Gina Kolata Peddling Oncogene Validity, Targeted Drugs

Study of Cancer’s Genetics Suggests a More Tailored Treatment Sept 10 NYT 2012 p A18 writes Gina “I love my best sources” Kolata

Is Gina misleading us by thoughtlessly buying into the oncogene mess?

Why does she say it fits with dogma when it seems to indicate cancer is disruption not mutation?

Interesting half page piece in the NYTimes Sept 10 Mon which is now on the web at http://www.nytimes.com/2012/09/10/health/research/for-a-lung-cancer-drug-treatment-may-be-within-reach.html (different title on line, Cancer Study Points to Tighter Pairing of Drugs and Patients)

As the picture of the scientist involved is captioned, Dr. Matthew Meyerson worked on a large study of squamous cell lung cancer. It found mutations that new drugs might target.

Kolata seems to include a couple of paragraphs gratuitously assuring us that the fact that mutated genes vary so much between patients with lung cancer that there doesn’t seem to be one common to them yet this is “in keeping with the genetic view of cancer”.!

Huh?
Kolata has training in molecular biology and applied mathematics so one would expect her to be a fairly reliable and accurate correspondent. Indeed, we have been assured by a reviewer at Publishers Weekly, she is the best in the business.

Who is Gina Kolata? This is her Times bio.

Her last book, Rethinking Thin, which is about How To Be Thin, Maybe (Its Mostly Genes, Stupid)

Anyhow the piece was published on September 9, 2012 on line where it garnered 124 Comments, a lot of them very wary of current practice in canecr treatment, noting it hasn’t won improved result for a very long time and certainly needs to be updated from slash, burn and poison.

But is it the responsibility of the New York Times to promote still unproven dogma in science? If not, where does the still fresh and perhaps too gullible Kolata get off by writing these two paragraphs in hr latest opus on September 10?:

The work became feasible only in the past few years because of enormous advances in DNA sequencing that allow researchers to scan all the DNA in a cell instead of looking at its 21,000 genes one at a time. The result has been a new comprehension of cancer as a genetic disease, defined by DNA alterations that drive a cancer cell’s growth, instead of a disease of a particular tissue or organ, like a breast, the prostate or a lung.

And, in keeping with the genetic view of cancer, no one mutation in this study of squamous cell lung cancer stood out — different patients had different mutations.

Is she a propagandist for oncogenes now?

Here is the piece:

Study of Lung Cancer’s Genetics Suggests a More Tailored Treatment

by Gina Kolata

The first large and comprehensive study of the genetics of a common lung cancer has found that more than half the tumors from that cancer have mutations that might be treated by new drugs that are already in the pipeline or that could be easily developed.

For the tens of thousands of Americans with that cancer — squamous cell lung cancer — the results are promising because they could foretell a new type of treatment in which drugs are tailored to match the genetic abnormality in each patient, researchers say.

“This is a disease where there are no targeted therapies,” said Dr. Matthew Meyerson of the Dana-Farber Cancer Institute in Boston, referring to modern drugs that attack genetic abnormalities. He is a lead author of a paper on the study, with more than 300 authors, which was published online in the journal Nature on Sunday.

“What we found will change the landscape for squamous cell carcinoma,” Dr. Meyerson said. “I think it gives hope to patients.”

The study is part of the Cancer Genome Atlas, a large project by the National Institutes of Health to examine genetic abnormalities in cancer. The study of squamous cell lung cancer is the second genetic analysis of a common cancer, coming on the heels of a study of colon cancer.

The work became feasible only in the past few years because of enormous advances in DNA sequencing that allow researchers to scan all the DNA in a cell instead of looking at its 21,000 genes one at a time. The result has been a new comprehension of cancer as a genetic disease, defined by DNA alterations that drive a cancer cell’s growth, instead of a disease of a particular tissue or organ, like a breast, the prostate or a lung.

And, in keeping with the genetic view of cancer, no one mutation in this study of squamous cell lung cancer stood out — different patients had different mutations.

As a result, the usual way of testing drugs by giving them to everyone with a particular type of cancer no longer makes sense. So researchers are planning a new type of testing program for squamous cell cancer that will match the major genetic abnormality in each patient with a drug designed to attack it, a harbinger of what many say will be the future of cancer research.

Squamous cell lung cancer kills about 50,000 Americans each year. That is more people than are killed in the nation by breast cancer, colon cancer or prostate cancer. Well over 90 percent of squamous cell cancer patients are or were smokers.

The new study compared tumor cells from 178 squamous cell lung cancer patients with the patients’ normal cells. More than 60 percent of the tumors had alterations in genes used to make enzymes that are particularly vulnerable to the new crop of cancer drugs. Many of the drugs are already available or are being tested on other cancers.

These enzymes function like on-off switches for cell growth, said Dr. Roy S. Herbst of Yale Cancer Center, who was not an author of the new study. When they are mutated, the switches are stuck in an on position. About a dozen companies, Dr. Herbst added, have drugs that block these mutated enzymes.

Yet even though the squamous cell cancers analyzed in the study often had mutations in genes for these enzymes, the genes and the mutations were different in different patients.

“Unfortunately, what the Cancer Genome Atlas has revealed is that everyone’s cancer could be very different,” said Dr. William Pao, a lung cancer researcher at the Vanderbilt-Ingram Cancer Center in Nashville and an author of the new paper. “The field is really moving toward personalized medicine.”

The study also found a real surprise, Dr. Meyerson said, something that had not previously been seen in any cancer. About 3 percent of the tumors had a gene mutation that might allow them to evade the immune system. By coincidence, an experimental drug that unleashes the immune system was recently tested in lung cancer patients. Some of those who did not respond might have the mutation, he said.

Now the challenge is to put the findings to clinical use.

First, researchers have to establish that the mutations in question actually are essential to the tumors’ growth, said Dr. Bruce Evan Johnson, a lung cancer researcher at Dana-Farber and an author of the new paper. There are several steps: show that if the mutated gene is added to normal cells, they turn into cancerous cells; show that if the mutated gene is added to mice, they develop squamous cell lung cancer; and show that if the gene is turned off — with a drug, for example — in cells grown in a laboratory, the cells die.

Then come drug tests in patients. But if only a small percentage of patients have each of the mutations, that poses a problem. Ordinarily a few medical centers would enroll patients with a particular type of cancer, like squamous cell. But if, instead, squamous cell patients are subdivided according to their gene mutations, there would be too few for a drug test within a single institution or even several.

So the plan is to cast a wider net. The major medical centers intend to form a consortium. In it, each center would direct one or more studies of one mutation and one drug that might home in on the specific mutation. So even though only a small percentage of squamous cell cancer patients would have that mutation, patients across the country could be in a clinical trial of a targeted drug. A patient’s own doctor could administer the drug, and the medical center directing the trial could analyze the data in partnership with the company that makes the drug.

That sort of system worked for another common type of lung cancer, adenocarcinoma, Dr. Johnson said, allowing researchers to test drugs that work for only 2 to 3 percent of patients.

And the work can move fast, he added. A Pfizer drug, crizotinib, which targets a rearranged gene in some adenocarcinomas, entered clinical trials in 2008 for lung cancers with the rearrangement. The results were reported in 2009 and were published in 2010. Crizotinib was approved in 2011 for patients with the gene rearrangement. The rearrangement is so rare that about 1,500 patients were tested to find 82 whose cancer had it. They were the ones included in the study.

For Pfizer, the experience was transformative.

