WATTBA: Gene That Spreads Cancer Through the Body Identified
Mostoslavsky and colleagues first compared gene expression patterns in primary versus metastatic tumors in mice with pancreatic cancer or breast cancer. After identifying various genes whose expression increased in metastatic tumor cells, the researchers silenced each gene individually.
In these experiments, silencing the Gstt1 gene had no effect on primary tumor cells from mice, but it stripped metastatic cancer cells of their ability to grow and spread. It also blocked cell growth in two metastatic-derived human pancreatic cancer cell lines.
That is from Mass General, and I do not think I will read a more cheerful article today. I am very far away from being an expert in this field (or any field, for that matter, for I strive to be truthful), but it does seem as if we are making progress in terms of trying to figure out how to stop the spread of cancer.
I got this from The Not Boring Newsletter, and if you haven't already, you should consider subscribing. As Packy so memorably put it (and you'll have to forgive me the profanity, but I happen to share Packy's views on the matter):
The next step would be developing a therapeutic that can safely and effectively silence the Gstt1 gene.
Fuck cancer. Fuck metastasis. Go science.
Speaking of subscribing to his newsletter, there are two other medical discoveries that Packy speaks about, the first of which will help us cure hereditary deafness in young children (seriously, WATTBA!), and the second will "modestly slow cognitive declines in patients with early stage Alzheimer's".
Now, that's the good news: modestly slow cognitive declines. And you might think that it isn't much of good news, because there is only a modest amount of slowing down. But it gets worse, because this was the good news. The bad news is worse: the drug comes with significant risks, including bleeding and swelling in the brain.
If you take the benefits and the costs into account, this seems like... not good news at all, right?
Well, that depends, because remember, one of the magic questions you should always be asking is "Relative to What?".
And for a patient with a diagnosis of Alzheimer's - a horrible disease with no known cure currently - yes, even this development is good news, and potentially worth the risk.
The question was whether that 4½ to 7½ slow-down was worth the relatively substantial risks of the drug. Alzheimer’s is a nasty, sad disease that currently has no cure. The committee approved the drug because, well, it ultimately decided that in the context of Alzheimer’s even a slight slow down of decline outweighed potential risks.
Donanemab still requires final FDA approval, but when and if it that occurs, the drug should become available to early stage Alzheimer’s patients. Of the current 6 million Americans currently suffering from the disease, approximately 50% are in early enough stages that donanemab could have a positive impact.
We love to see a common sense risk-benefit analysis from the FDA that takes both the risks and the benefits into account. Let’s get this drug live!
Opportunity costs, as any student of economics will tell you, are everywhere. Is it worth risking brain swelling and bleeding in order to stop a common cold? Definitely not. But is it worth it to stop (even if by a modest amount) Alzheimer's? Trickier question, and we may forever be unsure of the correct answer - but surely we can all agree that it isn't "Definitely not".
WATTBA for the win!
Apologies for the long radio slience - I was away in Manipal in the month of May, and then got sucked into a whirlwind project that turned out to be a whole lot of fun.
But I'm back in the saddle now, and hope to stay there for the foreseeable future.