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.
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.
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).
It seems relevant here because the question was “How will this potentially help me if I get cancer?” and the answer is “Not at all unless you get a particular form of cancer that this applies to”.
> 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.
> Except people don’t ask “what if I get bacteria” the way they ask about cancer.
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.
I agree with you about the media. Cancer is often presented as a monolithic thing by the media. I don’t agree at all about experts. Doctors and scientists who research cancers do not lack nuance.
Oncologists are actually way more specific than even that. Because there are many forms of breast cancer and different treatments depending on the type.
But yeah, oncologists aren’t telling people “you have cancer” the way they might say “you have MRSA”.
Yeah, it's WAY more specific. We got a genetic breakdown, multiple pamphlets on the drugs being used, what they are targeting, and why they work (along with the risks).
Honestly, I think people probably get false impressions because cancer usually hits old people and old people are, frankly, often not reliable narrators.
I understand where you are coming from here, but I think it is helpful for people to overtly grasp that there are very different cancers, very different treatments, and indeed very different outcomes.
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.
The other part that is simply missing is that cancer, very unfortunately, evolves and mutates. That's how you go from a cancer that responds to treatment to one that is treatment resistant.
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.
>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?
The next 1-5 years will tell us which cancers this new drug will work well on, right now it's only been tried in pancreatic cancer when people have failed their first treatment. The new drug from the article, daroxonrasib, has nine trials i see currently, here:
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.)
I think the meaning is that because we can see success with KRAS mutation of pancreatic cancer, we can now begin clinical trials for other cancers that may have KRAS mutation (colorectal, lung) and see if there is success there. If there is success in treating other cancers during clinical trials, it could be fast tracked through FDA to be more generally available and then become part of the national treatment option (ideally in 1-5 years after clinical trials).
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.
For every cell mechanism that's being abused by cancer to fuel its growth, there are other cells in the body for which that mechanism is crucial for their correct functioning. Wholesale editing every cell in the body mostly guarantees that the patient does not die of cancer -- the cure will kill them before the disease does.
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.
Please remember that science is under attack in the United States - new proposals would gut the nih even beyond the horror that is ongoing. As a scientist I am horrified and I truly hope that we don’t abandon the usas historically strong investment in the future.
1. Trump has been trying to cut Science budgers by larger percentages for a while now. Congress has not let them.
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.
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.
Another ongoing HN thread from yesterday around some exciting cancer treatment breakthroughs, this time with a CRISPR Cas12a2 mechanism: https://news.ycombinator.com/item?id=48505231
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!
I’m surprised Michael Levin’s research hasn’t expanded much beyond a certain YouTube media bubble. They’re able to start and stop cancer growth with only voltage changes between cells, likewise they can also trigger regeneration or anatomical changes using voltage changes. His research seems to suggest a lot of important anatomical plans are stored in an electric field around the body, not in the DNA. This model’s explanation for cancer is that some cells become disconnected from this field and start growing independently of the overall body plan.
His 2021 paper has over 520 cites. How is this not considered expanding on his work? It's been 5 years, and the story is never as simple as presented initially. Never.
Although, looking through the first 6 pages of cites from this year, he is a coauthor on almost every one of them....
I love his work (even though I know little more than what he says in interviews). I am also surprised it's not more widely known / applied. I am very skeptical of conspiracy-minded thinking, so I'd much rather assume his and his team's work hasn't reached escape velocity from obscurity. Especially with larger industries, it takes time and significant breakthroughs to become "a household name", so to speak.
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.
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.
> 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).
It seems relevant here because the question was “How will this potentially help me if I get cancer?” and the answer is “Not at all unless you get a particular form of cancer that this applies to”.
> 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.
> Except people don’t ask “what if I get bacteria” the way they ask about cancer.
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.
I agree with you about the media. Cancer is often presented as a monolithic thing by the media. I don’t agree at all about experts. Doctors and scientists who research cancers do not lack nuance.
