Good Immunotherapy is Amazing at Treating Cancer — And It’s Unnecessarily Expensive

Drugs are cheap to produce — it’s things like unjust government-granted patent monopolies that allow pharmaceutical companies to charge exorbitant prices that make drugs expensive.

To quote economist Dean Baker’s latest October 2018 paper:

“Many items that sell at high prices as a result of patent or copyright protection would be free or nearly free in the absence of these government granted monopolies. Perhaps the most notable example is prescription drugs where we will spend over $420 billion in 2018 in the United States for drugs that would almost certainly cost less than $105 billion in a free market. The difference is $315 billion annually or 1.6 percent of GDP. If we add in software, medical equipment, pesticides, fertilizer, and other areas where these protections account for a large percentage of the cost, the gap between protected prices and free market prices likely approaches $1 trillion annually, a sum that is more than 60 percent of after-tax corporate profits.”

On to the article though.

Last week, researchers James Allison and Tasuku Honjo were awarded this year’s Nobel Prize in medicine for their work on cancer immunotherapies, heralded by the Nobel committee as “seminal discoveries” that “constitute a landmark in our fight against cancer.”

Immunotherapies like those developed on the basis of Allison and Honjo’s work are indeed an important step towards a whole new way to treat cancer, as well as a host of other chronic diseases. However, this Nobel award should remind us that these innovative therapies are out of reach for so many patients in the United States due to the exorbitant prices drug companies charge for them.

Just weeks before the Nobel announcement, oncologist Ezekiel Emmanuel wrote in a Wall Street Journal essay, “We Can’t Afford the Drugs That Could Cure Cancer,” that “a cure for cancer has become possible, even probable” with immunotherapies, but that our health system cannot afford their price tag. Just after the Nobel announcement, Vox reporter Julia Belluz reminded us that “the average cost of cancer drugs today is four times the median household income” (emphasis added).

Immunotherapies constitute a part of the class of drugs called biologics (as opposed to chemical pharmaceuticals) that have shown very promising results in treating many previously intractable conditions, such as multiple sclerosis, asthma, chronic pain, and Crohn’s disease, due to their ability to more precisely target individual diseased cells. Therefore it’s no surprise that currently most of the top 10 best-selling drugs worldwide are biologics.

[…]

If biologics really are the future of medicine, we must change the way prescription drugs are priced in the United States, or millions of patients will be left behind. One way to do that is to invest in public pharmaceuticals that can assure an adequate supply of and equitable access to essential medications.

Using Virtual Reality in Beneficial Ways

Virtual reality is technology that’s advancing from being fringe to something that’s gradually becoming implemented more in the 21st century. This trend will only continue with lower costs of materials for virtualization and improved software.

The way virtual reality works is obvious enough — some sort of apparatus that covers the eyes and is able to transmit visual of a virtual world is required. Virtual worlds of course will have sounds to make them more immersive, and perhaps in the future there will be an option to stimulate other senses as well. It isn’t unreasonable to expect the possibility of VR technology that somehow provides the replication of smell, taste, and feel. Eventually there is likely to be VR technology with direct brain stimulation too.

Virtual reality is often presented these days as a fun way to spend time through gaming, and while it can be beneficial to provide people with an escape that doesn’t involve hard drugs in a world that’s often crazy and fucked up, virtual reality has other uses that deserve to be known about more.

One of the most notable recent findings is a study finding that people recall information better through virtual reality. Since knowledge is power, the enhanced ability of people to recall knowledge would be helpful in a variety of scenarios, such as training people for meaningful work, keeping fond memories more effectively, and assisting in educational endeavors. This could be combined with other research finding that drawing pictures is a strong way to remember information.

Most people are not especially good multi-taskers — the research tells us that only a few percent of people are “super taskers,” or those with the ability to focus on multiple tasks well. For whatever reason this is, it’s a general principle that human beings tend to perform better when their primary focus is on one task at a given time. Virtual reality thus provides an immersive environment that should allow people to focus more on one task than a traditional 2D learning environment.

