Personalized Cancer Vaccines Safely Fight, Kill Tumors In Early Human Trials (arstechnica.com)

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Personalized Cancer Vaccines Safely Fight, Kill Tumors In Early Human Trials (arstechnica.com)

Posted by BeauHD on Thursday July 6, 2017 @10:00PM from the custom-made dept.

Emily Mullin reports via MIT Technology Review: Now two personalized cancer vaccine approaches appear to have safely prevented cancer relapse in a dozen patients with late-stage skin cancer. In recent years, scientists have realized that each patient's tumor harbors a unique set of genetic characteristics, or mutations. So for cancer vaccines to be effective, they'll probably also have to be unique. Two clinical trials, detailed today in separate papers in Nature, are among the first to show that this might be possible. In one trial, eight of 13 melanoma patients who got a personalized cancer vaccine were tumor-free nearly two years after being treated. In a smaller study, four of the six patients who received a vaccine had no detectable cancer for more than two years after treatment. All patients had their tumors surgically removed before getting the vaccine. The customized vaccines are an emerging class of therapies that take advantage of neoantigens, proteins that appear on tumors and seem to be specific to each cancer patient. To make the vaccines, researchers first sequenced DNA and RNA extracted from each patient's tumor. They then used computer algorithms to analyze the mutations on each tumor and predict the best targets that code for neoantigens. Based on that data, they created a personalized vaccine containing up to 20 of these neoantigens. Each patient received several injections of the vaccine over a few months.

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Re: Unfortunately by Anonymous Coward · 2017-07-06 22:19 · Score: 2, Insightful

And 9 out of 10 slashdot AC:s turns out to be morons.
The problem is cost by Anonymous Coward · 2017-07-06 22:23 · Score: 5, Informative

This all sounds promising, but the problem with personalized treatment is the cost.
From the article:
"The customized vaccines are an emerging class of therapies that take advantage of neoantigens, proteins that appear on tumors and seem to be specific to each cancer patient. To make the vaccines, researchers first sequenced DNA and RNA extracted from each patient’s tumor. They then used computer algorithms to analyze the mutations on each tumor and predict the best targets that code for neoantigens. Based on that data, they created a personalized vaccine containing up to 20 of these neoantigens. Each patient received several injections of the vaccine over a few months."
Protein discovery is really hard to do. This is a good approach, by sequencing the DNA and using that to feed into a computer model to determine what proteins are expressed by the mutations. This modeling though is extremely complex and rarely accurate, as there are too many variables that are hard to determine without extensive lab analysis to support it. This could cost around $100,000 or more, if you're lucky it could cost less, but still in the $50k to $75k range.
Then once you have your target, you need to develop something to neutralize it. Most cancer immunotherapy are monoclonal antibodies, of which the methodology to develop them is well known in industry, but can still be expensive. There's never been a synthetic, computer modeled antibody that's as good as a mouse or rabbit monoclonal antibody, and to get one good antibody you're likely going through about 1,000 mice at around $200 to $400 a pop, so this is most likely around $200k to $400k.
And there's no way to scale this with volume, because it's discovery not production. Every person would need a new discovery every time, so you're looking at $500,000 per patient roughly speaking. So while promising science, no healthcare system can afford this without bankrupting itself.
Herein is the problem with cancer immunotherapy. The latest one on the market is Keytruda by Merck. One year's dosage can cost around $150,000, so while it's quite effective as a drug, it can bankrupt patients and payer systems very quickly. Somehow the cost aspects of these drugs need to be addressed, because there's simply no way they be effective on the broader market without some ability to lower the cost.
1. Re:The problem is cost by lisaparratt · 2017-07-06 22:59 · Score: 5, Insightful
  
  Isn't that premature optimisation? R&D costs money - it's surely a lot cheaper to cost down one working solution than to try to cost reduce every attempt.
2. Re:The problem is cost by Anonymous Coward · 2017-07-06 23:01 · Score: 1
  
