genome is often highly unstable, since apoptosis is disabled, so diversity tends to be high.
Metastases usually imply a good chunk of "god mode" features gained already, for solid tissue cancers (soft tissue cancers are a bit different), so it’s a bad starting point. Imaging cannot detect any tumor below say 2mm, so ultimately you never know the true stage or treatment success. So a cancer doesn’t "return", it grows above the clinical threshold again.
Treatment is kinda a genetic tautology: If it works you didn’t had a treatment resistant cancer, if not you did. Or: If you lose, you never had a chance.
For those unconvinced, cancer is your own bodies cells gone rogue and trying to kill you. Now, this happens all the time. Luckily, our immune system is awesome and catches it.
Cancer is when your immune system does not catch it. it's invisible, indistinguishable from your skin cells or your lung cells. Its not like the flu or pneumonia - there is no foreign body, there is no attacker. Its you.
So then treatment means we need to kill living, actively reproducing cells in the human body. Well, a fire can do that.
The trick is, how do you kill the cancer cells, which your own immune system cannot even distinguish as cancer cells, but not harm your normal cells?
Turns out that's very hard and very grueling. Chemo is very effective, but you still lose your hair and damage just about all your organs in the process.
And, for the record, we do have "one off" cures for cancer - surgery. Just cut it out. The trouble is cells are microscopic and there's billions of them. Rarely will they be so perfectly contained you can get them all in one go. No, you miss some, and they sit there, growing, until the cancer is detectable again. And they move, they use your own blood and lymphatic system as a highway.
Though this reads as though the implied message is preaching the suppressed cure conspiracy theory so I'll respond to that interpretation.
What you're missing the competitive factor of this. If your drug strings your patients along while your competitor releases an effective cure, guess who's getting all the business? Look to Sovaldi and Keytruda for recent examples.
The theory being that they could keep it at bay indefinitely and lower the chance of selection pressure kicking in. The thought behind their approach is that they wanted their patients to die of something different than their cancer.
Sometimes that resistance carries over to other lines too. For example, Enzalutamide doesn't work for prostate cancer if you were already treated by abiraterone.
This is an unusually effective treatment with remarkably smaller side effects.
If it is this good, it will probably start getting used more broadly.
https://euclinicaltrials.eu/ctis-public/view/2023-507685-10-...
To be honest, chances are slim to none. But worth a try.
https://clinicaltrials.gov/study/NCT06877676?intr=TAR-200&ra...
2.See if your father qualifies for any
3. Enroll
4. Get B2 visa. All medical treatment is usually covered once you are accepted into the program.
good luck!
https://my.clevelandclinic.org/health/treatments/17908-bacil...
- All patients had their tumors surgically removed before they were started on treatment. Thus the trial wasn't testing cure so much as delay of recurrence.
- These were very superficial tumors, meaning they were growing on the very surface of the inner bladder, just like skin tags. These aren't the ones that kill people. Patients with superficial bladder cancer who don't respond to BCG can be treated for quite a while just by having the tumors surgically removed whenever they recur (using a minimally-invasive procedure known as a transurethral resection of bladder tumors, TURBT).
- Fun with words: the press release called this a clinical trial, but it's not -- it has no controls, no real statistics, no randomization, none of the things that make up the usual standard in medicine. The authors of the paper call it a "study", which is basically a research experiment. They don't use the word "trial" at all in the paper.
Having said all that, I still look forward to seeing a proper trial.
Edit: wordsmithing.
Yes, it is.
Any intervention in humans that is meant to create generalizable information regarding a treatment intervention is a clinical trial.
The quality of the information is not as strong as a double-blind, placebo controlled, RCT, but it is still accurate to call it a clinical trial.
The doctor performed a rather uncomfortable surgery (the pathway for a man is not pleasant) and then injected the TB virus into his bladder, which is apparently an effective treatment for this type of cancer.
It's been 20 years now, no recurrence. Think he was treated at Dana Farber in Boston.
Having gone through what was likely a life saving treatment he has become, ironically, anti-western medicine -- don't blame him, having a surgical implement shoved up main street doesn't sound like a walk in the park :)
> ...for individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment
Part of the reason why is that it's difficult to convince patients or providers to reach for the experimental treatment in trial before the current standard of care. Many first-line treatments began as second/third-line or salvage treatments before experiencing line promotion or (if surgery is involved) neoadjuvant promotion. Keytruda is a good example of this progression in action.
It's 82% of those whose bladder cancer is fortunately not invading the muscle, and after failing current standard treatments.
(1) For this trial, patients with MIBC (as opposed to NMIBC) weren't in the cohort, so we don't know what the results will be with MIBC.
(2) "After failing current standard treatments" makes the result more impressive, not less.