VR has been shown to reduce the fear children have for needles in one study. This makes sense due to the distraction from VR’s intense immersion. Since the fear of needles is a suffocating one for some children, something as simple as a VR experience of going to an amusement park or a beach would be immensely helpful.

There’s a problem of too many people avoiding vital vaccinations in the United States, leading to diseases that should have been extinguished in the 20th century suddenly making recurrences in certain parts of the country. This is another example of how technology can be used to solve a real problem and protect society.

VR’s distraction could be extended to surgeries where local anathesia is used, thus protecting people from pain. It has already been found that virtual reality therapy is effective at reducing pain in hospitalized patients. It isn’t entirely clear why, but it may be because the VR experience is so immersive that the brain is unable to concurrently process the pain stimuli along with the VR.

It has been theorized that people have a fixed capacity for attention, and it has also been thought that when people are expecting physical pain in the immediate future, they tend to feel it more intensely. This may be because instead of the pain being a surprise, the increased focus on it before the pain hits may cause it to be felt more strongly.

Virtual reality will also have an important role in the journalism of the future. Studies have found that VR makes journalism more immersive, such as the VR story about factory farming being successful at raising more awareness of the horrific treatment often endured by animals.

VR can thus be an effective tool at fighting corruption and injustice in an era where young people generally — for whatever reason — are reading less than past generations. It has been found that too much use of fantasy-like elements in VR distract from the realism of the story and can make them less credible, however.

VR has also been referred to as an “empathy machine.” It’s conceivable that VR could be used for rehabilitation — use of the technology has already shown promise at increasing empathy levels, and VR shows promising mental health treatment results. The immersive virtual experience of owning a body in VR space has at times shown to really have an impact at altering perceptions and making important impressions.

In sum, while interactions in real life will always have importance that’s often most meaningful, there are many ways that virtual reality may improve the livelihoods of others.

New Blood Test Offers Better or Equal Skin Cancer Detection Rate than a Biopsy

Skin cancer is the most common cancer in the world, and it’s the one that’s most easily treated when caught early. Since the blood test is less invasive than a biopsy, this new advance should be helpful in convincing more people to receive treatment early on.

It’s a world first. A newly developed blood test is capable of the early detection of melanoma, with over 80 percent accuracy.

It could help save thousands of lives, according to the Australian Edith Cowan University Melanoma Research Group scientists who developed the test.

Melanoma is the most deadly form of skin cancer, claiming 59,782 lives around the world in 2015. Australasia, North America and Europe are the regions most susceptible to the disease.

There’s good news. If caught early, the survival rate for melanoma climbs to 95 percent. But if you miss that early window, your chances will plummet to below 50 percent. This is what the blood test is designed to help prevent.

[…]

The blood test, called MelDX, works by detecting the antibodies the body produces as soon as melanoma develops. The team analysed 1,627 different types of antibodies, and narrowed them down to a combination of 10 that indicate the presence of melanoma in the body.

They then took blood from 104 people with melanoma and 105 healthy controls, and found that MelDX was capable of detecting melanoma with 81.5 percent accuracy.

More specifically, it was able to detect the cancer in 79 percent of the patients with melanoma; and has a false positive rate in only 16 percent in healthy patients.

The detection rate may actually be a little higher than the accuracy of skin biopsies, which, according to a 2012 study, was 76 percent in an Australian public hospital.

That’s not a perfect result, but it does provide a starting point before other, more invasive tests are embarked on; in conjunction with current diagnostic techniques, it could improve early diagnosis – and therefore people’s chance of survival.

The next step, the researchers said, will be to take MelDX to clinical trial, which is currently being organised, and which could help refine the test.

“We envision this taking about three years. If this is successful we would hope to be able to have a test ready for use in pathology clinics shortly afterwards,” said Melanoma Research Group head Mel Ziman.

“The ultimate goal is for this blood test to be used to provide greater diagnostic certainty prior to biopsy and for routine screening of people who are at a higher risk of melanoma, such as those with a large number of moles or those with pale skin or a family history of the disease.”

Meanwhile, there are easy ways you can help protect yourself from melanoma and other skin cancers, including wearing sunscreen, staying in the shade during the hottest hours of the day, and avoiding UV tanning beds.