  Exactly. And while it seems possible to drive the cost down by "mass production" (in this case, of course, rather automation of the whole chain), this'll be only viable if you (expect to) get enough paying customers. The traditional way to achieve that has been up to now to bet investment capital, thus inflating the bubble we're accumulating in front of us ever more and more.
  Does it matter? I don't know, but I'm a bit wary to see how e.g. Tesla is valuated wrt. Chrysler or GM -- or Apple wrt. others who are doing useful shit. And the situation in big pharma or biotech isn't any better, and bound to worsen, as (yet affluent) population ages further. What happens when that investment bubble becomes untenable, as precarisation level (in the Western world) increases from, say, 35% to, say, 70%?
  No idea. But my hunch is that it won't be pretty.
3. Re:The problem is cost by FeelGood314 · 2017-07-06 23:39 · Score: 1
  
  Cost isn't a problem for a rich dying person. If it really was your only hope $500,000 is within reach of probably 25% of families in North America. And don't get me started on the stupidity of OHIP (Ontario's Health system), I've watched them spend close to $300,000 twice on friends or relatives who had zero chance of recovery.
4. Re:The problem is cost by CrimsonAvenger · 2017-07-06 23:46 · Score: 2
  
  This all sounds promising, but the problem with personalized treatment is the cost.
  Yeah, those new-fangled "computers" (anyone old enough to remember when "computer" was a job description?) cost so damn much there'll never be a real demand for more than a few dozen in the world, much less the country...
  
  --
  
  "I do not agree with what you say, but I will defend to the death your right to say it"
5. Re: The problem is cost by Anonymous Coward · 2017-07-07 00:04 · Score: 0
  
  Trans Atlantic flights sound like a good thing, but it will never happen because let's face it... The cost is astronomical and would bankrupt anyone but a Kennedy or Hughes.
  You fucking imbecile.
6. Re:The problem is cost by Anonymous Coward · 2017-07-07 00:25 · Score: 0
  
  Is that worse than spending $50 000+ per year on old people with self-inflicted renal failure?
7. Re:The problem is cost by Anonymous Coward · 2017-07-07 00:26 · Score: 1
  
  Maybe we finally found something useful for AI to do besides driving cars for people too lazy to steer a wheel
8. Re: The problem is cost by Anonymous Coward · 2017-07-07 00:43 · Score: 0
  
  But the rich can afford it, so it's really not a problem. We have too many poor anyhow.
9. Re:The problem is cost by angel'o'sphere · 2017-07-07 00:55 · Score: 2
  
  And don't get me started on the stupidity of OHIP (Ontario's Health system), I've watched them spend close to $300,000 twice on friends or relatives who had zero chance of recovery.
  That would happen in most western health care systems. And rightfully so. You never really know the chance of a small wonder.
  The only treatments in Germany which can be denied, not technically, but by playing the system are transplantations.
  People are on a list, basically how urgent it is. But there is also a factor involved, how likely and how long the receiver will survive. So if a 35 year old healthy father of a family and a 65 year old alcoholics are the two possible candidates, then the 65 is "technically" on top of the list, as he needs it more urgent, BUT: he will not get it because he is an alcoholics.
  Cancer treatment is always done with maximum use of every suitable weapon available.
  
  --
  Cost free eBook I read (by iBook/Kobo/Amazon/ObookO/Gutenberg etc.): "The Green Odyssey" by Philip Jose Farmer.
10. Re: The problem is cost by Kjella · 2017-07-07 01:31 · Score: 3, Insightful
  
  Not that long ago "sequencing the DNA" would have been a prohibitingly expensive step. Show that this works for broad classes of cancer patients and we'll find cheaper ways than guessing with lab rats. Lab work can also often be automated to a fraction of the cost in volume. For cancer in young people $500k is not bad if it keeps them cancer free, we spend huge amounts on medicines that only prolong the inevitable.
  