“The old way of doing clinical trials where patients are only tied together by the organ where their cancer originated, those days are passing,” said Dr. Mace Rothenberg, senior vice president of Pfizer oncology.

Dr. Johnson, too, sees it as a wave of the future.

“That was the first time we really went after the genetic abnormality,” he said.

Now, he said, with squamous cell cancer, “we are sort of where we were four or five years ago with adenocarcinoma.”

Below the piece there are 124 Comments:

billqueens, new york
According to a university research report, the vegetables that are most effective in preventing breast cancer include garlic, leek, green onions (scallions), brussels sprouts and cauliflower. All but cauliflower are most effective against lung cancer. The info was found in a research report by the University of Montreal in Quebec, Canada, titled “Antiproliferative and antioxidant activities of common vegetables: A comparative study.” Please pass on this info.
Sept. 11, 2012 at 7:47 a.m.RECOMMENDED2

Robert CohenWinder, Georgia
(Theraputic) marijauna is not necessarily smoked: the ole humorous brownies
solution is apparently being frequently utilized. Plus it may well be legal in only 25-50 more years, so let’s be understanding and patient.
Sept. 10, 2012 at 7:41 p.m.

Janice Badger Nelson RNPark City, Utah
Verified
When I worked with hospice patients who had lung cancer, I felt bad for them because lung cancer is so isolating. It is not like breast cancer; there are no walks, no pink ribbons. People feel ashamed of it even when they were non-smokers. Causes of lung cancer are varied; some research points to radon as being causative. But people think it is only caused by smoking and can be preventable. And they point fingers and say that the person caused it to happen. How short sighted many are.

I was just having a discussion with my husband who is a research scientist and another scientist, both brilliant and way beyond me in intellectual terms and as they were talkling about designing new compounds and such, I asked them why it is that we have not changed the treatment for cancer in all the decades that I have been a nurse. It is still the “knife, poison and burn club” as we used to say back in the 80’s ( Surgery, chemo and radiation) We should be putting more dollars into prevention and screening. Of course we should search for a cure, but I have seen so many cancers that could have been caught early and eliminated, but the insurer would not pay for that MRI or testing. Funny though, they paid thousands to try to “cure” a stage 4 cancer for naught. It is so upsetting.
I simply do not understand their logic. Or lack of it.

By the way, the scientists, my husband included, had no answer. Cancer is and always will be elusive it seems.
Sept. 10, 2012 at 2:37 p.m.RECOMMENDED7

Winston Smith 8495Everywhere, NY
Hopefully this finding ends the death sentence that cancer represents for so many patients. In 1985 my father died of a rare cancer called thymoma…if only he had received this promising treatment…
Sept. 10, 2012 at 1:12 p.m.RECOMMENDED1

YangbanSan DiegoNYT Pick
Unstated in this piece is the observation that the genetic changes in tumors are in constant evolution and may vary from cell to cell at any given time in a given patient. Thus, “targeted therapy” based on genomic analysis may be valuable, but the effects tend to be transient as further mutations occur, just as with conventional “untargeted” therapies. Personalized medicine is the buzz term driving the field at the moment, but terms such as this should be recognized as primarily marketing tools to enhance grantsmanship rather than reflecting a final destination in the struggle against cancer.
Sept. 10, 2012 at 11:04 a.m.RECOMMENDED9

marymaryWashington, DC
Your point is well taken but should interested persons just use an umbrella rather than concluding that the entire parade is likely to be rained out? I am not a scientist and therefore this parallel may be inapt, but if not mistaken viruses, such as the HIV virus, are constantly mutating, yet science and medicine do not cease to search for appropriate means to hinder activity nonetheless. True, there is a vast difference between cells gone necrotically wild, as in cancer, and cells subjected to live invasion, as with viruses, but the impossibility of addressing every potential circumstances does not mean that what can be done should not be explored.
Sept. 10, 2012 at 6:24 p.m.RECOMMENDED1

CitizenMaryland
What happens when many of these targeted drugs work for only a small subset of patients? RIght now, therapies for breast cancer, for example, work in “many” or “most” patients, leaving a much smaller number who will require these kinds of targeted therapies. But will the numbers remain large enough that the pharmaceutical companies will be willing to manufacter these targeted therapies that benefit only a few? Will the problem move from “we don’t have anything that works” to “we won’t manufactuer what works because there are so few of you who need it”?

I hope that most targeted therapies will work for vast quantities of cancer patients, but I also foresee an increasing percentage of patients being told that they have “rare” cancers for which no one is manufacturing the life-saving drugs that they need.

As the granularity increases — that is to say, when each cancer can be broken down into not one or two, but a thousand different types — will the pharmaceutical companies still be interested in developing the drugs that will save lives, or will the overhead just make it uninteresting for them?
Sept. 10, 2012 at 11:04 a.m.RECOMMENDED2

RobertNew York City
The people who claim that Stage IV cancers are always hopeless are overly pessimistic. I’m most familiar with ColoRectal cancer. For Stage IV: if the metastatic spread is 1 or 2 tumors on one organ which are surgically removable, the chances of a cure are good. There are a number of famous patients in this category, such as Herman Cain (Republican candidate) who had colon cancer with spread to liver about 6-7 years ago.
Sept. 10, 2012 at 11:04 a.m.

AlexanderNovia Scotia
This article seems to suggest that there are more mutations than expected in squamos cell lung cancer but not in the other named lung cancers. Given that the article also states that 90% of squamos cell lung cancer affects smokers, are drug companies just hoping to create designer drugs to match brands of cigarettes?
Sept. 10, 2012 at 11:04 a.m.

siste2raleigh, NC
Yes it is obvious today that treating each cancer case like a genetic disease is only available for the super-rich.
Why not someone come up with a device where anyone at home can sequence their cancer cells and send this information to a team of researchers where they can use a computer to figure out what kind of treatment is most likely to work?
This would solve 3 things: 1. more effective treatment 2. faster results
3. more cost effective.
I know this isn’t here yet and here’s why:
1. There is not a device like this on the planet that can differntiate between healthy cells and cancer cells. Well damnit – invent one.
2. There is no computer program that can select a treatment because there is not enough understanding of cause and effect of drugs.
Much of science in the health field is done without a deep understanding of how basic biological processes work. My wife complains all the time becasue medicine is such an “art” they can’t get it right all the time. There is a reason for this – cell biology is enourmously complex.
I beleive that collectively we know how to beat cancer – but no one has connected the dots. Its time that we get down to the fundamentals of biology just like Einstein did with his therory of gravity. His understanding was so basic he was able describe it entirely with a single equation. Its time a multidisciplinary crack team goes back to basics and works to understand cell biology until we beat cancer – and look at each case as deep as we can.
Sept. 10, 2012 at 11:04 a.m.RECOMMENDED2

RaerityHong KongNYT Pick
I am one of the lucky patients who was able to access Crizotinib at a very crucial time of my cancer journey. Since the 2007 diagnosis of muco-epidermoid carcinoma (a type of squamous cell cancer), found initially around the thymus and outside the lungs, I’ve gone through multiple surgeries, radiotherapy (thorax, abdomen, brain) and two rounds of chemotherapy, as well as other target therapies, all treating primary as well as metastases. Last year, my condition hit rock bottom during second-line chemotherapy, which itself was not effective. The tumours had invaded my bronchi, causing severe breathing problems. I coughed and wheezed constantly, my mobility was limited. We placed stents inside the bronchi to mechanically allow air flow.

Last July, just when we thought we were out of options, we discovered my gene mutation matched what Crizotinib targets. The positive effects were almost immediate and just plain amazing. I regained physical stamina, the bronchoscopic images of before and after were like night and day. More importantly, I reclaimed so much of my life.

