Thanks for the great recap, some of this looks very promising! I remember reading your personal blog several years back, you (and James Watson) were both optimistic about the possibility of leveraging the Warburg effect in cancer therapies. Why didn’t much progress happen on that front? Is it that we haven’t invested the necessary resources there and instead got excited by alternative promising directions? Or did we come to learn of new information that reduced the feasibility of that strategy?
And another thought, it seems like there is some need for rapid experimentation on voluntary patients to optimize protocols (e.g. how many days to fast, whether to do oncolytic virus therapy and immune checkpoint inhibitors together etc.), and the risk-averse hyper-bureacratization around clinical trial protocols seems like a huge impediment to progress for cancer specifically.
DenizT
Karma: 36
Only 1 way to figure out: test it on (consenting) new patients. The drugs are generic (so cheap), and don’t have intolerable side effects. It has anecdotally worked. So it’s positive EV for patients with terminal prognosis. And yet its explained away as a curious ‘spontaneous’ remission, using your very valid objection.
This is after all my bigger claim / criticism of the status quo. My objective is to make a meta-level criticism more so than to advocate for one particular protocol as the potential cure. My claim is that a medical system that acted with urgency and that wanted to maximize patient survival odds, would have at the very least attempted to replicate the protocol in a Phase II clinical trial. Instead, it was ignored due to status quo bias. Not because it lacked a scientific justification, but because the drugs are generic.
In other words, I use the lack of a replication attempt to update in favor of systemic issues in oncology and FDA.