Is it? I'm pretty sure oncologists will say "you have stage 2 breast cancer," but I wasn't in the room at the time.
Oncologists are actually way more specific than even that. Because there are many forms of breast cancer and different treatments depending on the type.
But yeah, oncologists aren’t telling people “you have cancer” the way they might say “you have MRSA”.
Yeah, it's WAY more specific. We got a genetic breakdown, multiple pamphlets on the drugs being used, what they are targeting, and why they work (along with the risks).
Honestly, I think people probably get false impressions because cancer usually hits old people and old people are, frankly, often not reliable narrators.
I understand where you are coming from here, but I think it is helpful for people to overtly grasp that there are very different cancers, very different treatments, and indeed very different outcomes.
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.
The other part that is simply missing is that cancer, very unfortunately, evolves and mutates. That's how you go from a cancer that responds to treatment to one that is treatment resistant.
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.
The problem is the similarities of cancer to normal cells. We have penicilin that works against all human cells. We call that poison.
Now, "no, i mean poisons that attack the special chemistry of cancer," oh yes, those we call chemo.
For chemo it's often "these chemicals kills cancer cells faster than they kill regular cells".
Benign cancers are a thing. They might not kill like they show in the Hollywood movies, but your quality of life will be significantly diminished.
>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?
The next 1-5 years will tell us which cancers this new drug will work well on, right now it's only been tried in pancreatic cancer when people have failed their first treatment. The new drug from the article, daroxonrasib, has nine trials i see currently, here:
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.)
I think the meaning is that because we can see success with KRAS mutation of pancreatic cancer, we can now begin clinical trials for other cancers that may have KRAS mutation (colorectal, lung) and see if there is success there. If there is success in treating other cancers during clinical trials, it could be fast tracked through FDA to be more generally available and then become part of the national treatment option (ideally in 1-5 years after clinical trials).
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.
For every cell mechanism that's being abused by cancer to fuel its growth, there are other cells in the body for which that mechanism is crucial for their correct functioning. Wholesale editing every cell in the body mostly guarantees that the patient does not die of cancer -- the cure will kill them before the disease does.
That was a really good summary, thank you.
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.
Please remember that science is under attack in the United States - new proposals would gut the nih even beyond the horror that is ongoing. As a scientist I am horrified and I truly hope that we don’t abandon the usas historically strong investment in the future.
Kindly share more details
1. Trump has been trying to cut Science budgers by larger percentages for a while now. Congress has not let them.
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.
To offer context for others:
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.
What's next then?
Other cancers, obesity, name it.
https://archive.ph/d4mT2
The relevant line is:
"oncologists went wild over the results of a drug called daraxonrasib."
https://en.wikipedia.org/wiki/Daraxonrasib
Does anyone have a link to the conference session?
The study this article references is here: https://clinicaltrials.gov/study/NCT06625320
Another ongoing HN thread from yesterday around some exciting cancer treatment breakthroughs, this time with a CRISPR Cas12a2 mechanism: https://news.ycombinator.com/item?id=48505231
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!
I’m surprised Michael Levin’s research hasn’t expanded much beyond a certain YouTube media bubble. They’re able to start and stop cancer growth with only voltage changes between cells, likewise they can also trigger regeneration or anatomical changes using voltage changes. His research seems to suggest a lot of important anatomical plans are stored in an electric field around the body, not in the DNA. This model’s explanation for cancer is that some cells become disconnected from this field and start growing independently of the overall body plan.
His 2021 paper has over 520 cites. How is this not considered expanding on his work? It's been 5 years, and the story is never as simple as presented initially. Never.
Although, looking through the first 6 pages of cites from this year, he is a coauthor on almost every one of them....
I love his work (even though I know little more than what he says in interviews). I am also surprised it's not more widely known / applied. I am very skeptical of conspiracy-minded thinking, so I'd much rather assume his and his team's work hasn't reached escape velocity from obscurity. Especially with larger industries, it takes time and significant breakthroughs to become "a household name", so to speak.
Thanks for posting useful link !