Friday, May 21, 2010

Bravo Newsweek!?

There is hope out there in the form of a Newsweek article in the May 31 issue. The article is called "Desperately Seeking Cures" by Sharon Begley and Mary Carrmichael. In it the authors strike some of the key themes I have been discussing regarding how senseless the current medical research environment is and how difficult is is to translate science into real-world cures. I am thrilled to see that someone else actually recognizes these fatal flaws in our quest for terminal disease cures.

They describe the well known "Valley of Death" that exists in translating science into cures and how the current way of doing things has created it. Frustrated NIH investigators are exemplified that cannot find the resources to reduce their work to clinical proof of concept and the flawed patent system which makes it impossible to patent findings already published is also cited. The purpose of the NIH is to commercialize its research as is the purpose of patents. Both instruments of cures are not working. Mention is also made of the redundancy of medical research and its lack of coordination, both of which have been discussed on this blog.

One would think that the authors have read this blog but the point is that we are not alone in recognizing this fundamental problem. Where are the Cures? this is the rallying cry that must ignite the fundamental changes required to remedy this tremendous and costly crisis. We are not lone voices in the wilderness.

This blog is the precursor of a book that I have given the tentative title, "Where are the Cures". The book has been in the works for three years and is 80% complete. It details the full spectrum of systemic flaws that inhibit the curing of terminal diseases and more importantly proposes some solutions on how to accelerate the generation of real world cures. The Newsweek article is the first example of the use of the phrase, "Where are the Cures" and I am thrilled that someone else appreciates this problem. It has been a lonely three years and this article will hopefully facilitate the completion of the book.

Sunday, May 2, 2010

A New Cancer Drug; lots of heat but not much light

Last week the FDA finally approved Provenge, a late stage prostate cancer treatment based on a "new" mechanism that involves patient specific treatment. The company that developed the drug has some very happy shareholders and the treatment is an incremental advance. That's the good news. The bad news is that it is not a cure, it only extends survival by 3-4 months and it will cost $93,000 for a three dose treatment regimen. It is being called the first cancer vaccine but vaccines generally prevent diseases and are cures; this is clearly not that. Is this the best we can do after 60 years?

The thought leaders seem somewhat enthused by these modest results since they think it might lead to something better as research progresses. This is the same refrain academia always uses the grease the grant funding wheel that pays their salary. The mechanism involves mobilizing the patients own immune system and is therefore simply a variation on a theme that has been tried many times before. After 15 years of work on this treatment and hundreds of millions spent it seems a poor return on investment.

Provenge demonstrates just how anemic our effort to cure terminal diseases is. The FDA delayed approval of this drug for almost 5 years, it is an advance but a rather subtle one and it will be very expensive to the health care system. Yet the media is all over it with front page headlines. We need to stop this endless raising of hope based on incremental progress that is thrust on us by academia and the drug industry and demand that this issue of curing terminal diseases is resolved. Health care reform got done in less than a year, we must insist that our leaders reform the quest to cure terminal diseases with the same determination. The path to that end is the subject of the two previous posts and the purpose of this blog is to mobilize grass roots support for the resolution of this tragic problem that claims 2 million lives each year.