Somebody has to pay for the trial. Drugs are expensive and the amount needed to dose a single person is orders of magnitude more than mice. So who funds the study?
If it's the government or philanthropic fund, you have to put in a grant and show that it's competitive in terms of preliminary results etc.
If it's the drug companies, you have to deal with lots of complicated things with combination therapies. Drug companies don't like their drug paired with other drugs that aren't in their portfolio. They also need to see a way to make a profit on it, which means they need to evaluate whether this is the most likely successful trial, assess bang for buck etc.
If you want to go compassionate use, then you need to get the pharma to donate the drugs or insurance to cover it. This is spain, so I guess insurance is just the government since they have universal healthcare. I have no idea how that works but I am guessing it doesn't move fast.
Somewhere between $500K and $2M for an mRNA vax is my guesstimate. You don't have to hypothesize about what the rich might do, though. The co-founder of GitLab was diagnosed with osteosarcoma a few years ago. He relapsed, leaving him without any standard of care treatments. He's spent the last couple of years throwing loads of time, effort, and of course money at lots of experimental treatments: https://osteosarc.com/ -- even released all the data gathered on his tumor over timepoints.
For all the folks complaining about "it's only in mice! things never work in humans!" -- I work at MSK and we definitely have seen success treating PDAC in humans: https://www.nature.com/articles/s41586-023-06063-y
"Why don't I see these treatments hitting the general public?" Because trials like these are phase I/II. Then you need a phase III that takes a long time to recruit a large cohort and has overall survival as an end point so you need a long time to measure the actual outcome you care about. And most trials fail in phase III because the surrogate end points used in phase II studies, like progression free survival (ie how long did patients go before their disease advanced in screens), are not necessarily great predictors of improved overall survival.
Specifically for cancer vaccines, this paper was a driving force behind MSK establishing a cancer vaccine center to scale up these personalized neoantigen mRNA vaccines. It's very very difficult to do and extremely expensive right now.
PI at a cancer center here. These two ideas are not mutually exclusive. Cancer is indeed not 1 disease but many countless ones. At the same time, cancer diagnoses are based on site of origin and histology (how it looks under a microscope). But often what drives a cell of one tissue toward pathogenesis is the same mutation or other molecular malfunction as a cell of another tissue type. In those cases, we can develop drugs that target that specific component and it may work across both cancer types.
Unfortunately, there are countless ways things can go wrong in cells. There are also rarely drugs that truly span a large swath of cancer types effectively. That's because even though two cancers from different sites may have the same driver, how they respond to treatments can differ. The difference in cell state may allow one of the two cancers to adapt to the treatment, such as by activating an alternative growth pathway, whereas the other cancer type's cell of origin may not have such an easy road to therapeutic escape.
> Some of the best ideas may initially look like they're serving the movie and TV industries.
So that's interesting. My startup somewhat falls into that category. Hollywood is so entrenched that the only way to change it may be to work around it until you're big enough to take it on.
As far "dying"-- I'm not so sure. Celebrity, status, fashion, and passive entertainment do not follow the same set of rules as search engines, cloud storage apps, or apartment subletting sites. There is no way to say objectively one form is better than the other from the consumer side of it. Some people still insist on listening to records, but hardly anyone would argue that they search on Alta Vista because they think the results "feel" more authentic than Google.
Also, Hollywood has a long history of doing this. If they are dying now because they're fighting this, then were they also dying when the VCR was introduced? Or the cassette tape? Isn't it possible that they simply use the legal system to slow down innovation until they can catch up?