Liquid Biopsy Continues to Disappoint

Confession: I have been burned by Guardant twice. Both times were my fault, the first on account of my wide-eyed idealism and the other because I didn’t stick to my guns when it counted, but this has seeded a personal and possibly misdirected venom toward the company.

It helps that the product sucks. Continue reading “Liquid Biopsy Continues to Disappoint”

Seattle Genetics Bags Irinotec- Er, IMMU-132

Two billion dollars seems spendy for a repackaged chemo agent that has been on the market since 1996. It’s no secret, either; irinotecan is standard of care in colon and lung, though, weirdly, it doesn’t get prescribed a lot in breast (despite the fact that irinotecan targets TROP-2, which is commonly overexpressed in breast).

What Seattle Genetics may be banking on is the branding; this is a “new drug” for triple negative breast cancer, which is great marketing when, in reality, there is no drug that is for TNBC. IMMU-132 is an opportunity to give patients who only have access to chemo, well, more chemo. This isn’t T-DM1, which was a game-changer because it enabled the targeted delivery of a chemo agent (emtansine) that was too toxic to give on its own. IMMU-132 is more of a Doxil/doxorubicin situation. Continue reading “Seattle Genetics Bags Irinotec- Er, IMMU-132”

“No Cure Yet”, but lots of baseless hype

I asked my friend @Buyersstrike yesterday if anyone took The Motley Fool seriously, and he replied that yeah, some people think it’s real. Whether anyone could take this particular example, entitled No Cure Yet for Breast Cancer, but 3 Big Advances in 2016, seriously is a separate and more concerning question (TL;DR: HOW?), but for entertainment’s sake, let’s pick it apart.

First, the title. No cure “yet”? Are we anticipating a cure? It’s just around the corner? There’s also a promise that said cure will save “millions of lives”, which, given that 40,000 people die annually from breast cancer, is a promise that will take a while to realize. But that’s just the kind of article this is, which you already knew from the happy pink-ribbon-adorned women in the accompanying photo. Continue reading ““No Cure Yet”, but lots of baseless hype”

My Experience with Liquid Biopsy

We know the narrative: liquid biopsy promises a safe, painless, non-invasive, less-costly method of interrogating tumor DNA to identify targeted therapies for patients who are not amenable to biopsy. Patients will have a real-time view into the resistance patterns of their disease (companies are promoting the idea that patients should have a biopsy after every line of therapy, which was never feasible with tissue biopsy) and be equipped to select treatments that are  more likely to work.

All this from a couple vials of blood? Well. Not so fast. Continue reading “My Experience with Liquid Biopsy”

Oh, Canada. “Limits to Personalized Cancer Care” in the NEJM

The NEJM, despite its habit of publishing every precision medicine milestone in the past 15 years (including the Herceptin and Zelboraf papers cited in the first paragraph of this editorial), elected to give voice to the naysayers: per an opinion from physicians at the Princess Margaret Cancer Centre, treating cancer based on genomic profiling is unproven, expensive, toxic, and requires further investigation in controlled trials before we should consider it as a treatment strategy. No shock that this came out of Canada, that hotbed of medical innovation.

Continue reading “Oh, Canada. “Limits to Personalized Cancer Care” in the NEJM”