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Notes -
Cancer immunotherapy is great, but it's not going to move the needle on deaths from cancer. You get maybe 30-40% cure rates in advanced melanoma (very difficult to give you exact numbers based on how you slice up your patient population), much lower cure rate in lung cancer and a statistically significant but depressingly small boost in survival for a bunch of other cancers. Typically those with high TMB. Then you have CARs which work wonders for two leukemias, but haven't been made to work in any meaningful way for solid tumors.
if you want to actually move the needle on cancer deaths, you need something with meaningful cure rates for lung cancer (vast majority is NSCLC), pancreatic cancer, prostate/breast cancer and colorectal cancer. Melanoma and ALL/multiple myeloma (leukemias that respond to CARs) don't even make the list.
AI has been great for lit review and protein design but otherwise hasn't really impact bio research yet. Even if they build autonomous agents that can run experiments, I fear they'll be trained on the same dogshit qualitative cartoon literature and it will be largely impossible for them to make the kind of progress singularitarians imagine.
Very bearish, for reasons I've outlined before and don't really have time to get into now. If you want the redux:
Look at Calico. Launched in 2013, raised 2.5 billion, and here's their pipeline. If you aren't used to looking at drug pipelines, theirs is pathetic for the age and funding of the company and...nothing is related to aging?
Aubrey de Grey is a hack. The internal research program at his institute was absolute garbage, and whenever he claimed credit for a significant paper it was because they gave grants to some traditional academic labs.
The vast majority of the drugs right now are small molecules or biologics (mostly antibodies) inhibiting single genes. Maybe you'll find something that can modestly extend lifespan, but aging is complex and poorly understood so the odds of something significant coming out of this approach is unlikely. But it will nevertheless be where most of the money goes.
Books like this seem more promising to me, but have plenty of problems of their own to overcome.
I handle a lot of cases involving mesothelioma due to asbestos exposure and, though this is completely anecdotal, immunotherapy seems to be working wonders on that front. It seems like a few years ago meso was a death sentence, and now there are people who, while not exactly cured, seem to be living with it for years. One case involved a 60 year old woman who had a resection and subsequent immunotherapy after being symptomatic for over a year before doctors even figured out the correct diagnosis, and she was judged to be completely cancer free, which is something I thought impossible. There are of course plenty of people who respond poorly to it, but these are usually people in their 80s who were probably close to death anyway. Some of these cases are surprisingly sad, though, beyond the fact that any cancer case is sad. One that I'm working on now involved an 87 year old man who was walking miles every day over challenging terrain without any problem and slipped on ice when out on one of his walks. He hurt his ribs and went to the hospital for a CT scan, which uncovered pleural effusions and was suspicious for meso, which a biopsy confirmed. I honestly wonder for a guy his age who wasn't having any problems if the treatment is worse than just living with the disease until he needs palliative care, considering that he was otherwise active but was wiped out by the cancer treatments.
I don't know mesothelioma because it's relatively rare, and I don't see patients - just lines on a graph. That being said, it seems like a pretty similar story with 2 year survival rates of 41% versus 27%. Don't get me wrong, if I get cancer I'll take the pembro, but we're laughably far from curing cancer or LEV.
If you get diagnosed with a solid tumor (i.e. not a leukemia), basically you're either lucky and we caught it early enough to remove it entirely by surgery or you're going to die from it with vanishingly rare exceptions.
I imagine that's bad for your bottom line. Or she lived long enough for you to collect?
Yeah. That's the choice to be made. Hopefully he was of sound mind and deciding for himself.
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