Why Cancer 'Cure' Stories Are Mostly Nonsense
We probably won't be annihilating all solid tumors any time soon
At least once a year, we get a series of media headlines proclaiming that scientists have hit the holy grail. That we’ve found the big one. That the cure for cancer is just around the corner, or potentially already here.
We’ve recently seen a perfect example of this hubbub. News sources across the globe have been touting new research as an almost universal treatment for cancer. According to the press release for the study, the new drug could “annihilate all solid tumors”, which sounds incredibly impressive for a single medication.
Unfortunately for all of us, the most likely outcome for this new drug is that it has no benefit in the treatment of cancer. This is a well-worn track of hyped results that often have little to no meaning for actual humans receiving cancer treatment at all.
The Cycle Of Cancer Hype
Let’s contextualize this story, because the new study is just another symptom of the same disease. When it comes to cancer research - and most pharmaceutical therapeutics - there are a number of steps that researchers and funders have to go through to get a drug on the market:
Identify an interesting molecule
Run preclinical research to see if that molecule does anything to cells in a lab
Phase 1 trials to test the basic impact of the molecule on humans
Phase 2 trials to test the measurable side-effects on humans
Phase 3 trials to test whether the molecule has any identifiable benefits clinically
Most people are at least tangentially aware of this labyrinthine process. We all know drugs take a while to go from conception to fruition, even if we’ve never thought in detail about what that means.
But when you see a story about a pill potentially annihilating tumors, you don’t think cells in a dish, or rats in a cage. Naturally, you assume that the pill is being given to real people like yourself, because why else would you care about the story?
It’s an entirely reasonable belief, not least because most cancer drugs fail. Almost every molecule that pharmaceutical companies develop to treat cancer falls apart well before it is ever used to treat any condition. Of the cancer drugs that reach Phase 1 trials, only 1 in 27 is ever licensed as a medical product, and even then a substantial percentage offer no improvements over existing therapies.
The problem with this whole system is that real treatments going into use aren’t particularly interesting. For example, a new drug that slightly improves survival for people with colon cancer is very important for a small segment of society, but not really news to the rest of us. No one clicks on a link online that says “New drug marginally benefits colon cancer patients, slow trudge towards better care continues”.
What we want to read about is the headline-grabbing stories. The cancer treatment that somehow, despite ‘cancer’ being made up of thousands of different diseases, manages to treat them all. No one is interested in a slight improvement in the lives of people unlucky enough to get diagnosed with the Big C - everyone is incredibly excited to read about how we might cure it forever.
You can probably see the problem. If we’re talking about demonstrable benefits, the stories are boring. But if we talk about the potential for new treatments…well, there’s a lot more there. Every treatment has potential, until it fails. A drug that works in a petri dish on cancer cells may not be proven, but it can make a really good story.
And so we get this endless cycle of news. A cancer drug is developed, and it works very well in a lab. It goes into Phase 1 trials, and we forget about it entirely. Five years later, the molecule is abandoned by the pharmaceutical companies because they found no benefit, but at that point no one cares because there are ever more potential cures being talked about every year.
Curing Cancer
Which brings us to the newest story. There’s a new cancer drug that’s being developed that worked really well in preclinical research. When tested against different tumors, it killed the cancer cells but left human cells mostly alive. It’s a pretty cool molecule, with a lot of potential, and it’s already entered Phase 1 trials in real human beings.
That means that this drug now has that 1 in 27 chance of ever being licensed to treat people. Cells in petri dishes aren’t human beings, and preclinical research doesn’t tell us that much about how the drug actually works in real life. Maybe it increases the risk of death for unforeseen reasons. Maybe people can’t tolerate the side-effects, or it interacts with common medications in weird ways. There are a million reasons that medications fail, and this drug just hasn’t been tested enough yet.
It’s possible that this drug will indeed annihilate tumors and cure people of cancer. But the much more likely outcome is that it won’t work well, or at all. The reality of clinical research is less huge leaps forward and more tiny, halting steps.
You could just argue that all media headlines about cancer are wrong, but I think it’s good to be skeptical but optimistic. One day, there may be a treatment that has a benefit for pretty much every type of cancer in actual human beings, and that will be a brilliant day. Granted, it’s extremely unlikely because ‘cancer’ describes thousands of wildly different diseases, but still, you never know.
But for now, I’d recommend taking these headlines with a huge pinch of salt. So far, every single time the news has proclaimed a cure for cancer was around the corner, it’s been wrong. Chances are that the headline you’re reading this month is just as misleading as the ones that came before.
This reminds me...are you still running that "in mice" twitter account?