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WigWag's avatar

Congratulations, Owen. This is a really excellent survey. My hope is that rather than just offering your readers a survey of important scientific findings that you will also serve up some detailed, longer essays on particularly intriguing scientific topics.

I’ll even offer up a topic that readers might find fascinating. In your debut post you mentioned the idea of using viruses as therapeutic agents to treat glioblastoma. The benefit of this approach is that the genetically engineered viruses (especially viruses that target neurological tissue) can directly destroy cancer cells while at the same time serving as delivery vehicles for cancer-fighting compounds. The virus becomes both a treatment and a vector that delivers medicines directly to the tumor site in a highly specific way.

One reason that glioblastoma multiforme is almost impossible to successfully treat is that even after the brain tumor is successfully resected, cancer stem cells (that are impossible to see) remain in the brain. Chemotherapy has been completely ineffective at killing these stem cells. That’s why gliomas almost always recur.

The magnificent thing about the oncolytic viruses in clinical trials is that they have demonstrated an ability (at least preliminarily) to kill both brain cancer cells as well as the stem cells that cause recurrence. It’s all very promising.

Several biotech firms are working on a variety of different types of oncolytic viruses which may someday offer much better treatment options for patients with glioblastoma multiforme.

There is another experimental treatment that shows some promise in treating what is an otherwise intractable brain cancer. The ketogenic diet is an ultra low carbohydrate diet (less than 20 grams of carbohydrates per day) that has become a standard treatment for drug-resistant epilepsy. It’s mechanism of action (without going into too much detail) is converting the respiration of brain cells from oxidative phosphorylation to glycolysis.

There is reasonably good preliminary evidence that healthy neurological tissue works just fine when using glycolysis but cancerous glial cells don’t; they need to rely on oxidative phosphorylation to thrive. A diet that prevents brain cancer cells from respirating properly weakens them and makes them more vulnerable to treatment.

Getting back to oncolytic viruses; various viruses are being explored as treatments for many different types of solid tumors, not just brain cancer.

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Your Average Engineer's avatar

Glad to see something like the white pill coming back to Substack! I was so sad when the white pill left Substack. I hope techno-optimist will stick.

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