Comment by gcanyon
1 day ago
As is often the case, the title is hyperbolic. The discovery applies to 20% of tumors, and "one of cancer's significant defenses" or "a key weakness of cancer" would be more accurate.
That said, I'll happily take "we discovered a key weakness in 20% of cancers," please and thank you.
20% is still a huge number. (Your comment also acknowledges this of course. That just popped out at me.)
Not hyperbolic, just incomplete ... this drug inhibits the KRAS mutation that is the "master switch" for 90% of pancreatic cancers and 50% of colon cancers. KRAS was considered "undruggable" so this is a huge breakthrough which is why oncologists gave a standing ovation for nearly a minute in the middle of a talk, with some of them in tears.
Aren't those 20 per cent of tumors more concentrated on the "intractable" side? If so, then the hyperbole is forgivable.
It does seem like those 20% are exactly on the nasty side. So even more impressive.
I'm no expert, and don't know if it applies in this case, but for a cancer I had (lymphoma) I was told that aggressive can often be easier to treat or "cure" (as defined by survival rates, etc.) since it also can often be hit more brutally by the treatments.
Anyway, since many in my family have died from this horrible cancer, its fantastic news to hear of any improvements there.
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What does this mean in layman's terms? How will this potentially help me if I get cancer?
Cancer is not one thing, it's a huge zoo of many many many ways that cells start to break the social contract and divide in an uncontrolled manner.
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.
How does it avoid targeting KRAS in healthy cells? Or is this another form of chemotherapy where we're trying our hardest to deliver the right amount of poison that kills the cancer before it kills the rest of you?
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>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,
Can you help disambiguate this? Are there treatments now, or are there potential treatments with trials in 1-5 years?
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That was a really good summary, thank you.
Can we end up with a situation like antimicrobial resistance, where cancer itself evolves to resist these new treatments?
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Thanks for the explanation!
The golden panacea for this would be a gene editing mechanism that will work in every cell in the body. Once we have something we can do whole hog gene replacement, most human health problems would be solved forever.
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> Cancer is not one thing,
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).
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It won't help... mind you this is an article from the economist. There is no such thing as a cancer "master switch", that would equal a disease master switch and that point we have solved biology.
What do you mean “it won’t help”?
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.
One of the many therapies that are being developed so that you can survive longer even with the most lethal tumours.
Only on HN can you get content like this. What a community.
You should be thankful that they're posting about a real drug that is in human trials and yet another "in mice" pipedream