Linda and Carolyn in Borrego Springs
Probably 2009
I try to build a little humor into these blogs, to reward
you for reading them. I’m going to be
up-front about it. Click on
and get a chuckle.
Then read the rest of the blog, which will be boring.
My good
friend Kathy from Fred Hutch sent me a link to an article published in the
journal “Gynecological Oncology”. This little two-page snippet contain a link
to a “white paper” elaborating on the same themes. The latter is 18 pages long. Both articles are largely free of academico/biochemistry-research
jargon and thus are intelligible to the public.
(They can’t resist a little fancy language from time to time, though. Try “financially incentivize”, which is a ponderous
way of saying “pay”)
These articles
are reports of the deliberations of the Ovarian Cancer National Alliance, which
met in late 2012 to consider “Current Challenges in Ovarian Cancer”. The three most pressing challenges, in their
view, are:
Including Patient Reported
Outcomes (PROs) in the investigation of the efficacy of new drugs and/or
treatment protocols.
Improving patient access to
clinical trials.
Personalized medicine (e.g.,
targeted therapies).
A typical
PRO might be “I was on standard chemo for four sessions, then I developed neuropathy
in my fingertips.” Apparently the two
most common side effects are neuropathy and “chemo brain”. The problems that need to be overcome, it
seems, are several fold. First, such
anecdotal evidence is hard to integrate rigorously into clinical trials and,
second, these reports are seldom delivered directly to the research team but
rather to the treating physician, who may or may not pass them on.
Clinical
trials are most common, and most commonly effective, if conducted at major research
centers (like, for instance, Fred Hutch).
The authors of this report deplore this, and suggest ways to incorporate
women from the boonies in trials. The
major stumbling block here is “financial incentivization”. This should come as little surprise.
And finally,
targeted medicine. The idea here is to
turn from “organ-based” therapy (e.g., hit all ovarian cancer patients with the
same cocktail of drugs.) to a therapy based on an understanding of which
mutations are aiding and abetting the cancer.
It seems to be true that a biochemical-pathway malfunction that
produces ovarian cancer in one woman may cause, for instance, colorectal cancer in somebody else. So, identify the pathway(s), figure how to correct
or stifle them, test the cancer patient, and give him/her the right stuff. Mutation-based
therapy I guess it could be called. As
you might correctly guess, this also will require considerable -- financial incentivization.
Okay, I am going to stop here. The author group-suggests remedies in all three cases outlined above. Some are nebulous, in my view, and several are downright incomprehensible. My computer skills being what they are, I have been unable to figure out how to give you the links, so you can read for yourselves. So, next best thing: I will forward an email to any of you who are curious. The email will tell you how to get the other stuff up. Really, it isn’t all that tough to read this material. Maybe between plays on SuperBowl Sunday.
No comments:
Post a Comment