I have just read ‘The Breakthrough : Immunotherapy in the race to cure cancer‘ by Charles Graeber.
Graeber tells an amazing story about the ongoing journey to find the cure to cancer. Immunotherapy is about using our own immune system, and get our cancer killing cells to do their job as quickly and selectively as possible.
Immunotherapy is very different from today’s mainstream options of ‘cut, poison, and radiate’.
A recent new comer is ‘re-booting your system’, through a stem-cell transplant.
I have used the chemotherapy, radiation, and stem cell-transplant.
Over 226 pages in nine chapters and three appendices, Graebner tells the human story of the innovators in this new field and the people who entered human trials as their last chance.
He uses plain English and artful analogy to take you through what would, in the hands of a less skilled writer, be complex and unclear.
Pharma’s Story
The pharmaceutical industry create solutions that save or prolong lives. They are bringing treatments onto the market for diseases that would just a few years been a death sentence.
If you hear them you’d think you were chatting with an accountant taking through a spreadsheet, or a data collector more happy in Eurostat. All too often, their argumentation reads as if it is written by Intellectual Property lawyers.
Pioneers in search of a ‘Hail Mary’ Miracle
Graeber tells a different story. He has talked to the pioneers. He tells the story of the patients who went into the human trials – Jeff Schwartz in 2011 and Emily Whitehead in 2010 – who were recalled to life . It tells the story of the patients who did not survive, like Brad McMillian, who spent 12 years at the cutting edge of science.
It saved Jimmy Carter (link).
Five Observations
1. We are not mice
Most research is done on mice. But even if a the substance works on mice, 90% of all cancer drugs work in mice fail in human trials.
2. Idiot Savants
Jeff Schwartz – one of the first to be cured – talks about meeting the scientists who made the cure for him. He describes so “ because these guys are geniuses, they’re all like idiot savants, they never leave the lab.”
These geniuses are great in the lab, but like any savant, they find dealing with the real world intolerable. It’s why a talented journalist needs to tell their story and not savants.
3. Mistrust of anything new
Prejudice rejects new evidence because we all have our preconceived blindness. Scientists appear to be especially blind. As recently as 1968, the scientist who mentioned the very idea of the T cells was told he was talking ” bullshit”.
Often, scientific evidence takes a long time to catch up with what’s being observed. Just because you can’t prove why it is happening, does not mean it is not happening.
The idea has been around since 1890 but only got approved around 2017.
4. Innovation by mistake
Many of the great advances in immunotherapy, and innovation in general, happen by accident. Discoveries were made by accident. It takes a long time – around 15 years.
Often, researchers stood on the shoulders of their colleagues and took things to the next level. Sharing intellectual property spurred discovery.
5. Public paid for it
Public funding is vital. Graeber writes ” It is worth noting that a study published in the proceedings of the National Academy of Sciences of the United States of America found that every single one of the drug approval since 2010 – 210 of them – can be traced back to the $ 100 billion NIH – National Institute of Health – budget for the drug development. This breakthrough is built on tax dollars, and it’s yours.”
Afterthought
Every regulator, politician and lobbyist dealing with this issue should read the book.
It would be useful if politicians and regulators read to understand how they design a system that first helps find the cures, and second, makes it available to patients.
Lobbyists should read it to see how even the technical and complex can be communicated clearly.