14 months since Crizotinib however, the effects of the treatment seem to have started to taper off: the tumours are active again. We are hopeful for new medication though, there appears to be a number of them in development.

I’m only 36, I hope very much there will be many more breakthroughs in cancer research, and that I will live to see their glorious effects. Not for me alone, but for generations beyond.
Sept. 10, 2012 at 11:03 a.m.RECOMMENDED8

F. St. LouisNYC
What about dark DNA, the nucleotides between genes? Is it also involved in cell division and, if so, is it being sequenced for differentiating between normal and malignant cells?
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

hen3ryNew York
When are we going to hear about the side effects or the lost potency or mutations in response to the initial treatment? This article, while interesting, doesn’t address those issues. Based upon the years I spent in cancer research I cannot believe that there is a treatment with no side effects and no chance of resistance from some cells that are left over from treatment.

The other issue is cost. Most of us cannot afford mildly serious illnesses. How are we going to pay for something like this:drugs are tailored to match the genetic abnormality in each patient, researchers say. Our insurance companies are not going to pay enough of it to make it affordable. And the ongoing treatment, since it will, presumably be individualized, won’t be affordable either. Staying alive is nice but if costs us our savings, our jobs (and it will in some cases), and puts us in debt what good is that?
Sept. 10, 2012 at 10:12 a.m.RECOMMENDED2

Robert CohenWinder, Georgia
“Medical marijauna” has been approved in several State referenda, though formally nixed by the Supreme Court.

So whether Romney or Obama, and whether Democrats or Republicans will control the Senate and/or the House, if enough victims, and our friends and our families, suffering from disease express ourselves by way of social networks which are proven as amazingly influential, “medical marijauna” becomes a major issue which implicitly lmpacts elections, the Tea Party comes to mind, then we will see the Supreme Court changing or a constitutional (a la Volstead) amendment enacted.I perceive there is a good possibility if not probability for the phenomenon realization in 25 to 100 years, so never mind.
Sept. 10, 2012 at 9:08 a.m.

RJPasadena, CA
No where in this story does it state the benefits of these tests in terms of response rate, progression free survival, or overall survival. At best a patient might get 3 months to an year extra of life.
Sept. 10, 2012 at 12:33 a.m.RECOMMENDED6

Fountain of TruthLos Angeles
So … we should end all research that doesn’t guarantee an immediate and permanent cure?
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

AnonWisconsin
It’s interesting to think about how mutation-based vs. organ-based categorization of tumors would lead to a totally different mindset about managing cancers. Will sequencing tumors become the first step in any clinical workup? If tumors are broadly categorized by mutation instead of by organ, and there are many more mutations than organs, will it be possible to power clinical trials with a sufficient number of volunteers to properly evaluate the performance of designer drugs that target a particular pathway?
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED4

TMCNYC
Research centers like Dana Farber and Yale have been doing DNA work ups on new patients for years with the idea that as new therapies are developed they can go through their data base and match them with patients to whom they might apply. This could also be a source of patients that would be appropriate for a trial
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

What nextKansas
Research on lung cancer was put on hold because it was easier to blame the disease on smokers. We had a war on smoking and it worked. Now, quit blaming smokers for a cancer that occurs in non smokers. Who wants to smoke anymore? ME! I quit, but I miss it.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED5

Katelyn B.Atlanta
What on earth makes you say that lung cancer research was put on hold? This is surely not true. Furthermore, are you implying that smoking is not in fact a major cause of lung cancer? Cancers are caused by gene mutations that allow cells to grow out of control. Smoking is the thing that induces those changes in many people who develop lung cancer. The cause-effect relationship is very well characterized and not in question, as you seem to suggest.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED1

BanduNYC
So gratifying to know that some of these advances are being made in Cancer Rx. Unfortunately, it did not help my wife who was battling Ovarian Cancer and passed away last year. The focus for Women’s cancer remains on breast cancer, but Ovarian Cancer deserves a big focus, since it is so difficult to diagnose it early.
Bandu, MD
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED15

harrymichigan
Prevention! Have we forgotten the most important tool in the fight against the big C? All of these new treatment modalities cost a ton of money, where do we think this money comes from— China?
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED2

Dave WymanLos Angeles
My wife, who has lung cancer, didn’t smoke, exercised a lot, and ate well. I don’t think there’s anything more she could have done to prevent the cancer that she has.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

Gerrykingston, canada
Congrats to Serena but I am seriously missing something. Who is on Mars?
Sept. 9, 2012 at 11:07 p.m.

clarkbhall Middleburg, VANYT Pick
My dear wife succumbed to breast cancer that spread to the liver.

For 3 1/2 years, we tried everything that MSK offered and none of it did any good. As her decision-maker (Deb avoided the topic), I listened to the recommendations of repeated oncologists who were really just guessing as to the efficacy of the chemo of the moment when in fact they had no earthly idea what would work. The entire experience has left me bitter, hurt, and deeply cynical of the state of Stage IV cancer treatment.

If I could do it all over again, I would tell my wife the terrible truth and let her know there was no hope. As it is, I lied to her and gave her “hope,” when she knew in her heart there wasn’t any hope.

And now I listen to cancer commercials on television that promise “hope,” and a “cure.” Not for my beloved wife, nor most anybody else whose cancer metastasizes… There is no such thing as hope when so afflicted.. And that’s the truth.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED9
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Mary AnnNYS
Yours is a sad story clarkbhall. You are right that it is a guessing game when treating stage IV cancer. I am sorry for you and all who have endured such sorrow, both patients and those who love them.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

JCNJ
I am skeptical about MSK…we had a family member there 12 years ago getting radioactive iodine scan after scan after scan for what was guessed to be a distant (lung) recurrence of 20-year-previous thyroid cancer. None of the tumors picked up the RAI until the NIGHT BEFORE he was scheduled for RAI treatment. Suddenly the scan lit up (or so they told us), and he received a massive dose of RAI the next day. Thyroid cancer is highly responsive to this treatment, but it just made him sicker and he died six months later. To this day I believe what he had was lung cancer, not a recurrence of thyroid, but his endocrinologist just would not look down any other path.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

SusanEastern WA
I am so sorry for you and for what your wife endured. But your critique does not apply to all cancers.

My doctors were very hesitant to even tell me the stage of my throat cancer, because most are diagnosed at stage III or IV, yet it’s highly curable. You just have to live with the sometimes-miserable effects of treatment.

This article just reinforces the idea that there will be no “cure for cancer,” as it’s not just one disease. And now we see that each type of cancer may not be a single type, either.
Sept. 10, 2012 at 6:24 p.m.

Peter MelzerCharlottesville, VA
Cancer cells mutate as they rapidly divide, producing unique subsets of cells. At the time of diagnosis, several subsets may already exist. The more targeted the drug, the less effective it will be in wiping the slate clean. Some targeted therapies may extend survival. Personalized medicine, however, will not provide a cure.
Sept. 9, 2012 at 11:07 p.m.

Dave WymanLos Angeles
This is wrong. There are people on targeted therapies who have lived for years.

Chemo therapy did not work for my wife, who had advanced lung cancer. Before she began a targeted treatment, her doctor told her she had perhaps two months before she would die.

She started targeted therapy in November, 2010. For now, there is no sign that her cancer mutated. In fact, for now, there is no sign of any living tumors in her body. So targeting the particular genetic makeup of her cancer saved her life and has given a lot of extra time.

