Will this targeted approach be beneficial to other cancer types? Is there any data or theory about this class of drugs as a more general therapy?
Here's a great blog post on this, "How to build a cancer vaccine, and whether they will work this time": https://www.owlposting.com/p/how-to-build-a-cancer-vaccine-a...
Here's the blog post I wrote on personalized mRNA vaccines: https://hedonicescalator.substack.com/p/did-paul-conyngham-r...
Moderna used a simple heuristic, "how likely is this antigen to show up on the cell surface?" which makes sense, since an antigen has to show up on the cell surface for the immune system to see it. But there's so much missing from this model, and we just don't have enough data. Failures in clinical trials of mRNA vaccines may well be caused by this problem. (Yes, this is a good problem for AI, if we can get enough data).
The problem now is finding the correct antigens targeting the cancer cell type. Cancer cells are similar to health cells. You don't want to program a mRNA to generate antigen proteins that target health cells, which causes autoimmune problems.
The comment is wrong because it's stupid. Just because we've known that personalized immunotherapy was a promising idea for a long time, and have been trying it with the limited tools we had (CAR T being the poster child, and while an incredible advancement for blood cancers and many other diseases, it is notoriously dangerous and expensive), does not mean we had the technology to accomplish it. Today's results are only possible because of recent advancements in multiple fields, and to respond with "they've tried immunotherapy for decades" is profoundly ignorant. You may as well say, "scientists have been trying to cure cancer for years."
My thoughts as well, Keytruda alone has been a miracle to many many people at this point (quoting GP: "scientists, for decades, have tired [sic] to harness the immune system to attack cancer and it almost never works."), I frequently get ads for local CAR-T centers (unthinkable a little over a decade ago)
"Almost never" is doing a lot of work. You may be aware that most drugs fail over the course of development and human trials?
Anyway, checkpoint inhibitor therapy is a massive boon to oncology and was only brought into widespread use over the past 15 years.
Those few exceptions have been monumental in how they've changed cancer treatment. Skin cancer has been particularly well treated with immunotherapy, but other cancers have also benefited from the exact same research and drugs (as it turns out, the specific mutations the immunotherapies like Keytruda target express in other cancers). The reason skin cancer gets so much attention is because it's one of the most commonly diagnosed and treated cancers. (Colon is more common, I believe, but it often doesn't get detected. Get your colonoscopies folks).
It has moved fast enough that I've heard from multiple oncologists that the all 5 year survivability numbers are dated because the treatments are newer than the studies.
We've come a LONG way in a very short period in terms of cancer treatment. It still sucks, but not as much as it once did.
For non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (such as pembrolizumab, nivolumab, or atezolizumab), median overall survival typically ranges from about 10 to 20 months in advanced stages as opposed to 10-12 months for standard chemotherapy treatments.
That's great news especially as they would likely be better tolerated. Bt let's please not call living a handful of months longer as a 'revolution'.
Having a plethora of drugs and treatments is vital because cancer is not "one thing". Each type of cancer will respond better to some treatments than others.