That's a pretty cool job! As you mentioned in your other note, I'm sure you've seen all sorts of progress being made over your career.
I had very little knowledge of blood cancers before I ended up getting MM, but what's being done to fight them is really quite fascinating. Nothing like having a disease yourself to focus your mind on how progress treating it is going.
Funnily enough, I was just thinking of doing a 'Midweek Musings' (not necessarily with that name) as part of Techno-Optimist where I could expand on some of the news items. But I probably won't be starting that immediately just do to time concerns. I want to make sure I get the main newsletter up and running, try and build up a bigger audience, etc. first. But yes, I am hoping to eventually do something along those lines.
The oncolytic virus angle is of particular interest to me. I actually have multiple myeloma (its in a very good remission, usually it's older folks who get it, but sometimes younger ones like myself do too), and that got me interested in cancer treatments, and I really dove into oncolytic viruses.
I think the best way forward for cancer is a 'silver buckshot' approach. The idea of a cocktail of oncolytic viruses + two or three seperate cancer vaccines all given together might just do the trick. That sort of thing is where treatment is heading I think, but it'll take 2-3 decades to get there.
I'm actually seriously considering trying to get a startup going to jump forward on exactly these sorts of methods...Likely two to four years down the road still before I can get going on that.
Owen, the progress in developing new and highly effective treatments for multiple myeloma is one of the most stunning successes in medical research. There was a time that this cancer was very difficult to treat. Now, remarkably effective treatments are receiving FDA approval constantly. If only the treatment options for solid tumors were progressing as rapidly as the treatment options for blood cancers, things would be much better than they are.
One of the most fascinating stories in modern medicine is how thalidomide, (the universally reviled drug that induced horrific birth defects in the infants of mothers who took it for morning sickness) was discovered to be a remarkably successful treatment for multiple myeloma.
One of the best drugs for this disease is J&J’s Darzalex (daratumumab). It’s coming off patent at the end of 2024 and it’s price should plunge.
The company to watch for new multiple myeloma drugs is J&J (it’s the Janssen Division of the company). I think it has the most promising pipeline for the disease. J&J has two bispecific antibodies that it’s working on; teclistamab and talquetamab. Early trial results show promising efficacy with very high response rates. J&J is also developing CAR-T therapy for multiple myeloma. Many good treatment options already exist and even better treatment options are on the way.
Indeed! I'm actually on a slightly altered version of thalidomide (lenalidomide) to help keep the cancer in remission + Daratumumab. So Godwilling I'll have a very very long remission.
You sir appear to be something of a renaissance man. Fairly detailed knowledge of an impressively wide variety of topics. Something I aspire to.
Exciting news hot off the presses on multiple myeloma. From “Endpoint News.”
“GSK wants to present Blenrep to regulatory bodies sooner.
The UK pharma will submit Blenrep in second-line multiple myeloma to US, European and Japanese authorities in the second half of 2024, which is earlier than the original 2025 guidance, according to its first-quarter earnings report. The filings will be based on positive outcomes from the Phase 3 DREAMM-7 and DREAMM-8 studies reported earlier this year.
We’re encouraged by the data from DREAMM-7, which showed a tripling of progression-free survival,” CEO Emma Walmsley said on an investor call Wednesday. Nonetheless, “we’ve obviously got a journey to go on with the regulators,” she said, adding that more detail on a path forward will be presented at this year’s ASCO meeting...”
Not a Renaissance man; sadly not even close. But until I retired a year ago, my career was spent organizing trials for drugs designed to treat autoimmune conditions. Many of the drugs we considered pursuing were originally developed for blood cancers, especially blood cancers implicating B cells.
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.
That's a pretty cool job! As you mentioned in your other note, I'm sure you've seen all sorts of progress being made over your career.
I had very little knowledge of blood cancers before I ended up getting MM, but what's being done to fight them is really quite fascinating. Nothing like having a disease yourself to focus your mind on how progress treating it is going.
Funnily enough, I was just thinking of doing a 'Midweek Musings' (not necessarily with that name) as part of Techno-Optimist where I could expand on some of the news items. But I probably won't be starting that immediately just do to time concerns. I want to make sure I get the main newsletter up and running, try and build up a bigger audience, etc. first. But yes, I am hoping to eventually do something along those lines.
The oncolytic virus angle is of particular interest to me. I actually have multiple myeloma (its in a very good remission, usually it's older folks who get it, but sometimes younger ones like myself do too), and that got me interested in cancer treatments, and I really dove into oncolytic viruses.
I think the best way forward for cancer is a 'silver buckshot' approach. The idea of a cocktail of oncolytic viruses + two or three seperate cancer vaccines all given together might just do the trick. That sort of thing is where treatment is heading I think, but it'll take 2-3 decades to get there.
I'm actually seriously considering trying to get a startup going to jump forward on exactly these sorts of methods...Likely two to four years down the road still before I can get going on that.
Owen, the progress in developing new and highly effective treatments for multiple myeloma is one of the most stunning successes in medical research. There was a time that this cancer was very difficult to treat. Now, remarkably effective treatments are receiving FDA approval constantly. If only the treatment options for solid tumors were progressing as rapidly as the treatment options for blood cancers, things would be much better than they are.
One of the most fascinating stories in modern medicine is how thalidomide, (the universally reviled drug that induced horrific birth defects in the infants of mothers who took it for morning sickness) was discovered to be a remarkably successful treatment for multiple myeloma.
One of the best drugs for this disease is J&J’s Darzalex (daratumumab). It’s coming off patent at the end of 2024 and it’s price should plunge.
The company to watch for new multiple myeloma drugs is J&J (it’s the Janssen Division of the company). I think it has the most promising pipeline for the disease. J&J has two bispecific antibodies that it’s working on; teclistamab and talquetamab. Early trial results show promising efficacy with very high response rates. J&J is also developing CAR-T therapy for multiple myeloma. Many good treatment options already exist and even better treatment options are on the way.
Indeed! I'm actually on a slightly altered version of thalidomide (lenalidomide) to help keep the cancer in remission + Daratumumab. So Godwilling I'll have a very very long remission.
You sir appear to be something of a renaissance man. Fairly detailed knowledge of an impressively wide variety of topics. Something I aspire to.
Exciting news hot off the presses on multiple myeloma. From “Endpoint News.”
“GSK wants to present Blenrep to regulatory bodies sooner.
The UK pharma will submit Blenrep in second-line multiple myeloma to US, European and Japanese authorities in the second half of 2024, which is earlier than the original 2025 guidance, according to its first-quarter earnings report. The filings will be based on positive outcomes from the Phase 3 DREAMM-7 and DREAMM-8 studies reported earlier this year.
We’re encouraged by the data from DREAMM-7, which showed a tripling of progression-free survival,” CEO Emma Walmsley said on an investor call Wednesday. Nonetheless, “we’ve obviously got a journey to go on with the regulators,” she said, adding that more detail on a path forward will be presented at this year’s ASCO meeting...”
Wow that is good news! Great news!
Not a Renaissance man; sadly not even close. But until I retired a year ago, my career was spent organizing trials for drugs designed to treat autoimmune conditions. Many of the drugs we considered pursuing were originally developed for blood cancers, especially blood cancers implicating B cells.
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.
That's definitely the plan! It takes a fair bit of time to do, so I'm hoping it grows and succeeds (tell your friends).
I want to keep this going for years.
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.
Some references:
Oncolytic viruses for glioblastoma. See,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632333/
Ketogenic diet for glioblastoma. See,
https://link.springer.com/article/10.1007/s13668-020-00332-2