While most people do see a recurrence of their lung cancer on this treatment, a few people have been alive for almost a decade. How long will my wife live? No one knows. I do know that without that targeted therapy, she would have died in early 2011.

As we slice the genetic pie of lung cancer into smaller and smaller pieces, we will indeed be able to retarget cancers that mutate.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED4

Gerrykingston, canada
Gina, live your life.Want to become someone? When the headline reads cancer can be beaten. Not exactly truthfull. Sorry given how many drugs are available. People die.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED1

Connect::the::DotsNYC
The goods news is that different mutations in different patients doesn’t mean the fundamental pathways of dis-regulation are dissimilar, and in fact we’ll likely find a limited number of pathways common to all forms of cancer, treatable therefore with a common set of targeted drugs/therapies.

This will probably happen much much faster than anticipated as rapid progress is made on isolating/decoding the meaning of various mutations and
common patterns of dis-regulation start to emerge.

There’s definitely cause for optimism.
Sept. 9, 2012 at 10:49 p.m.RECOMMENDED4

Newton4MarylandNYT Pick
As a physician-researcher, I feel compelled to assert that the vast majority of NYTimes readers will not be able to afford these “personalized” therapies. This is the hidden dark-side of cutting edge biomedical research. While many politicians eschew other medical systems because they are not highly innovative, these resultant therapies are ultimately of no value to Americans if they disproportionately inflate the cost of care or are priced out of the incomes of most persons. Ms. Kolata needs to step back from the glow of the science to consider these practical issues that will ultimately compromise the hopes for innovation.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED29
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JFMSan Diego
As a fellow bench to bedside researcher I agree. As a former Pharma exec familiar with the process of calculating return on R&D investment, I feel that there is not enough investigative journalism on how “personalized medicine” will be delivered.
Sept. 10, 2012 at 11:21 a.m.RECOMMENDED3

Frank LipskyScottsdale ,AZ
Newton4:
You have valid point about affordability but to be logically consistent;don’t physicians and hospitals have duty to turn end of life patients(<90days) over to hospice instead of running up bills for these patients Sept. 10, 2012 at 6:24 p.m. christineseattle Thank you for writing this. I couldn't agree more. The "glow of science" indeed. Sept. 10, 2012 at 7:24 p.m. HJMaryland After all those years with the wars on cancer, it looks as if we are only beginning to see how we could find cures after the fundamental change in our understanding of what cancer is thanks to genomic revolution. All of our cells keep dividing, making copies of DNA; they make enough mistakes in doing so, the genetic programs go into uncontrolled infinite loops just like computer codes with bugs do. Kudos for the human genome project. Critics complained what we were going to do with the sequenced data that we don’t understand.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED1

PBManlius NY
FLAG
As an older person who taught at a medical school and health science center, I have seen the old laborious, skeptical, cautious, see-if-you-can-prove-yourself-wrong “scientist model” transformed into a “business model.”

Medical research has become literally & figuratively a rat race for grants, big bucks, personal & institutional status, patents, and market share.The conflicts of interest and gaming the system that permeate drug research in particular are staggering.

Today, advertising and framing is the name of the game. Check some of the language, hyperbole, and false optimism (at this point in the research) in this “objective” NYT report. And, why are the answers mostly: “have we got a drug for you to treat whatever!” How much research goes into issues of lifestyle and prevention vs. expensive treatment at the back end?

I have seen too many friends and family so hopeful about their cancer treatments–all ginned up on the promises they believe their infallible doctors sold them on–only to come out of the experience angry, depressed, and, if they make it, living with a life time of side effects and damage. And in some cases, broke. If they don’t make it, these same feelings are expressed by family members.

Yes, the treatments mercifully work for some, but the medical Industry is now promising too early & much more than it can possibly deliver, and it is not just to keep up patients’ hopes. Follow the money (including lobbyists and political pressure).
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED31
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PatrickLong Island NY
Thanks for the insight. Like the old saying goes; “An ounce of prevention is worth more than a pound of cure.”
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED2

RJPasadena, CA
Lots of money will be made through this process. Lab tests will skyrocket for the gene tests and people will be given false hope.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED1

Dave WymanLos Angeles
Maybe because your older – old? – you aren’t able to see the benefits of increased technology, Manlius.

I take objection to your claim that the medical industry promises more than it can deliver. Let’s see some links to back that up, especially with cancer treatment, and even specifically with targeted cancer treatment for lung cancer. Just where has false hope been given?
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED1

MetastasisChapel Hill, NC
Many people seem exasperated that “cancer” hasn’t yet been cured. Well, here’s why: even by old morphological criteria there were probably 200 types of cancer, each requiring different understand of its etiology and treatment. Now we know that each type of cancer is probably made up of scores of genetic types that only show up by their sequence (and the heterogeneity of their response to treatments). So now we’re talking many thousands of diseases.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED8

TreblaSoCal
This is promising news but still a long way off for real treatment to start.
An issue barely touched is the cost of this stuff and the public support of basic research, without which, this would not have happened. The Pharma Corps owe some fealty to the people of the country that did the basic research for them.
My malignant melanoma IV (Very bad) was stopped cold one year ago by ipilimumab. The basic science was developed at UC Berkeley with public funds. S-K bought the company which was developing clinical trials. S-K charges $30,000 per dose, and plans to make a $billion. While I’m glad and amazed that I’m her, and she’s cancer-free for now.

Tarceva costs $5,550 if you are wealthy and don’t have insurance. If you have insurance, cost depends on who insures you. For my wife, the cost is $100 per month. It doesn’t cost her insurance company $5,450 per month.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED2

DanArlington, VA
In the meantime, try any one of the many natural cancer treatments. It amazes me that people keep thinking that synthetic (i.e., toxic drugs) are going to cure anything; they’re as bad as the disease itself. We are the product of nature and nature provides all the substances we need to survive. If nature doesn’t, maybe we meed to accept that we can’t live forever. Bankrupting our families and our country for the sake of living an extra few months just doesn’t seem to be the way to go.
Sept. 10, 2012 at 10:51 a.m.

workerbeeFlorida
A previous NYT article on genomics, which is what today’s article seems to be about, was “How Bright Promise in Cancer Testing Fell Apart,” published July 7, 2011. According to that article, hopes for a successful cancer treatment based on individual genetics were high until one of the most promising cancer researchers, Dr. Anil Potti, was accused of falsifying data and claiming that he was a Rhodes scholar but wasn’t one. The incident has become known as the “Potti scandal.” That article says, “While researchers agree there is great promise in this science [genomics], it has yet to yield many reliable methods for diagnosing cancer or identifying the best treatment.” The article also indicates that the FDA hadn’t been enforcing its regulations in this area of research from individual labs, and that cancer researchers are chasing the money, yet there have been no significant breakthrough discoveries.
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED7

Rob L777Conway, SC
These article truths show how much remains to be done in this field, and how slow progress will be:

“Yet even though the squamous cell cancers analyzed in the study often had kinase mutations, cells have many kinase genes and the mutations were different in different patients.

“Unfortunately, what the Cancer Genome Atlas has revealed is that everyone’s cancer could be very different, said Dr. William Pao, a lung cancer researcher at the Vanderbilt-Ingram Cancer Center and an author of the new paper.”

I wonder if genetics will truly revolutionize medical science, or merely create extremely expensive, individualized treatments for the few lucky enough to afford them, and receive them. In that sense, every article like this one promises way more than can be delivered in a reasonable future time-frame. Hence, it constitutes a kind of well-meaning hype for more such Big Pharme, this part of the business seems obscene to me.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED23

Dave WymanLos Angeles
” S-K charges $30,000 per dose, and plans to make a $billion.”