Boosting Serotonin Can Speed Learning

I’m sure this research has more implications than currently realized.

Serotonin is thought to mediate communications between neural cells and play an essential role in functional, and dysfunctional, cognition. For a long time, serotonin has been recognized as a major target of antidepressants (selective-serotonin-reuptake-inhibitor (SSRIs) that are used to treat various psychiatric conditions, such as depression, obsessive-compulsive-disorder and forms of anxiety. However, serotonin in humans, and other animals, is associated with a bewildering variety of aspects of cognition and decision-making, including punishment, reward and patience.

[…]

In the experiments, mice were trained to choose one of the two targets to receive water rewards. Mice continually had to learn which of the targets was more rewarding, as the reward rates changed without warning. Crucially, sometimes serotonin release in the brain was temporarily boosted in mice with genetically modified serotonin neurons by a technique called optogenetics, allowing the effects of serotonin on learning to be assessed.

Iigaya built a computational account of mice behaviour based on reinforcement learning principles, which are widely used in machine-learning and AI. Iigaya found that the learning rate, i.e. how fast the modelled mice learn, was modulated by serotonin stimulation. He compared trials with and without stimulation of serotonin neurons, and observed that the learning rate was significantly faster when stimulation was delivered, meaning that boosting serotonin sped up learning in mice.

[…]

The authors conclude: “Our results suggest that serotonin boosts [brain] plasticity by influencing the rate of learning. This resonates, for instance, with the fact that treatment with an SSRI can be more effective when combined with so-called cognitive behavioral therapy, which encourages the breaking of habits in patients.”

Substantial clinical research shows that SSRI treatment is often most effective if combined with cognitive-behavioural-therapy (CBT). The goal of CBT is to change maladaptive thinking and behaviour actively, through sessions that are designed for patients to (re)learn their way to think and behave. However, scientists have had limited understanding of how and why SSRI and CBT work together for treatments. The new findings point to a possible functional link between the two, with serotonin boosting the learning inherent to CBT, providing clues as to one of the roles that this neuromodulator plays in the treatment of psychiatric disorders.

Some Genetic Links of Psychiatric and Neurological Brain Disorders Found

Research to improve the treatments of the future that also highlights how much there is about the human mind that isn’t yet scientifically known.

Today, we use sophisticated methods, such as DNA tests, AI analyses, and high-tech treatments, to understand brain disorders such as depression, Alzheimer’s, and schizophrenia.

But there’s still a lot of really basic stuff about these conditions that we simply don’t understand. That hinders our ability to effectively treat the hundreds of millions of people suffering from psychiatric and neurological illnesses.

In an effort to improve our understanding of brain disorders, an international team of researchers unified under the name the Brainstorm Consortium set out to determine if there’s a genetic link between different disorders.

They published the results of their study this week in the journal Science.

The first step in the study was gathering a lot of data.

First, the researchers pulled data from various genome-wide association studies (GWASs), which look for tiny variations in the human genome that crop up more frequently in people who have a certain disease or disorder than in those who don’t.

In total, the GWASs that the researchers analyzed included data on 265,218 patients with at least one of 25 brain disorders. Ten disorders were psychiatric (major depressive disorder (MDD), schizophrenia, etc.) and 15 were neurological (Alzheimer’s, epilepsy, etc.).

The GWASs also included 784,643 people not diagnosed with any of those disorders to act as control subjects.

[…]

The point of all this data? To find connections that might give the researchers clues about where else to look for information about these brain conditions, especially what they might have in common.

Once they gathered all this data, the Brainstorm Consortium researchers could start to look for those connections.

They discovered that many psychiatric disorders shared the same genome variants. Schizophrenia in particular overlapped significantly with most of the other psychiatric disorders.

The same was not true for the neurological disorders. The researchers believe this suggests that psychiatric conditions are more closely related, at least genetically, than are neurological disorders, which seem to have more distinct genetic causes.

[…]

Ultimately, better understanding the genetic connection between various disorders could improve how we treat them in the future, Pat Levitt, one of the authors of the Brainstorm Consortium’s paper, noted in a news release.