  --
  Live today, because you never know what tomorrow brings
11. Re:The problem is cost by wren337 · 2017-07-07 02:13 · Score: 3, Insightful
  
  I also expect that we will find some number of relatively common mutations, over time. Cancer is a coding mistake that leads to uncontrolled growth. The fact that we've named certain of these errors, that we know how they progress and how to treat them, tells me that there are common coding mistakes that trigger cancerous growth. If we got this down to 100 or 1000 or 10000 different vaccines that covered 75% of cancers, and you could pick the right vaccine(s) with a DNA test, we'd be kicking ass.
12. Re:The problem is cost by Anonymous Coward · 2017-07-07 02:23 · Score: 0
  
  >Cancer treatment is always done with maximum use of every suitable weapon available.
  Except that isn't the case in Ontario. OHIP means the government decides if you live or die, rather than you and your pocketbook.
  http://www.torontosun.com/2016/12/30/province-refuses-to-pay-for-hamilton-youths-cancer-treatment-in-mexico
13. Re:The problem is cost by Anonymous Coward · 2017-07-07 02:41 · Score: 1
  
  You seem to be saying that the cost cannot come down in the future, to which I disagree. Just look at the price of gene sequencing: $100M in 2001 per genome, to less than $10k per genome in 2012, to just over $1k per genome in 2015 (google: "price of gene sequencing"). As biology becomes an information science, it will see the same gains
14. Re:The problem is cost by Anonymous Coward · 2017-07-07 02:46 · Score: 1
  
  The problem is not the cost. Cancer treatment is already expensive, right now.
  https://costprojections.cancer.gov/annual.costs.html
  To pretend that things like sequencing and protein analytics won't improve is disingenuous at best, idiotic at worst. Yes, it will scale in the sense that people tend to get much better at any repeated, analytic task.
15. Re: The problem is cost by Anonymous Coward · 2017-07-07 03:14 · Score: 0
  
  Another way of looking at it is that you people who don't mind driving have nothing better to do than rotate a wheel right and left while jabbing at pedals for one hour every day.
16. Re: The problem is cost by backslashdot · 2017-07-07 03:31 · Score: 1
  
  Uhh you just said that they use computer algorithms to determine the neo-antigens.
  I read the Nature papers as well. I am familiar with most of the techniques described. Aside from the initial sample gathering. I saw nothing that can't be automated. Once the tumor is sampled there is very little (if any) human judgement needed. You will of course need robots to perform the assays and make the vaccines, but all of that is highly automatable.
  The only parts of the process that are difficult (though not at all impossible even with today's technology) to automate is the surgery or biopsy -- something done routinely for cancer anyways.
17. Re:The problem is cost by Kazoo+the+Clown · 2017-07-07 03:42 · Score: 1
  
  As long as rich people are getting these diseases, there will be money to develop effective treatments.
18. Re: The problem is cost by Anonymous Coward · 2017-07-07 03:47 · Score: 0
  
  But the cost will come down.
  1) improvements in processor speed.
  2) improvements in processor costs
  And more importantly
  3) better algorithms and models
  Also, any patents on these will eventually expire. I suspect they will expire at a serendipitous time where outfits with fewer resources can capitalize on it due to lower costs.
19. Re:The problem is cost by e3m4n · 2017-07-07 04:14 · Score: 1
  
  that's always the case in just about any sort of technology. We throw away outdated smart phones that are hundreds of times more powerful than the computer that put apollo 11 on the moon. At one time only a few people on the planet had access to the sort of computing power we take for granted daily. Eventually this kind of therapy will take an hour, require a needle biopsy of the mass, and a smartphone to run the sequencing via bluetooth to some piece of field-grade lab equipment to sequence the structure. Eventually this will be the sort of thing a general doctor can do in his office and just charge regular office visits for.
20. Re:The problem is cost by micahraleigh · 2017-07-07 05:10 · Score: 1
  
  I realize there's a slashdot memo that says the earth is over populated so we have to appraise the cost of solar as plummeting and break through health techniques as soaring, but come on here.
  
  The differences between people is being closed by ALGORITHMS. ALGORITHMS have zero overhead. You can moan about IP or whatever, but competition can bring that difference way, way down.
  
