That said, I'll happily take "we discovered a key weakness in 20% of cancers," please and thank you.
One of the most commonly observed broken mechanisms is mutation in the gene KRAS that turns this on/off growth switch into the permanently on position.
This has been known for decades, of course. And there have been huge amounts of effort to try to develop drugs that target KRAS in cancer, but for decades it's always been thought of as 'undruggable' because of the difficulty of finding any molecules that would affect it.
This new drug, that finally treats KRAS mutated cancers, goes about it in a new way. Instead of trying to gum up the works of a single protein by sticking a small chemical in it, it effectively "glues" the KRAS protein to another protein, CypA, which keeps the switch away from reaching the normal areas where it's "on switch" activity works.
So this new drug means two things: 1) a lot of the most difficult to treat cancers are now far more treatable, and in the next 1-5 years clinical trials will tell us which cancers this particular drug works well for, 2) there's an entire new class of drug activity that everybody is chasing at this very moment, so in 5-25 years we'll likely have a huge number more of these sorts of treatments.
I know this is a popular "well actually" to do, but it is not always useful in a conversation. Yes, all cancers are different, but yes, cancer is also one thing: unchecked, harmful division of cells.
Bacteria are also all different, but still they are "one thing", and despite their diversity, antibiotics exist that can deal with many species of them at once. It is reasonable to talk about bacteria and antibacterial medications, it is also reasonable to talk about cancer and cancer treatment. I truly hope cancer will meet its "penicillin" one day (yes I know this is unlikely).
> Bacteria are also all different, but still they are "one thing", and despite their diversity, antibiotics exist that can deal with many species of them at once.
Except people don’t ask “what if I get bacteria” the way they ask about cancer. If the story was about a new antibiotic that only affected 20% of common infectious bacteria strains and someone asked “in laypersons terms, how will this help me if I get a bacterial infection”, it would be appropriate to clarify that it only applies to some bacteria.
Yeah, but doctors also don't tell people "you have bacteria" or claim "we found a cure for bacteria". The lack of nuance on average is largely due to a lack of nuance from experts. The media treats cancer as one big thing and bacteria and viruses as separate things. Thus the average joe inherits 'treating cancer as one big thing' from the media.
But yeah, oncologists aren’t telling people “you have cancer” the way they might say “you have MRSA”.
Honestly, I think people probably get false impressions because cancer usually hits old people and old people are, frankly, often not reliable narrators.
Without this understanding it becomes a quick jump from "we're spending all this money on cancer" to "we've made no progress"
An example of the nuance plays out in the common cancers (like breast and prostrate). These have between 90 and 100% 5 year survival rates. Others (like the one in this article, pancreatic) have very poor survivability.
As you note, it's very unlikely that we'll "cure cancer". But we already "cure" (for some definition of cure) some cancers. Progress is slow, methodical, and incremental. It can feel like a lost cause when viewed from afar, but up close very real progress is being made. And that's an important message to pass along.
Like you said, for a lot of common cancers we have multiple treatments. It's usually not just one magic drug, but rather the doctors working with the most effective treatments down to the least effective treatments.
Now, "no, i mean poisons that attack the special chemistry of cancer," oh yes, those we call chemo.
Can you help disambiguate this? Are there treatments now, or are there potential treatments with trials in 1-5 years?
https://clinicaltrials.gov/search?intr=daraxonrasib&viewType...
The first two are the trial that just completed and showed success: people that have pancreatic cancer that failed other treatments, then a "trial" that is meant to give quick access to more people now that it's been shown to work.
Then there's a trial for using it as the first-line treatment for pancreatic cancer, one for lung cancer (NSCLC), and also various combinations with other drugs. I expect we'll see a ton of new trials registered in the coming year. Especially something in combination with colon cancer, because a common drug resistance mechanism in colon cancer is to develop KRAS mutation.
The thing is that we don't really know which cancers it will work well in until we try. And there's limited number of people with cancer that enter clinical trials, and we want to give each person their very best chance at survival, and then there's the massive expense of running the clinical trial itself, so learning happens slowly, one month of survival at a time, or one cancer recurrence at a time, or one death at a time. Patients that take part in clinical trials really are the heroes here. (Especially with the side effects of this new drug, which are horrible. It is a revolutionary drug, but we need to learn how to manage the other things it does as well, and that's going to take time.)
It most likely will help if you get pancreatic cancer. It might help if you get one of the other types of cancers with this mutation.
And it will likely lead to new treatments for some of the worst kinds of cancer.
2. NIH funding notice of awards has slowed to a crawl since Trump did not get his wish to cut Science funding.
3. Putting scientific funding under political control, instructing them to ignore the reviews conducted by peer scientists.
4. Have practically made international collaborations on grants impossible. An expert in Canada or Europe that would be great? Pretty much, too bad.
5. Pushing policies that make grants cancelable at any moment without need to have a justified reason, including potentially for exercising free speech, disagreeing with Administration doctrine, etc, or because you're ugly. This and the funding uncertainty makes planning difficult...just like business, stability/predictability matters.
6. Pushing policies that prevent funds to help cover costs of dissemination, including conference costs.
It makes no sense to cut off the hand that saves you even as a rich billionaire who wants to control people in a fascist society.
In reality, mediocre thinkers with inflated egos and little understanding of long-term consequences are pulling the strings almost everywhere.
The bigger deal about this is that KRAS was considered an "undruggable" target.
Recent advancements have allowed us to design biologics to do things we previously thought impossible, which broadens the horizons for other treatments in the future.
Baby steps.
This subthread there is a fascinating explainer about one user's journey into funding and incentivizing research into their own rare form of blood cancer, and how they are able to push forward the state of the art: https://news.ycombinator.com/item?id=48506997 - something of a modern-day (and more accurate) Lorenzo's Oil!