So the last two blog entries have painted a bleak picture on the anti cancer drug development process.
I do not think that the picture need to stay dark and there is some reason to hope that things will change in the future. Furthermore, there are certainly some gains and headway being made in the US, Europe and some parts of Asia in terms of new ideas coming into the pipeline and so on. So, things are not all doom and gloom. In fact, the best gains have been made with early detection of breast and prostate cancer, vaccines against HPV in preventing cervical cancer and finally with non smoking campaigns which are finally seeming to sink in.
However, where do we go from there with drug companies and researchers. Here are some suggestions. Reward risk takers. Fund researchers who are not following the herd…give money to those who think outside of the current dogma. Fund project that reward groups of researchers working together in unique ways to uncover overlapping and interrelated pathways so that more patients may benefit instead of just a few. Program project grants are awarded by the NIH, but at much lower levels that the PI initiated grants (a PI is a principal investigator usually working on his or her own lab). Fund projects that combine drugs and or that look at multiple pathways, not just one as is very typical. Stop funding in such large amounts ‘me too’ research that uses the same mouse models that are injected with human tumors and that look at tumor shrinkage as an end point.
We need to pressure the FDA to remain vigilant for safety but to start taking some risks as well. 1) Why not allow clinical researchers to start with patients who starting treatment for the first time to be placed in clinical trials instead of those who have failed all forms of treatment? 2) Why not allow multiple forms of therapy to be used at the same time (yes I realize that it makes for a highly complex statistical task and does add risk, but may prove to be much more affective at helping to ‘cure’ a patient’s cancer? 3) Why not allow new classes of drugs to be tested even if we don’t have tons and tons of data on it?
For the legal community and tort law, well this is a tough one….how to minimize this. We have got to put some sort of halt on the legal community in conjunction with the drug companies for allowing companies to ‘patent’ or hold legal rights to the combinations on drugs. this push by the legal community to allow this drives up the cost of the drug and almost always prevents it from getting marketed due to arguing by companies and such. The cost of all the litigation is in part driven by the FDA and the patient care issues. We should think about revising the entire legal tort law process for cancer drugs. This again is not easy and will cause much pain but will also lower costs and speed up the process of getting promising drugs to the patient.
As we age as a population, we are going to see cancer becoming more and more prominent. As I have mentioned over and over again, complete cures for cancer is not an achievable goal for the forseeable future. HIV patients now live for a long-long time with AIDS but are not cured. That is one disease. Cancer is many. But, for sure we can make headway in preventing cancer and keeping it at bay once it is detected. Early treatment can be something that is promoted at the clinical schools and in public health initiatives. People will continue to die of cancer, but perhaps they will die of it in old age and not young. Perhaps their quality of life can be enhanced and perhaps we can find drugs that are less toxic but very effective.
Thanks for reading this blog and this series of ‘War on cancer’. Please look out for more entries and do visit my cancer made simple page.