  You make a claim that this approach is rarely accurate, but that's not reflected in the data above. By the same token gene sequencing (not that different btw) was EXTREMELY expensive 10 years ago, but now YOU can get your personalized gene sequence affordably in days, not years. Actually that's been around for a while.
  
  Would some people spend $50k if it would SAVE THEIR LIFE? Sure. More power to them. That fact all by itself makes the effort worthwhile. The fact that some people don't want to make that kind of money happen or whatever doesn't compromise the value here.
21. Re:The problem is cost by Anonymous Coward · 2017-07-07 06:09 · Score: 0
  
  This method of immunization is target T-helper CD-4+ cells which is where the regulatory T cells are a subset of. These are the cells that regulate the whole process whether a CD8 cell killing response or generation of endogenous antibody by B cells. These cells somehow know which response to do. The use of antibodies as a drug are to either engage or block a receptor. NOT WHAT THESE GUYS are doing.
  Costs will come down as they streamline the antigen creation step. You will unlikely be able to do this ex vivo because the regulatory T cells do not float around the body. They reside in the nodes (largely) and MALTs ( mucosal associated lymph. tissue).
22. Re:The problem is cost by Shotgun · 2017-07-07 06:16 · Score: 1
  
  I was interviewing for a job a couple years ago. It was a company bought up by Quintiles that was automating the process of DNA sequencing. They were targeting sub $1,000 tests with the use case being targeted cancer drugs.
  
  --
  Aah, change is good. -- Rafiki
  Yeah, but it ain't easy. -- Simba
23. Re:The problem is cost by tobiah · 2017-07-07 06:38 · Score: 2
  
  Good summary of established technology, but cost is a red herring:
  1) Moores Law may not be as fast for manufacturing, but it still holds that things get cheaper on repetition. Cars, TVs and computers all used to be luxury items for the well-off.
  2) I've done a fair amount of coding for DNA/RNA analysis, and the resulting assays cost a few hundred dollars to run. A profitable $1000 test could be developed that IDs the cancer and describes the treatment in a few years time. An alternative to monoclonal antibodies is antisense drugs, which directly redirect/reprogram DNA of specific organs of the body. Antisense can be remarkably quick to produce, as the delivery package (retroviruses,etc.) are generic and there are various commercially available machines that mass-produce the genetic sequence of your choice. Isis Pharmaceuticals is one that's been working on antisense drugs for nearly 30 years, ten years ago I'd watch their R&D spit out a dozen possible drugs per day. Not hard to write D/RNA, not hard to read it, just need to bring those worlds together, along with a big database and proper analysis tools.
  D/RNA looks just like software code, with start/end markers, execute statements, comments, etc. A rapid read-write interface is only a matter of time.
  
  --
  "The ability to delude yourself may be an important survival tool" - Jane Wagner -
24. Re:The problem is cost by Anonymous Coward · 2017-07-07 07:38 · Score: 0
  
  The Toronto Scum? Really?
25. Re: The problem is cost by erapert · 2017-07-07 07:55 · Score: 1
  
  ...we spend huge amounts on medicines that only prolong the inevitable.
  ALL medicine is only prolonging the inevitable.
26. Re:The problem is cost by tobiah · 2017-07-07 09:18 · Score: 1
  
  ..or too blind
  
  --
  "The ability to delude yourself may be an important survival tool" - Jane Wagner -
27. Re:The problem is cost by slickwillie · 2017-07-07 13:42 · Score: 1
  
  Not to worry, Martin Shkreli will buy it and reduce the cost. Oh wait.
Re: Unfortunately by Anonymous Coward · 2017-07-06 22:34 · Score: 0

you must be in the 1 out of 10 who's merely an idiot. "turn" out to be morons, not "turns", dumbass
Early Human Trials by famebait · 2017-07-06 23:14 · Score: 2

Now we only need to try it out on modern humans.