Let’s see a link to back up that claim. In fact, the drug is marketed by Bristol-Myers Squibb, and yearly sales are expected to reach one billion dollars by 2017 – the plan isn’t to make a billion off the drug.

See this – http://www.blogoup.com/blog/2011/3/27/ipilimumab-a-great-university-star…

“basic science was developed at UC Berkeley with public funds”

How do you know that lab wasn’t financed by outside sources? Link? Not only that, but Berkeley most likely still makes money from the development of ipilimumab, because it licensed the technology for the drug, it didn’t sell it.
Sept. 10, 2012 at 11:04 a.m.

DollyDallas TX
My husband recently died after a 3 year battle with non-small cell lung cancer. He never smoked and hardly ever had a chest x-ray. He participated in a clinical trial that for a new drug that dramatically reduced the size and density of his main tumor but not enough people had improvements so the clinical trial was stopped and the drug is no longer available. I am certain we got an extra year together because of this drug so I am grateful for that. He did have a DNA analysis to see if he had a gene mutation that is common for his type of cancer and it was positive. I hope someone is correlating the results of his clinical trial with his DNA in the hopes this could someday help others. This should be done for all clinical trials. I think there is new insight to be gained if this can be done. My husband worked in the computer industry – that is what computers are great at – correlating massive amounts of data. It is quite obvious that cancer is a highly individual disease and the more we learn about genetics the closer we will get to a “cure”.
Sept. 9, 2012 at 6:55 p.m.RECOMMENDED20

marcchi, IL
these “individualized” approaches will bring huge money to drug companies (and genomics centers), but meanwhile other –less profitable but more promising– approaches are neglected… like a full-spectrum cancer vaccine that targets cells expressing in an out-of-context manner some normal(=non-patentable) gene products that only opportunistically de-/mis-regulated cancer cells ever get to express in an individual (e.g., opposite-sex surface proteins). [a group in 2009 successfully cured a specific breast cancer case by vaccinating against a lactation protein expressed only by lactating females, i.e., by vaccinating against a single such anomalously expressed antigen; but a full-spectrum cancer vaccine would target them all. Meanwhile the evidence is growingly clear that the vast majority or cancer cells are opportunistically very mis-/de-regulated].

this vaccine would protect everybody who gets vaccinated before any cancers develop (and would protect against misregulated aging cells)!
Sept. 9, 2012 at 6:55 p.m.RECOMMENDED5

PNew Orleans
There is a vaccine out there that’s very promising and has shown to substantially reduce the rate of at least many of these squamous cell cancers. Look into it.
Sept. 10, 2012 at 11:06 a.m.

HowieLawrence
Why are government and academia so darn slow in providing new drugs? It seems they know what to target.
Sept. 9, 2012 at 6:54 p.m.

TreblaSoCal
It’s really hard science. That takes a while.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED2

ShowMeMissouri
Do any of the chemicals fed to animals and plants to increase agriculture production come through the food and stimulate cancer growth?
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED9

DanArlington, VA
You betcha, as well as chemicals like Bisphenol-A in plastics, genetically modified foods, sugar, grains, etc. that the Government promotes to our detriment. Know this, company profits always come first before human health. The FDA, for instance, approves killer drugs and then leaves them on the market until the death toll rises too high (think Vioxx, 60,000 dead). Meanwhile the FDA outlaws natural treatments that work to protect company profits. And then we have conventional medicine that only knows pharmaceutical drugs for any condition as the standard of care.
Sept. 10, 2012 at 7:27 a.m.

CycledocEverson WA
The facts sadly are that we are not doing much better treating lung cancer today than we did 25 years ago. The 5 year survival rate for small cell lung cancer is under 10%, for non-small cell lung cancer the rate is 15%. The earlier the diagnosis, the better the outcome.

There has been progress and there are some patients who do exceptionally well, but then again there were always a few patients who confounded the predictions. (http://lungcancer.about.com/od/whatislungcancer/a/lungcancersurvivalrate…

The new approaches are hopeful but completely unproven. Ms. Kolata has connections with the pharmaceutical industry and I’ve found her articles often more optimistic than warranted by proven data. (Such as her articles on anti-aging, alzheimers treatments, cancer preventing drugs and so on)

Hopefully something will pan out and we will be able to afford the approach. New drugs for cancer today are costing in the range of $6000-$10,000/month. Most offer very modest improvements in outcomes in most patients.
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED12

Dave WymanLos Angeles
“The new approaches are hopeful but completely unproven.”

This is not true. Tarceva, a targeted biotherapy, gives those who respond to the drug an average of 10 months of life before lung cancer begins growing again. My wife has now been on the drug for 22 monthsa research.

We live in a society where death from any cause whatsoever is unacceptable to most Americans. We are all the ones driving up the cost of medicine because of our unrealistic fantasies of immortality, stoked by the promise of ever more astronomically costly scientific research. I don’t see how this ends well, philosophically, or financially.
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED10
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lwbaumHong Kong
“I wonder if genetics will truly revolutionize medical science, or merely create extremely expensive, individualized treatments for the few lucky enough to afford them, and receive them.”

I think the answer is Yes–to both. Genetics will revolutionize medical science, particularly cancer treatment, and it will create extremely expensive, individualized treatments for a few people. However, after the drugs come off patent, they will be more affordable for the next generation. It’s like planting an orchard. There will be no payback for years or even decades, but if you don’t invest in planting the trees and caring for them, your children will not get the fruit.
Sept. 10, 2012 at 10:51 a.m.

Rob L777Conway, SC
anon, I am happy for your good fortune regarding your husband’s treatment, and its costs being covered by your insurance. Most who get sick with rare cancers will not be so fortunate, or so lucky.

Your good fortune does not alter the points I am making about our scientific, technological society. As a society, we can not afford the medical treatments we are developing. The corporate, university and government entities developing these treatments have no regard for the greater consequences of their actions. They only see their work as pathways to fame, wealth, and endowments.

Cancer isn’t one illness, or a hundred different illnesses. It is probably thousands of different illnesses. It will not be possible to cure them all. From a financial standpoint alone, the continuing development of these treatments will eventually bankrupt us.

They will also lead us to rationing treatments, whether we want to do this, or not. There will not be enough wealth in society to support using these treatments for everyone who needs them. So they will go first to the wealthy, then the well-connected, then to those whose cases garner public sympathies via the media. Perhaps we could develop a lottery system for treatments, but it is difficult to see how useful it would be.

Science and technology are our new gods, and we, as a society, are incapable of developing the ethical and moral frameworks needed to contain them and use them properly. This failure will be our destruction.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED1

Dave WymanLos Angeles
And my wife, who is 66, has a life expectancy of 80. She certainly doesn’t expect to live forever. I think she’s glad, though, she’s been kept alive by her targeted drug therapy for lung cancer for the past two years, long enough to enjoy hikes in the Sierra Nevada Mountains and to see the marriage of her daughter (and our daughter’s first child is due in a few days).
Sept. 10, 2012 at 11:04 a.m.