While the authors assert the need for further studies, their international collaboration puts us one step closer to understanding the human brain.

If we’re lucky, that understanding will improve how we treat disorders to such an extent that today’s “high-tech” treatment options will seem antiquated when compared to the treatments of tomorrow.

Research: Depressive Episodes Can Damage Memory

The extent of the damage depends on the severity and length of the depressive episodes. This new research gives a concrete example of why it is important to improve mental health outcomes — it turns out that depression can have directly negative effects on the brain, and there are plenty of implications for human society based on that.

During a depressive episode the ability of the brain to form new brain cells is reduced. Scientists of the Ruhr-Universität Bochum examined how this affects the memory with a computational model. It was previously known that people in an acute depressive episode were less likely to remember current events. The computational model however suggests that older memories were affected as well. How long the memory deficits reach back depends on how long the depressive episode lasts. The team around the computational neuroscientist Prof Dr Sen Cheng published their findings in the journal PLOS ONE on 7th June 2018.

Computational model simulates a depressive brain

In major depressive disorder patients may suffer from such severe cognitive impairments that, in some cases, are called pseudodementia. Unlike in the classic form of dementia, in pseudodementia memory recovers when the depressive episode ends. To understand this process, the scientists from Bochum developed a computational model that captures the characteristic features of the brain of a patient with depressions. They tested the ability of the model to store and recall new memories.

As is the case in patients, the simulation alternated between depressive episodes and episodes without any symptoms. During a depressive episode, the brain forms fewer new neurons in the model.

Whereas in previous models, memories were represented as static patterns of neural activity, the model developed by Sen Cheng and his colleagues views memories as a sequence of neural activity patterns. “This allows us not only to store events in memory but also their temporal order,” says Sen Cheng.

Impact on brain stronger than thought

The computational model was able to recall memories more accurately, if the responsible brain region was able to form many new neurons, just like the scientists expected. However, if the brain region formed fewer new brain cells, it was harder to distinguish similar memories and to recall them separately.

The computational model not only showed deficits in recalling current events, it also struggled with memories that were collected before the depressive episode. The longer the depressive episode lasted the further the memory problems reached back.

“So far it was assumed that memory deficits only occur during a depressive episode,” says Sen Cheng. “If our model is right, major depressive disorder could have consequences that are more far reaching. Once remote memories have been damaged, they do not recover, even after the depression has subsided.”

Developing Drug Impairs Process Cancer Cells Use for Growth

It looks like this will be useful later on.

A drug discovered and advanced by The University of Texas MD Anderson Cancer Center’s Institute for Applied Cancer Science (IACS) and the Center for Co-Clinical Trials (CCCT) inhibits a vital metabolic process required for cancer cells’ growth and survival.

IACS-10759 is the first small molecule drug to be developed from concept to clinical trial by MD Anderson’s Therapeutics Discovery team, which includes IACS and the CCCT. Therapeutics Discovery is a unique group of clinicians, researchers and drug development experts working collaboratively to create new treatment options, including small molecules, biologics, and cell-based therapies.

[…]

Metabolic reprogramming is an emerging hallmark of tumor biology where cancer cells evolve to rely on two key metabolic processes, glycolysis and oxidative phosphorylation (OXPHOS), to support their growth and survival. Extensive efforts have focused on therapeutic targeting of glycolysis, while OXPHOS has remained largely unexplored, partly due to an incomplete understanding of tumor contexts where OXPHOS is essential.

“Through a comprehensive translational effort enabled by collaboration across MD Anderson, we have identified multiple cancers that are highly dependent on OXPHOS,” said Marszalek.

This effort inspired the discovery and development of IACS-10759, a potent and selective inhibitor of OXPHOS. Its advancement to clinical trials was made possible by a multidisciplinary team of more than 25 scientists across Therapeutics Discovery.

“Through this collaborative, 18-month process, we identified and rapidly advanced IACS-10759 as the molecule for clinical development,” said Di Francesco. “We believe IACS-10759 will provide a promising new therapy for cancer patients.”