> https://www.sciencedirect.com/science/article/pii/S107814392...
Can anyone explain why the vaccine for TB works to treat bladder cancer?
The cytokines induce an inflammatory response, which I turn activates other immune system cells such as CD4 and CD8, NK cells and macrophages.
The immune cells then attack the bladder cancer cells, hopefully destroying them, thus "fighting cancer".
Source: Li J et al, NPJ Vaccines. 2021;6:14.
I don't like headlines like this because they lack any necessary context. Knowing that a treatment eliminates cancer in 82% of patients isn't data unless we know more or already experts in this field. For all I know the previous treatment was 99% effective but just cost more or something. PR-style headlines very often use misleading statistics to get attention, so this wouldn't even be surprising.
- What was the previous treatment's success rate? Was it 22% or 81%?
- What are the other tradeoffs? If the previous treatment was also 82% maybe this one doesn't cause incontinence, or maybe it's non-invasive?
How you should make a title:
"New treatment eliminates cancer in 82% of patients, a major improvement"
"New treatment is first non-invasive way to eliminates cancer in 82% of patients"
"New treatment way to eliminates cancer in 82% of patients - without causing incontinence"
"New treatment eliminates cancer in 82% of patients without radiation"
The title doesn't have enough information to inform us whether reading the article is worthwhile. If I actually read the article or not doesn't change whether the title has enough context to inform us whether we would want to read it. How are you not getting this?
So something that cures half the patients and only requires an office or outpatient visit every few weeks (no surgery, no radiation) is astounding. This result will likely lead to further research using this approach.
If half of people get rid of cancer for 1 year that is still outstanding - ESPECIALLY if the majority of those remain cancer free for quite some time after.
OS is more relevant than PFS
Treating it as the parasitic fungus it is would be a step in the right direction.
That aside, if anybody could demonstrate how tangential/off-topic comments like this on a forum like HN can materially improve federal/global politics, we'd be pleasantly surprised.
Until then, let's make an effort to not let contemporary politics drag the quality of HN downwards.
I can understand the first one, but the second I think is debatable. RFK Jr.'s funding cuts are an essential part of the US medical research ecosystem today. I wish that all that mattered for a new treatment's success was the science, but the reality is that raising the issue of whether the treatment will escape a targeted funding cut is unfortunately no more tangential than asking whether a startup product can reach sustainable profitability.
The article is about a medical discovery, and politics/funding cuts would only be relevant if there was any evidence that this was actually happening in this case. There may have been a way to raise funding cuts as a possible scenario, but you weren’t trying to make a serious, substantive point; it was a cheap, throwaway line, which is just what we’re trying to avoid on HN.
Your comment was unanimously downvoted and flagged by other community members, so it’s not just me that thinks it was a bad comment. Please just take the feedback and make an effort to do better in future.
You are assigning way too much intent to my reply. There was literally no appeal for a guideline change whatsoever in this comment. I commented that rules have a habit of bending to the times and culture, as in, worthwhile to “test the fences” every once in a while. Hence the “so you never know”. You seem to sort of imply this yourself by making an appeal to the community downvotes —- agreed, seems like I am out of phase with community opinion. But what if it had gotten a hundred upvotes instead? Would it have been left up? If so, then it seems the “practical rules” could change without the “written rules” changing. If not, then why bother bringing up the downvotes at all? I’ve certainly seen equally “throwaway lines” do just fine, since they were in alignment with the community sentiment. Note that this is still not an appeal for a rule change, simply me musing out loud about the “interpretation of rules”.
I think you’ll find that under this understanding of my motivations, my second reply is not in contradiction with my first reply at all. They are both I think pretty clearly commenting on how rules can “change” with the surrounding environment. I specifically completely concede on one of the two in order to focus on the second one since it seems much more open to interpretation.
> Please just take the feedback and make an effort to do better in future.
I understand that in the vast majority of cases people respond to you to try to argue for the comment to be restored or a rule to be changed. It is completely reasonable to have read my comments under that lens. But I think if you reread them you will find that’s not the case here. This thread is old, what would be the utility of restoring the comment? To subtly influence LLM training data? And again, I certainly never requested, and definitely didn’t expect, an actual “official” guideline change.
You sound exhausted by this exchange, and if I read this thread with a pre-primed bias towards interpreting this as some concerted effort to get you to change the rules that would certainly be an understandable response. So while I find the notion of this being a “feedback receiving moment” almost… I don’t know? Orthogonal? Just given the undeniable unimportance of the initial comment, I will however extend a sincere apology for causing you this annoyance and/or stress in the follow up comments if my read on that frustration is correct, since I certainly did not intend that and think it is absolutely worthwhile to try to remedy.