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.

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