--
sudo ergo sum
1. Re:Early Human Trials by Anonymous Coward · 2017-07-06 23:24 · Score: 0
  
  Modern humans are autistically afraid that vaccines cause autism.
2. Re:Early Human Trials by miketheanimal · 2017-07-06 23:39 · Score: 1
  
  Some modern humans are afraid that vaccines can trigger autism in infants who are not ill, and are unlikely to be permanently affected by the disease being vaccinated against. The vaccines here are being used on adults who are already seriously ill.
3. Re:Early Human Trials by umafuckit · 2017-07-07 00:19 · Score: 1
  
  Some modern humans are afraid that vaccines can trigger autism in infants who are not ill, and are unlikely to be permanently affected by the disease being vaccinated against.
  It's not an evidence-based fear, though, is it?
  
  --
  soylentnews.org
4. Re: Early Human Trials by Anonymous Coward · 2017-07-07 00:46 · Score: 0
  
  Natural Selection will sort that out just fine. Cancer isn't a contagious disease so I'm OK with the anti vaxxers skipping this one.
  Of course this isn't really a vaccine in the traditional sense of the word, but I don't see any need to point that out to the antivax nutjobs.
5. Re:Early Human Trials by Anonymous Coward · 2017-07-07 01:21 · Score: 0
  
  The "unlikely" only remains true if everyone else vaccinates.
6. Re:Early Human Trials by Anonymous Coward · 2017-07-07 01:22 · Score: 0
  
  Maybe we just haven't found the evidence yet. For a long time there was no evidence that abestos caused cancer.
7. Re: Early Human Trials by moeinvt · 2017-07-07 01:24 · Score: 0
  
  "Of course this isn't really a vaccine in the traditional sense of the word,"
  What makes you say that? A "vaccine" is something that triggers the immune system to recognize a certain strand of DNA(typically a virus) as an infection and develop the capability to attack it.
  A tumor also has its own unique DNA. According to these papers, the immune system can also be stimulated to attack that specific DNA. Wouldn't that meet the definition of "vaccine"? The only difference being that something like the smallpox virus is the same no matter who it infects so one vaccine works for everybody. Unfortunately, tumors really are "unique"(recurrent tumors are apparently the same) which is why this particular vaccine needs to be individualized.
8. Re:Early Human Trials by Anonymous Coward · 2017-07-07 01:33 · Score: 1
  
  There was no evidence of that because nobody was looking for it.
  If lots of people go looking for evidence of something and nobody finds anything concrete in years of study chances are very good there is nothing to be found.
  All this effort trying to prove a vaccine autism link that almost certainly doesn't exist would be better spent trying to find other explanations.
9. Re:Early Human Trials by Anonymous Coward · 2017-07-07 02:47 · Score: 0
  
  When every single test shows there is not correlation any reasonable human being would presume there is no connection. These people religiously believe that vaccines cause autism, evidence be damned.
  First their accusation was that the thiomersal in vaccines was the cause. Then that was removed from vaccines and autism rates were unaffected. So then these dogmatic people just shifted their argument.
10. Re:Early Human Trials by Anonymous Coward · 2017-07-07 03:26 · Score: 1
  
  It's not an evidence-based fear, though, is it?
  Correct on two counts: no evidence that vaccines trigger autism, and no evidence (in fact, plenty of contrary evidence) that unvaccinated infants "are unlikely to be permanently affected by the disease being vaccinated against."
  Measles can kill. Vaccination has resulted in a 75% decrease in deaths from measles between 2000 and 2013. And that's just one example.
11. Re:Early Human Trials by Anonymous Coward · 2017-07-07 03:29 · Score: 0
  
  Most asbestos doesn't. Of the three kinds of naturally occurring asbestos, only one is linked to cancer. Unfortunately it happens to be the one most commonly used in industrial applications, although only in some of those does it end up in a form where it can be inhaled.
12. Re: Early Human Trials by Anonymous Coward · 2017-07-07 03:36 · Score: 0
  