SF MDNY
Unfortunately, this article will raise hopes when the data is still not conclusive. On the other hand, there are clearly things breast cancer patients should push their doctors to be doing [which they do not do as a result of no financial incentive] such as reduce false negatives in pathology reports. I would encourage those interested to read the abstract of this paper:
http://jco.ascopubs.org/content/early/2011/06/27/JCO.2010.32.9706

Sept. 9, 2012 at 6:54 p.m.RECOMMENDED5

KAHCentral, NJ
This all sounds very promising until you realize that the pharmaceutical companies have been laying off their drug discovery researchers like there’s no tomorrow. I have no idea how they plan to come up with these miraculous new customized drugs they’re touting since those of us who used to do that work are now unemployed. You’d think called oncology drug discovery researchers would be pretty valuable. Apparently not.
It s not any easy job and not just anybody can do it. My heart goes out to cancer patients.
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED13

maureennova scotia
All of the respondents above: Please show me any credible evidence that marijuana causes disease; in addition, do your own research about medical marijuana and check the number of university studies showing its potential benefits. Finally, none of you know me so please don’t make assumptions about me or my history. And one last thing, no one is asking anyone who doesn’t want to use marijuana to use it, to grow it or to buy it. Adults make all sorts of decisions and each of us has a right to decide for ourselves if we want to buy guns (I don’t), smoke cigarettes (I don’t and never have), drink alcohol (I don’t and never had). We, Americans, seem to be anti so many things that are really none of our business (i.e. living a homosexual lifestyle, marrying out of our religion or ethnic backgrounds, making decisions about birth control, abortions etc…when did we stop being a free people able to make personal decisions for ourselves??)
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED5

PeteHSydney, AU
I am not going to comment on your choice to use cannabis, Maureen, because it is, as you have rightly stated, none of my business. I would, however, commend the following papers to you:

Hashibe M, Morgenstern H, Cui Y et al. 2006.
Marijuana use and the risk of lung and upper
aerodigestive tract cancers: results of a population-based
case-control study. In: Cancer Epidemiol
Biomarkers Prev, 15, 1,829–1,834 p.

Aldington S, Harwood M, Cox B et al. Cannabis use
and risk of lung cancer: a case-control study. In: Eur
Respir J, Feb, 31(2), 280-286 p.

Rickert W, Robinson J and Rogers B. 1982. A comparison
of tar, carbon monoxide and pH levels in smoke from
marijuana and tobacco cigarettes. In: Can J Pub
Health, 73, 386–391 p.

Mittleman MA, Lewis RA, Maclure M et al. 2001.
Triggering myocardial infarction by marijuana. In:
Circulation, 103, 2,805–2,809 p.

Lee MH and Hancox RJ. 2011. Effects of smoking
cannabis on lung function. In: Expert Rev Respir Med,
Aug, 5(4), 537-546 p; quiz 547 p.

Tetrault JM, Crothers K, Moore BA et al. 2007. Effects
of Marijuana Smoking on Pulmonary Function and
Respiratory Complications: A Systematic Review. In:
Arch Intern Med, Feb 12, 167(3), 221-228 p.

I could go on…

There is abundant evidence that cannabis smoking has serious cardiopulmonary and immunological sequelae, not to mention the potential psychiatric effects. By all means, smoke it but don’t claim that it’s harmless. It’s not.
Sept. 10, 2012 at 10:51 a.m.

DanArlington, VA
Hip hip hooray for you Maureen; you’re the woman!
Sept. 10, 2012 at 10:51 a.m.

Gerrykingston, canada
There are hundreds of research centres. Then there are Winnipeg, Minnesota/St. Paul and Atlanta. Quit smoking is easy. Maybe America get in the face of of public schools cafetirias (sp).
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED2

Ron DayBloomington, IN
It always seemed to me rather unclear, other than as historical and sociological prejudice, that cancers were classified morphologically. For one, where exactly do the lungs or colon or breasts begin and end??? It is like the 19th century study of organisms as distinct based on morphology, rather than as historical/evolutionary expressions. Sure, one can say that a certain organ’s cell appears cancerous, but that hardly tells you that the cancer is a cancer _of that organ_, that is to say that the cancer mutation of that cell is the causal origin of the cancer, rather than an expression of a more fundamental mutation that may, if the conditions are right, be shared with other organs throughout the body though it may or may not be expressed as a cancerous mutation. The whole thing seemed illogical, though that hardly seems to have mattered given the sociology of cancer research and treatment, organized by morphological epistemologies. Perhaps the thinking on this is changing and somehow can change the NIH and the whole sociology of cancer research and treatment. Let’s hope. Many lives can be saved and many have been lost. Sometimes ‘science’ is misled by poor _a priori_ assumptions, which are kept out of the doing of science by the ver practices of science. Perhaps this is the case here and we can learn a lesson elsewhere in science/engineering, as well?
Sept. 9, 2012 at 5:08 p.m.RECOMMENDED3

MetastasisChapel Hill, NC
How about that! You’re smarter than all of the cancer researchers!

Morphological characteristics and tissue of origin were the only available diagnostic criteria until very recently. Don’t you remember how long and how expensive it was to get the human genome sequence, just 11 years ago? Well, it’s taken this long to get sequencing on the scale and cost where these kinds of questions could even be asked. People speculated about profound genetic differences all along, but without the tools to find them.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED3

Marc SchaefferlWyckoff NJ
One wonders whether cancer patients of modest means or with bare bones insurance or unable to receive treatment beyond a community hospital will be able to get the genetic analysis of their tumors that will permit them to receive genetically targeted treatments? Media reported that Steve Jobs spent $100k on DNA analysis of his tumor.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED13

RobertNew Hampshire
Mitt will give each of us a coupon which we will take to the nearest Consortium and knock on the door for enrollment, right? The unfortunates with lung cancer will be fortunate if the coupon covers the entry costs along with all other healthcare costs, for sure.
Sept. 9, 2012 at 6:54 p.m.RECOMMENDED9

SMLNew York City
And guess what? He died anyway.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED2

PhytoistN.j.
Moment,spot/place & the way life would end is carved in every living organism’s destiny of chart-no one ever gonna win over it. Only thing HUMANBEINGS can do is follow the scientific treatment course to ease pain associated with a disease,pray god,keep doing good in life & give up extreme greed. Look @ Leno,who took 50% salary cut to avert lay off amongst his working staff,he deserves our congratulations good wishes from fellow workers.
Sept. 9, 2012 at 11:07 p.m.

chesterNY
Tapas Fleming, an LA Acupuncturist, healed her own breast cancer (stage 3) using an acupressure technique she developed. She had only 3 of an anticipated 20 chemos. She has been cancer free for 8 years.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED2

CycledocEverson WA
Be skeptical of such reports. Such chemotherapy is often offered to prevent recurrence after surgery rather than to treat advanced disease. Often times these patients have a limited risk of recurrence even without treatment. It would not be surprising that an individual would have such an outcome.

On the other hand, if you took 100 patients who had a 50% risk of recurrence and treated them to prevent recurrence, only 25 or so would recur. The treatment has utility but trying to evaluated it’s efficacy in an individual case, unless there is measurable disease, has not validity.
Sept. 9, 2012 at 6:29 p.m.RECOMMENDED4

DanArlington, VA
All these billions spent on cancer research with so little to show for it when there are a host of natural treatments that prevent cancer and actually cure it. The problem is that natural treatments are cheap and won’t megamillions for pharmaceutical companies and oncologists, and won’t offer the promises of riches for researchers that come up with new drugs. Even something such as the use of some chemotherapeutic drugs in combination with DMSO, which targets glucose-hungry tumor cells is not widely used because it only requires a tenth of the chemo. Surprise, that’s only a tenth of the profit. Or how about intravenous vitamin C; gee, too cheap! Or how about Burzinski’s anti-neoplaston therapy: no, too cheap. And where’s the FDA in all these? Out protecting the pharmaceutical companies, the FDA’s master.Then, there is Essiac tea; again, too cheap.

