Some Good News in an Ocean of Bad

Breakthroughs and Standing Ovations at the American Society of Clinical Oncology

I was just wondering if everyone has been seeing all the positive news in recent days on cancer breakthroughs. The American Society of Clinical Oncology just finished their annual meeting two days ago.

Here are three big results.

Pancreatic cancer. This killed my dad. And roughly 50,000 Americans a year. It is insidious because there aren't usually symptoms until you are at stage 4. Then you typically have three to six months to get your affairs in order.

The breakthrough: 90% of people with this type of cancer carry a mutated KRAS gene. For 40 years, NOTHING worked against this protein. It was considered undruggable. Until now. In a phase 3 trial, the drug daraxonrasib cut the risk of death by 60% over standard chemo, with fewer side effects. My dad had the chemo, and the side effects were horrid. It also works regardless of the specific mutation. And for patients who've already been through one round of treatment, this drug is available now. It is ready to go. Pancreatic cancer has eluded doctors and scientists for years. Alex Trebek, Steve Jobs, Patrick Swayze, RBG, Alan Rickman, Sally Ride, Michael Landon, Aretha Franklin — all succumbed to it. Daraxonrasib received a standing ovation at the conference. Forty-two seconds of cheering, whistling, and yelling.

Breast cancer. Another asshole whose treatment sets off a whole slew of monstrous side effects that can last for years. I have friends whose immune systems are so shot after chemo that it triggers autoimmune diseases they have to manage for the rest of their lives. So the news that early-stage breast cancer patients receive little to no benefit from chemo is HUGE. Testing the makeup of the tumors shows who can and can't avoid chemo based on tumor biology. 68% of patients could safely skip it. The Prosigna test, which provides the genetic diagnosis, is already commercially available.

Lung cancer. Apparently there are a lot of different types of lung cancer. The one addressed in this trial was squamous non-small cell lung cancer. A drug called ivonescimab blocks two pathways cancer exploits to grow. This trial showed a 34% reduction in death — though the study was conducted in Asian populations, and broader trials are underway to confirm whether the benefit holds across Western populations too.

Sometimes progress is slow. Both my grandmothers' deaths were cancer-related. One ovarian, the other lung. My BFF's aunt, brain cancer. A cousin, ovarian cancer.

The conference also revealed promising research that didn't work. A cancer-detection blood test had been hoped to catch over 50 cancers in their early stages. It failed.

That is science. Try, fail. Try, fail. Try, fail. Try, succeed. There are scientists who started pushing these balls uphill decades ago. Their failures allowed the next group to cross those ideas off their lists.

Science doesn't suck. It plays the long game, because that is the only one it has. What does suck? Interruptions to research — whether that comes in the form of funding cuts, political or otherwise. The cost is lives. When we don't support the long game, we all lose. When we do, doctors give standing ovations because they might be able to deliver hope to their patients rather than a death sentence.