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Comment by ekianjo | Hacker News Reader

> But these OVs are one-time deals. So a single dose treatment is a very interesting alternative. The only problem is, MM is extremely resilient, and the cells are everywhere. It's so hard to eradicate, unless the OV is a cure, it's just another tool in the box to manage MM and extend lives.

Yes, the key point to watch next is to see if the MM does not come back after a couple of years.

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One thing I don't understand is this attitude of "well we can't detect it, so job is done". I don't know the specifics of detectability, but presumably it means that n<N for some N. So there could still be some cells left. Why not throw every weapon in the arsenal at them, to ensure the cancer is completely gone?

EDIT, addendum: If you have a few treatments that each can kill 9999/10000 cancer cells. It seems the current approach is apply treatment a. Not detectable yay! They grow back to original numbers. Apply treatment b! etc. If you did them all at once, they wouldn't have time to grow back in-between treatments giving a larger chance you get them all.

Because some weapons in the arsenal will be killing the patient as well as killing any possible cancer cells.

At some point the risks of the treatments outweigh the risks of leaving some cells.

This is correct. As a matter of fact, even dosing one chemotherapy may be a challenge for a patient if the side effects are too server (lowered immune resistance, can't keep food down, etc). We're talking about drugs with such small therapeutic windows that given too often can easily kill a healthy human.

That isn't the current approach. For instance:

http://www.cancer.org/cancer/breastcancer/detailedguide/brea...

That's general audience information that discusses treatments before and after surgery that are intended to work along with the surgery. If you click through to the various therapies, there is lots of discussion of combining them.

That is very interesting, sorry for spreading misinformation.

Great question. I've wondered the same thing for bacterial infections. Wouldn't it lower the risk of resistant bacteria developing to always use two different types of anti-biotics, so in case a few bacteria develop a resistance to one, they're still killed by the other.

This is much easier for bacterial infections vs cancer -- chemotherapy is (excuse the non-medical phrase) very close to actual poison. Antibiotics are very well-tolerated, so taking two at once is something that could be done and is indeed deployed in serious infections or when there is high risk of one.

This - nearly all antibiotics target parts of the bacterial cell that humans don't have. Antifungals have the problem that many of their targets are shared between eukaryotic fungal cells and our own. Chemotherapy agents have a huge problem in that they are targeting cells that used to be our own. It's a race between toxic to cancer cells and toxic to the rest of you.

For some bacterial infections where resistance is a concern, such as TB, this is already the routine standard. See also anti-HIV medication cocktails.

Patient 1 did have a recurrence of a single tumor that was resolved with site specific treatment, though her marrow remained clear. I didn't see/hear anything about recurrence in patient 2.

Source: video/source article at http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

Edit: Accompanying editorial to go along with the paper and video: http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

The virus is gone from her system. The MM is not at undetectable levels. So unfortunately, this OV is not a cure. This particular patient, her MM cells aren't surging just yet.

I think the curative approach will ultimately come from immunotherapy, training the body to attack the cells. OV could certainly have it's place, for example as an alternative to ASCT.

>I think the curative approach will ultimately come from immunotherapy, training the body to attack the cells.

As i know, just killing the cancer cells is not enough. The real curative treatment is to kill cancer stem cells using drugs.

http://www.survivingmesothelioma.com/news/view.asp?ID=001532

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