Instead of continuing to spend our future on cancer research that only focuses on therapies that will reap billions, let’s spend more on research that will reap billions in saved health care costs.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED8

KTBCaliforniaNYT Pick
As someone who works for a major biotechnology company responsible for developing targeted therapeutic proteins, I am sometimes struck by the general misunderstandings the public harbors concerning scientific methodology, the applications and scope of personalized medicine, and the ability of “cheap” or “natural” remedies to meaningfully address disease conditions.

First of all, there are many substances, primarily small-molecule “chemicals” (which might include chemotherapeutic agents such as methotrexate as well as substances such as vitamin C) that exhibit cytotoxicity in vitro. One could technically claim, in these artificial circumstances, that concentrated antioxidants (for example) kill cancer cells. The problem is that when these agents are generally distributed within a living body, they tend not to discriminate between cancer and regular cells, and the effects can be detrimental to the organism as a whole. Targeted therapies seek to attack a single aspect of cellular expression that is typically, or predominantly, an attribute of abnormal cellular proliferation. An example would be an anti-VEGF drug, which acts by inhibiting the formation of vascular supply routes to rapidly proliferating cell bodies (such as cancer), but has minimal effects on normal tissues.

Second, each of these biopharmaceutical drugs undergoes extensive characterization and testing in an attempt to thoroughly understand the mechanism of action. The same cannot be said for natural remedies.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED12

MetastasisChapel Hill, NC
Really? Name one that has been proven. Just one.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED5

PeteHSydney, AU
None of the “treatments” you mentioned are promoted as cancer therapy, Dan, because none of them have been shown to work. Period.
Sept. 10, 2012 at 10:51 a.m.

Dave WymanLos Angeles
The headline of this article is misleading, as we don’t find out until we are well into it that target therapies work with people who have adenocarcinoma lung cancers.

My wife takes pill each day that acts on the specific lung cancer cells that she has, cells genetically different than the lung cancer cells most people. She’s been cancer-free for 20 straight months (the drug: Tarceva).
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED3
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KTBCaliforniaNYT Pick
Tarceva is one of the drugs that we make. Another drug is Herceptin. My mother took Herceptin for stage 3C breast cancer (she was a high-expresser of the HER-2 gene) and was cancer free for another 6 years. Her quality of life during this period was normal in every respect. Because it is my profession, and because I have seen the results of these drugs first hand, I will defend their development and appropriate use strenuously. They are expensive because the scientific and technological challenges and regulatory requirements are extraordinarily difficult to surmount, not because these companies want to gouge sickened individuals. Our primary goal is to develop safe, pure and effective treatments for significant unmet medical needs, and the entire business model is predicated upon meaningfully improving disease outcomes in patients.

I hope your wife remains in remission, and I am glad every time I hear of a successful outcome with any of these drugs. It is personally meaningful to me.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED12

LauraNew York
@KTB, my father was a leading researcher on the drug that eventually became known as Gleevec, and was telling me 15 years ago that genetic testing (but first, the availability of cheap genetic sequencing) was the key to defeating cancer. Unfortunately and ironically, he died of cancer before Gleevec was in clinical trials. But I share many of your sentiments – the lack of general science knowledge in the public (especially those who rant about Big Pharma withholding cheap lifesaving remedies from cancer patients) and the pride in hearing of someone who had extra time with their loved one because of the drug my father helped develop.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED2

LBSDel Mar, CA
My brother has been living a pretty normal life for 6 years after being diagnosed with stage 3B non-small cell lung cancer. After initial chemo and radiation, he has been taking Tarceva. The tumor is still there, but so is he.

So sometimes it works.

His medical care is with Kaiser.
Sept. 10, 2012 at 10:51 a.m.

maureennova scotia
The anecdotal evidence from people suffering from this lung cancer and about their unlawful use of cannabis to treat themselves show that they have had amazing results from its use; likewise, people suffering from brain cancers and other types of cancers as well, report remission of their symptoms and tumors. The scientific research bears them out, but the study of this modality has been stifled by the the insane war against drugs in the U.S. (just one of the countries many wars). The study of medical marijuana was stopped in the United States in 1974! They suppressed, at that time, the emerging evidence of the efficacy of marijuana in the treatment of cancers. Now researchers in other parts of the world are studying this drug with promising results.

At best, marijuana, despite media and government propaganda to the contrary is less harmful that other recreational drugs (esp. the use of alcohol).

Why won’t the government allow adults the right to make this choice for themselves without fear of prosecution?
Sept. 9, 2012 at 3:59 p.m.RECOMMENDED17
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chesterNY
Do lung cancer patients smoke this medical marijuana?
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED1

Paul CometX NYCNew York
Maureen wrote: “They suppressed… the emerging evidence of the efficacy of marijuana in the treatment of cancers.”

She forgot to mention the source of that evidence. Was it High Times magazine?
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED3

MetastasisChapel Hill, NC
Again, show me. Such a potent cure must surely be documented, right?
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED1

BrodstonGretna, Nebraska
There must be hundreds of separate research centers in the United States all working on cancer cases. Why aren’t we concentrating all the resources into two or three megacenters or at least coordinating the work? The present system of scattering resources about seems like wellfare for academics and fund raising entities. In regards to smoking, this despicable addiction (which is also subsidized by the American taxpayer in the form of agricultural subsidizes to those who grow tobacco) raises the incidence of all forms of cancer but especially lung and oral neoplams. Second hand smoke has also been implicated. Statistical analysis confirms that It also contributes to emphysema, asthma, sinusitis, all forms of pneumonia, fatal house fires and car wrecks.
Sept. 9, 2012 at 3:59 p.m.RECOMMENDED7

Katelyn B.Atlanta
I think you’re misunderstanding how biomedical research works. Research is always collaborative, regardless of whether it’s taking place at different centers. All research builds off of previously published work, and centers do in fact communicate, share data sets, etc.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED7

workerbeeFlorida
Indicated but not stated explicitly is that there is still no cure for cancer, only treatments, most of which remain experimental, and cancer specialists never know for sure if a particular treatment will be successful on any particular patient. A lot of money is being spent on cancer research but the results so far are not encouraging. This article provides a reason for hope but not much else. Rarely mentioned as a cause of cancer is the excessive use of xrays of the chest area, especially lung and breast xrays which are promoted as preventive measures.
Sept. 9, 2012 at 3:17 p.m.RECOMMENDED11
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KRCWA
I’ve been cancer-free for almost 40 years. I would say I am cured. It depends a lot on the type of cancer.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED4

Katelyn B.Atlanta
Marc makes an excellent point. “Cancer” is not really one disease. It simply describes cells in the body that are growing out of control. The causes for cancer–and thus the treatments–are hugely variable. We are thus not necessarily looking for THE cure to cancer, so much as we are looking for many different cures for many different cancers.
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED10

schbrgdallas, texas
Having had cancer, I can tell you that oncologists are acutely aware of the carcinogenic properties of x-rays and scans….hence their recommendations of MRIs if you many cancer check-ups in your future.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED1

SusieQNew York
This is why we should also be investing in more stem cell research – we’ll have the ability to tailor drugs to the individual – www.nyscf.org – the New York Stem Cell Foundation is a privately funded not for profit that is advancing work in this area.
Sept. 9, 2012 at 3:17 p.m.RECOMMENDED6

Mary AnnNYS
Three of the first five comments wrote “quite” when what they meant is “QUIT smoking.” One comment I assume a typo, in three comments, it’s a pattern.
Sept. 9, 2012 at 3:17 p.m.RECOMMENDED6

PatrickLong Island NY
You’re right! It went right past me, thanks. I use the word quite very often. Take care, pat

QUIT SMOKING!

