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posted by cmn32480 on Tuesday October 11 2016, @01:54PM   Printer-friendly
from the seems-better-then-what-we-are-doing-now dept.

Arthur T Knackerbracket has found the following story:

An immunotherapy drug has been described as a potential "game-changer" in promising results presented at the European Cancer Congress.

In a study of head and neck cancer, more patients taking nivolumab survived for longer compared with those who were treated with chemotherapy. In another study, combining nivolumab with another drug shrank tumours in advanced kidney cancer patients.

Immunotherapy works by harnessing the immune system to destroy cancer cells.

Advanced head and neck cancer has very poor survival rates.

In a trial of more than 350 patients, published in the New England Journal of Medicine, 36% treated with the immunotherapy drug nivolumab were alive after one year compared with 17% who received chemotherapy. Patients also experienced fewer side effects from immunotherapy.

The benefits were more pronounced in patients whose tumours had tested positive for HPV (human papillomavirus). These patients survived an average of 9.1 months with nivolumab and 4.4 months with chemotherapy.

Normally, this group of patients, with advanced or treatment-resistant tumours, are expected to live less than six months.

Early data from a study of 94 patients with advanced kidney cancer showed that the double hit of nivolumab and ipilimumab resulted in a significant reduction in the size of tumours in 40% of patients. Of these patients, one in 10 had no sign of cancer remaining. This compares with 5% of patients showing tumour reduction after standard therapy.

[...] As yet, nivolumab has only been approved for treating skin cancer and in June it became one of the fastest medicines ever approved for NHS use, in combination with ipilimumab, for the same cancer. Nivolumab and ipilimumab both work by interrupting the chemical signals that cancers use to convince the immune system they are healthy tissue.


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  • (Score: 0, Disagree) by Anonymous Coward on Tuesday October 11 2016, @07:29PM

    by Anonymous Coward on Tuesday October 11 2016, @07:29PM (#413069)

    You are talking about a 36% success rate for $300,000. Most people wouldn't take those odds.

    The few immunotherapy drugs I'm familiar with have insane side effects, are tricky to administer, and as such are usually used as a hail marry on the way to the grave.

    It maybe a step forward with further development, but as of now it is an insanely expensive beta.

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  • (Score: 2) by Joe on Tuesday October 11 2016, @08:51PM

    by Joe (2583) on Tuesday October 11 2016, @08:51PM (#413109)

    In this trial, there were less severe and life-threatening (grade 3 and 4) adverse events in the immunotherapy treatment group (13%) compared to standard therapy (35%). One of the reasons why immunotherapy drugs are being used in patients "on the way to the grave" is because they've been shown to still work after standard therapy has failed.

    Most people wouldn't take those odds

    Do you have a reference?

    You are projecting a dispassionate and rational perspective on people who are dealing with a very emotional topic. People often disproportionally value their own life and the lives of their friends/family, lack an understanding of odds/statistics, and have not prepared for these types of decisions.

    http://www.nejm.org/doi/full/10.1056/NEJMoa1602252#t=article [nejm.org]

    - Joe

    • (Score: 0) by Anonymous Coward on Tuesday October 11 2016, @09:51PM

      by Anonymous Coward on Tuesday October 11 2016, @09:51PM (#413134)

      And how successful were the treatments to those adverse reactions comparatively? Standard chemo has more side effects, but can be treated usually.

      You are projecting a dispassionate and rational perspective on people who are dealing with a very emotional topic.

      As it should be since there isn't unlimited resources to treat everyone, someone has to be the voice of reason asking if the cost/benefit analysis adds up.

      If people are paying this out-of-pocket, fine.

      But increasingly these types of treatments are being spotlighted as a gap between the rich and poor, and are heavily subsidized for very little benefit. $300,000 a pop pays for a ton of prenatal care or some of the very best hospice care.

      And if the average life increase is under a year, someone should be questioning the value.

      • (Score: 2) by Joe on Tuesday October 11 2016, @10:48PM

        by Joe (2583) on Tuesday October 11 2016, @10:48PM (#413149)

        I fully agree that there should be more reason involved in healthcare decisions, but I recognize that many people are not very rational about it or do not fully understand the cost/benefit of these decisions.

        And how successful were the treatments to those adverse reactions comparatively?

        Table 3 from the linked paper shows that the immunotherapy treatment had the same adverse reactions (with the exception of mild itchy skin) with a lower percentage in everything except mild rash.

        It is also worth noting that the average life expectancy is not the full picture because there is a large variation in the treatment effectiveness across individuals. While everyone hopes that they would be part of the 10% of responders that completely clear the cancer, I expect that we will be able to better understand what accounts for the variation and better choose which patients it is a realistic option for or how to modify treatment strategies to increase their effectiveness.

        - Joe