Moonshot - thoughts?

[Celestia]

so Biden/Obama's cancer moonshot is getting lots of press, at least in the media that I consume.

Are you all hopeful? Skeptical? Is this just a waste? Thankful for the potential research monies that might come?

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[eteshoe]

I'm happy about the money but honestly they tried the moonshot approach in the '50s-'60s and saw that that sort of campaign strategy was not effective. Cancer discovery (and basic science for that matter) tends to be on the slow and incremental side. Throwing money and saying "we will find a cure by 2020" or whatever is delusional and a disservice to the public


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[Celestia]

I'm happy about the money but honestly they tried the moonshot approach in the '50s-'60s and saw that that sort of campaign strategy was not effective. Cancer discovery (and basic science for that matter) tends to be on the slow and incremental side. Throwing money and saying "we will find a cure by 2020" or whatever is delusional and a disservice to the public


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I agree a healthy dose of reality is probably good along with the inspiring speeches. On the other hand, I am a hopeless optimist and do see many many advances / fruits of basic science efforts, NGS, Human genome project tumbling quickly after each other in recent years.

Did they really say "cure by 2020?" I haven't been paying that much attention, but that seems entirely unlikely.

That's only 4 years away.

 

[TheTao]

The Moonshots program isn't new, I worked on it back in 2014 at a major cancer research institution:
https://www.mdanderson.org/about-md-anderson/facts-history/moon-shots-program.html

My take, cancer is a "business" so the idea of a "cure", EVER, for most cancers isn't realistic IMHO.

 

[Celestia]

What's new is the reinjection of this idea into the public consciousness on this scale.

I don't disagree that cancer medicine is a business- although the implication that no one is motivated to find a cure because there is financial incentive not to do so seems entirely too jaded.

If anyone did find a true cure for cancer, they would easily be a billionaire.

If there is no cure found, I think it's more likely that it's just scientifically difficult, as eteshoe said.

(Our simplification in speaking of a single cure ignores the fact that cures for some cancers have already been found, I feel the need to point out. )

 

[TheTao]

If anyone did find a true cure for cancer, they would easily be a billionaire.

If there is no cure found, I think it's more likely that it's just scientifically difficult, as eteshoe said.

(Our simplification in speaking of a single cure ignores the fact that cures for some cancers have already been found, I feel the need to point out. )

1) Most cancers aren't just one type, they're often heterogeneous subtypes of malignant cells. That's part of what makes a "cure" for most cancers HIGHLY improbable. A google search could provide more clarity.

2) I think idealism is a great personal trait though I imagine after you get a few more years under your belt in the medical profession, that will change.

3) Finding a cure for cancer could make the inventor a billionaire, but cancer treatment is a TRILLION dollar business. In other words, basic math.

4) Thanks for pointing out the obvious which I already gleaned from a 15 year career as a cancer researcher.

 

[Celestia]

1) Most cancers aren't just one type, they're often heterogeneous subtypes of malignant cells. That's part of what makes a "cure" for most cancers HIGHLY improbable. A google search could provide more clarity.

2) I think idealism is a great personal trait though I imagine after you get a few more years under your belt in the medical profession, that will change.

3) Finding a cure for cancer could make the inventor a billionaire, but cancer treatment is a TRILLION dollar business. In other words, basic math.

4) Thanks for pointing out the obvious which I already gleaned from a 15 year career as a cancer researcher.

Do you find it interesting that the checkpoint inhibitors actually show more promise for cancers with more molecular heterogeneity?

 

[TheTao]

Do you find it interesting that the checkpoint inhibitors actually show more promise for cancers with more molecular heterogeneity?

Significant progress was made during the time I worked on Melanoma. So am I pleased about the progress? Sure. Will those breakthroughs really translate into lives saved? We'll see.

My work now centers on cancer health disparities and for reasons too numerous to name, those breakthroughs never seem to reach the target population I'm focused on. Hence, my cynicism.

 

[Celestia]

Significant progress was made during the time I worked on Melanoma. So am I pleased about the progress? Sure. Will those breakthroughs really translate into lives saved? We'll see.

My work now centers on cancer health disparities and for reasons too numerous to name, those breakthroughs never seem to reach the target population I'm focused on. Hence, my cynicism.

I understand your cynicism. I hope you can continue to find the motivation to do good work, though. Can you imagine how discouraging it would have been to do melanoma work prior to the past several years? Trial after trial after trial with same PFS and OS?