  Cancer isn't a contagious disease
  Cancer isn't a single disease. Some types are in fact contagious. A number of cancers (chiefly cervical, but it can affect other areas, including penis, mouth, throat (oropharyngeal) and lungs) are caused by several different types of human papilloma virus (HPV).
  Fortunately (for the non-idiots) there's a vaccine for that.
13. Re:Early Human Trials by miketheanimal · 2017-07-07 03:36 · Score: 1
  
  Indeed. Vaccinations have been very effective at reducing mortality, globally. But it is a matter of fact that in the UK, measles death rates were reduced by better than 99% *before* vaccination was introduced. Anyway, my point was that the OP's jibe at anti-vaxers would likely not apply to this vaccination.
14. Re:Early Human Trials by aquabat · 2017-07-07 15:07 · Score: 1
  
  Oh my God, this is so dangerous. Even if we discount the ethical issues of experimenting on our distant ancestors, the temporal danger is enormous. If Wikihistory has taught us anything, it may be that messing with the timeline could have had far-reaching and pan-dimensional consequences. I mean, for all we know, this could will have been what causes cancer in humans the first time.
  
  --
  A republic cannot succeed till it contains a certain body of men imbued with the principles of justice and honour.
Re: Unfortunately by Anonymous Coward · 2017-07-06 23:58 · Score: 0

Don't be a moran.
I know one of the patients by CharlieG · 2017-07-07 00:08 · Score: 5, Informative

He thought he was dead for sure - stage IV melanoma. He's cancer free. Amazing stuff

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-- 73 de KG2V For the Children - RKBA! "You are what you do when it counts" - the Masso
1. Re: I know one of the patients by Anonymous Coward · 2017-07-07 02:44 · Score: 0
  
  Could you put me into contact with the person you know, I have a family member in this situation and we are looking for ways to help. Thanks, laclark@ualberta.ca
So cancer is a virus now? by Anonymous Coward · 2017-07-07 00:34 · Score: 1

This isn't a 'vaccine'. Besides which, there is on such as 'vaccination' because Jenner was a fraudster.
http://www.whale.to/v/hadwen1.html
Why has nobody rebutted that speech yet? Ever? Anywhere on the entire internet?
1. Re:So cancer is a virus now? by Anonymous Coward · 2017-07-07 00:54 · Score: 0
  
  " Besides which, there is on such as 'vaccination' "
  Do you even English, brah?
2. Re:So cancer is a virus now? by Anonymous Coward · 2017-07-07 01:51 · Score: 0
  
  A vaccine is a substance that make the immune system produce antibodies to something. Doesn't need to be a virus.
Control group by Meneth · 2017-07-07 01:36 · Score: 1

What about the patients that DIDN'T get a vaccine? Did they do better or worse than the treated ones?
1. Re:Control group by Pasquina · 2017-07-07 02:50 · Score: 5, Informative
  
  Early stage (Phase I) trials usually don't have control groups because the goal is to test for toxicity of the therapy. Later stage (Phase II, III) look to compare efficacy against the "standard of care." In this study, no one was admitted to the study but did not receive the therapy - that will happen in the next study.
  
  Phase I trials are traditionally done in health volunteers, but these days, cancer trials are frequently performed in late stage cancer patients because they are desperate and have no other (Western medical) options. These patients had exceedingly little chance of spontaneous recovery, so you can assume the "control" group would have close to 0% survival.
  
  The fact that they got such a huge response is amazing and highly promising.
2. Re:Control group by captaindomon · 2017-07-07 03:41 · Score: 1
  
  Agreed. The stage IV survival rate for Melanoma for five years is 15%. To be two years along without any relapse is remarkable, IMHO.
  
  --
  Just because I can hook a shark from a boat, I do no offer to wrestle it in the water.
3. Re:Control group by Anonymous Coward · 2017-07-07 04:19 · Score: 0
  
  What about the patients that DIDN'T get a vaccine? Did they do better or worse than the treated ones?
  They died.
Initial cost, sure by Weaselmancer · 2017-07-07 01:37 · Score: 1

The first of anything is going to be ridiculously expensive. The first transistor was the size of a fist and took years in a lab to build. Your pc right now has millions of transistors in it. If you could move it back to 1947, the cost of your computer would exceed the GDP of the entire planet.