How’s that?
Sept. 9, 2012 at 3:59 p.m.RECOMMENDED3

Mary AnnNYS
QUIT SMOKING is great Patrick! take care as well.
Sept. 10, 2012 at 11:06 a.m.RECOMMENDED1

KDGreat Falls, Va.
Great news for lung cancer patients. Amazing developments in the works with reports on Friday of experimental drug Bavituximab doubling survival rates in cancer patients at Stages 3/4.
http://articles.chicagotribune.com/2012-09-07/lifestyle/sns-rt-us-peregr…
Sept. 9, 2012 at 2:29 p.m.RECOMMENDED4

EinsteinAmerica
This is very interesting research.

“While as many as 30 percent of adenocarcinoma patients never smoked, well over 90 percent of squamous cell cancer patients are or were smokers.”

The question is : would these genetic abnormalities still result in lung cancer even if none of the patients ever smoked?
Sept. 9, 2012 at 2:29 p.m.RECOMMENDED4

David MarkunArlington, MA
The abnormalities are in the cancer cell lines, but are not found in the normal cells of the patient. We tend to think of DNA as being identical in every cell of a multi-celled organism, but this is true only if every cell division is carried out with perfect accuracy. Mutations arising during cell division in certain cell lines created these abnormalities — and smoking has been shown to be an effective way to promote such mutations. In short, these are not genetic abnormalities as we normally think of them: abnormalities inherited from the parents.

So the short answer to your question is: These genetic abnormalities almost never occur without diligent smoking. By smoking, you can rise above your ho-hum genetic heritage and create an exciting, expensive, fatal cancer mutation.
Sept. 9, 2012 at 3:17 p.m.RECOMMENDED9

schbrgdallas, texas
Yes, what smoking does is to increase the probabilities of developing cancer, and not just lung cancer.

Essentially, the two critical gene families involved in oncogenesis are proto-oncogenes and tumor suppresor genes. Inclement mutations to the DNA bases, and/or epigenetic factors in some cases, can bring about a fully cancerous cells.

Proto-oncogenes, for example, are some of the most evolutionary-wide genes in existence as they control cell division. And when I say “evolutionary-wide” I mean almost all multi-cellular organisms, and even single cell, such as yeast. Which is why yeast is a model organism for studying cancer.
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED1

EinsteinAmerica
David Markun-

Let’s not leap to conclusions.

Since when is 30% ‘almost never’?

Is it possible that the underlying problem in all these cases is with their DNA repair mechanisms not with smoking by itself?

Why does smoking NOT always lead to fatal cancer mutations in all smokers?
Sept. 9, 2012 at 11:07 p.m.RECOMMENDED1

PatrickLong Island NY
If you quite smoking, there will be immediate health benefits. There will be less chance of a heart attack.
Sept. 9, 2012 at 1:51 p.m.RECOMMENDED8

Frank LanguageNew York, NY
Not everyone gets lung cancer from smoking or even secondhand smoke; Donna Summer, who died this past year, was convinced her lung cancer had come from her proximity to Ground Zero. We’ll probably never know that one for sure, but Andy Kaufman—a non-smoker—also died from lung cancer.
Sept. 9, 2012 at 3:17 p.m.RECOMMENDED2

Connect::the::DotsNYC
Frank –

Many performers have spent decades breathing second hand smoke in nightclub settings….
Sept. 9, 2012 at 3:59 p.m.RECOMMENDED4

PatrickLong Island NY
Do it for the money! I quite smoking cold turkey 13 years ago and it was much easier than I thought it would be after smoking two packs of cigarettes a day. I love to see the cigarette prices in the store now. Here, the price is about 10 dollars a pack. That means at two packs a day, I’m saving 600 dollars a month or 7,200 dollars a year. That’s pretty good incentive to quit, don’t you think?
Sept. 9, 2012 at 1:51 p.m.RECOMMENDED30

Kate MadisonDepoe Bay, Oregon
How about a larger, more effective campaign to STOP smoking? This is the major issue! I really do believe that an ounce of prevention is worth a pound of cure. Especially with smokers and lung cancer! Let us get real.
Sept. 10, 2012 at 10:51 a.m.RECOMMENDED1

Gerrykingston, canada
I know, I know, I know. Come Monday morning we will be back to what the Kardishians are doing. Still, this is a pretty cool article.
Sept. 9, 2012 at 1:51 p.m.RECOMMENDED10

PatrickLong Island NY
Fabulous news and this is why I still support pharmaceutical research investment. Don’t smoke cigarettes because if you do you have a one in three chance of dying, and if you quite now, it will take about ten years for your lungs to clear the residue and you will have a far greater chance of living a long life.
Sept. 9, 2012 at 1:51 p.m.RECOMMENDED11

WMSnodgrasEl Paso, TX
Hi Patrick,

Where did you find information documenting healing process of the lungs over time, following the cesation of smoking?
Sept. 9, 2012 at 5:07 p.m.RECOMMENDED1

PatrickLong Island NY
Howdy WM at the pass

I took a course in Respiratory therapy many years ago. That knowledge helped me quit smoking.
Sept. 9, 2012 at 8:09 p.m.RECOMMENDED1

Crazy EddieNew York, NY
“While as many as 30 percent of adenocarcinoma patients never smoked”. Can anyone confirm that second hand smoke has been factored out on this percentage?
Sept. 9, 2012 at 1:51 p.m.RECOMMENDED11
Comments are no longer being accepted. Please submit a letter to the editor for print consideration.
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So the fact that Mother Nature’s compounds are cytotoxic in vitro is admitted, but the claim is that they become unselective in vivo? And that this doesn’t apply to chemo?

Have to study this comment thread carefully, since iot shows that the alternative is not dormant in the minds of many.

Meanwhile here is the Times bio of this delightfully receptive and warm hearted correspondent:

My focus at The Times is on science and medicine and my training is in science — I studied molecular biology on the graduate level at M.I.T. for a year and a half and have a masters degree in applied mathematics from the University of Maryland.

My work at The Times has led me to be a Pulitzer finalist twice — for investigative reporting in 2000 and for explanatory journalism in 2010. Other writing awards include ones in 2010 from the Silurian Society for a series on the war on cancer, and from the Associated Press Sports Editors for writing about the Caster Semenya intersex controversy at the world track championships.

In previous years I have received awards from other groups, including the American Association of Health Care Journalists, and the University of Maryland, which gave me a Distinguished Alumnus Award. Bowdoin College gave me an honorary doctoral degree. And I was made a Kentucky Colonel, just like Col. Sanders.

I have written several books, including Rethinking Thin: The New Science of Weight Loss and the Myths and Realities of Dieting (Farrar, Straus and Giroux, 2007), which was a finalist for the Quill book awards in 1997.

I have also lectured at various universities and medical schools.

Besides working for The Times, my passions include spending time with my family, reading literary fiction, distance running, road cycling, cooking and knitting.

If you would like to contact me directly, please send an e-mail to kolata@nytimes.com.

It must be hard to investigate the briefings you get from sources that your editors view as impeccable authorities, and don’t want to alienate. But surely Kolata need not join the brigade of women who have served as stenographic science writers over the past thirty years propagandizing bad dogma with their willing and flattering pens.

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