And lives are already being saved. I could point to Jimmy Carter but I can see how it would only confirm your impression that these advances make it first to the privileged. I work with an inner city population and I am trying my best to make sure they have access to cutting edge care as well. But yes there are barriers.

In any case, thanks for talking to me. It seems there aren't a lot of folks here who want to talk oncology. I suppose they are all too busy with real life.

 

[doctorplatelet]

Without the money for research, there will be no progress .... i think everyone understands that this is not an easy problem to solve.. hence the term "moonshot" ?? The more money we put it, the faster the results come out, more trials get funded, more ideas get tested... who knows! there might be the next pembrolizumab in those bunch of drugs that can now be funded by NCI !..

 

[doctorplatelet]

1) Most cancers aren't just one type, they're often heterogeneous subtypes of malignant cells. That's part of what makes a "cure" for most cancers HIGHLY improbable. A google search could provide more clarity.

2) I think idealism is a great personal trait though I imagine after you get a few more years under your belt in the medical profession, that will change.

3) Finding a cure for cancer could make the inventor a billionaire, but cancer treatment is a TRILLION dollar business. In other words, basic math.

4) Thanks for pointing out the obvious which I already gleaned from a 15 year career as a cancer researcher.

I think you are being too cynical. We are only as good as our technology. Many researchers in 1850 also worked on "insert random field" without much progress, but enter a new technological breakthrough ( insert telescope, electron microscope, calculus ) , changed things beyond. Dreaming is good... dreaming sets the foundation for tomorrow. Your job as a cancer researcher is to encourage people to do that and to tell them that nothing is impossible... except for the laws of physics... and hell.. we still dont know for certain if thats true.

Cheers

 

[Celestia]

http://www.usnews.com/news/the-repo...utm_medium=facebook&utm_source=&utm_term=aacr

Editorial.

 

[TheTao]

Dreaming is good... dreaming sets the foundation for tomorrow. Your job as a cancer researcher is to encourage people to do that and to tell them that nothing is impossible... except for the laws of physics... and hell.. we still dont know for certain if thats true.
Cheers

Dreams are perfectly fine, until you get in the "real world" and realize that the ONLY one dreaming is YOU. Reality prevents me from permanently wearing rose colored glasses when it comes to the cancer research field.

That said, my "job" as a cancer researcher is to continue to avoid the numerous violations of ethics, morals and everything else that defines integrity, that I observed working in the Pharmaceutical Industry, while maintaining my sanity (NOT as easy as it sounds in a moraless work environment) and a successful research portfolio. I did that by leaving Pharma and focused on opportunities in Academia and with the Feds. And no those employers aren't perfect, but playing politics with "dolphins" is VERY different than playing with "sharks".

Cynicism is usually born of experience and once people have "experience", cynicism usually isn't very far behind. Especially for cancer researchers.

 

[TheTao]

http://www.usnews.com/news/the-repo...utm_medium=facebook&utm_source=&utm_term=aacr

Editorial.

Pharma = some of the strongest lobbyists in America = Cynicism.

But I AM thrilled that the funding will be there for the remainder of my education, after YEARS of NIH funding decline.

 

[Celestia]

I have misgivings about Pharma as well. Nonetheless, I can't argue that the biggest breakthroughs of the past few years are primarily Pharma/Industry driven (well, usually with some initial federal investment, then Pharma investing in the most prominent discoveries and reaping all the profit). (Side note- government and public might benefit if companies paid appropriate amount of taxes. I am not sure how tax law works for Pharma- I hope the government gets some of its money back).

I do think it is atrocious that they charge so much. Once they recoup their costs, can't they back down to some less obscene level?

I was happy to tell drug rep recently I am glad they have competition to push down their prices. I think he expected me to be appalled that some insurance company was limiting access to his drug.

I am also happy about the government funding. Hope it bears fruit.

 

[eteshoe]

I do think it is atrocious that they charge so much. Once they recoup their costs, can't they back down to some less obscene level?

Those execs are usually not willing to take any cut in their profit margin. A shame though.

 

[Celestia]

Of course not willingly, but perhaps they could be persuaded to do with the right tactics. The only forces I see to equalize might be price negotiation on the part of buyers, as well as fostering more effective competition. And some degree of equitable taxation, as I said before. Shouldn't the government/public benefit at least a little from market transactions?

I found out recently that oncology Pharma also is actively attacking generics. That is another atrocious move which I hope is effectively broken up by antitrust legislation.