--
Weaselmancer
rediculous.
1. Re:Initial cost, sure by Anonymous Coward · 2017-07-07 02:52 · Score: 0
  
  You spelled billions wrong
2. Re:Initial cost, sure by ChrisMaple · 2017-07-07 13:06 · Score: 1
  
  The first transistor was the size of a fist
  Nonsense.The first transistor, a point contact device, was perhaps the size of a thumb nail. It was surrounded by mechanisms to hold and tension the contacts, and the whole contraption might be called fist sized, but not the transistor.
  
  --
  Contribute to civilization: ari.aynrand.org/donate
Or we could just fix our payer system by rsilvergun · 2017-07-07 03:14 · Score: 1

maybe stop fighting pointless wars. Solve our energy problems instead of exacerbating them to protect rich guys oil investments. That'd work too.

--
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
distributed computing? by Anonymous Coward · 2017-07-07 03:50 · Score: 0

Im guessing the need for cpu horsepower for this kind of discovery work is massive. I wonder if something like the folding@home project canbe leveraged to work these kids of datasets.
Im not an immunologist... by e3m4n · 2017-07-07 04:04 · Score: 1

Im not an immunologist, but why couldn't this same vaccine not also be given to someone fighting their first battle with cancer also? Wouldnt these sequencing shots also serve as an immune system booster for that specific rna/dna sequence?
1. Re:Im not an immunologist... by Pasquina · 2017-07-07 06:28 · Score: 1
  
  Short answer: Yes, in theory.
  
  Unproven therapies usually start out by treating patients with no other good options. Without good data, there is no reason to believe the new therapy is better than the standard of care - that's the whole point of late stage trials.
  
  As doctors and the FDA and insurance companies and patients get more convinced that a therapy is useful, there will be a push to use it at an earlier line of therapy, and the company will run trials in earlier stage patients. Eventually, this could be used as a first line treatment if it proves better than the other options, but it's not statistically convincing yet, so it would be considered unethical to withhold the standard of care in favor of the vaccine.
  
  Combinations of treatments (standard of care + vaccine vs. standard of care alone) are difficult because they are expensive (the vaccine manufacturer would have to pay for all drug for all enrolled patients) and the combination could potentially have increased toxicity.
This could get really cheap by lamer01 · 2017-07-07 05:11 · Score: 1

Once a large enough library of these neoantigens is created wouldn't the process become as simple as a google search for the right combo seen before and just use it? I understand that currently the sample size is small thus the neoantigens seem to be unique to each patient but as the sample size increases I am confident we will start seeing repeats. Can anyone who know about this comment?
Re: Unfortunately by Anonymous Coward · 2017-07-07 05:13 · Score: 0

Speak of autism and it shows its ugly little head I see.
Re:Unfortunately by tobiah · 2017-07-07 06:00 · Score: 1

lol

--
"The ability to delude yourself may be an important survival tool" - Jane Wagner -
Re:MISSING FACTS YOU NITWITS by Anonymous Coward · 2017-07-07 06:10 · Score: 0

As mentioned above, early stage (Phase I) trials don't usually have control groups because the goal is to test for toxicity of the therapy. Later stage (Phase II, III) look to compare efficacy against the "standard of care" and those trails do in fact have controls.
You'd have to be some kind of nitwitt not to know that............
Re: Unfortunately by Anonymous Coward · 2017-07-07 06:43 · Score: 0

Get a brain Morans! Go USA!!!!
Re: Unfortunately by Anonymous Coward · 2017-07-07 09:22 · Score: 0

Why do you hate Mormons?
Specious Reasoning by Anonymous Coward · 2017-07-07 12:42 · Score: 0

You cannot give a drug, observe a lack of relapse, and say the drug caused the lack of relapse.
It's like I have this rock, and I tell you this rock keeps tigers away... you don't see any tigers around, do you? Therefore the rock works!