So I just got back from the American Society of Clinical Oncology (ASCO) annual conference and I have found the Holy Grail. Well, not actually. But I have discovered what Big Pharma’s “eye on the prize” crown jewel is—and how every company in the industry is on a cannonball run chasing after this nebulous and improbable moving target of a finish line.
It’s a mad, mad, mad, mad world and it just got madder.
For the first time in what seems like a millennia, there are actually new drugs on the market that truly alter the trajectory of survival rates for potentially millions of people. Gone, perhaps, are the days of the same old batch of rote yet reliable “Breakfast Club” chemotherapy agents we’ve come to know and love—and hate and vomit up. You know, those fabulous chemicals that end in all sorts of colorful suffixes like “platin,” “trexate,” “mycin,” “idex,” “azine,” “abine” and “istine” among countless virtually unpronounceable others.
New Drugs Target DNA
Well, these new drugs are so futuristic they almost don’t care about your cancer at all. They care about your DNA and what is wrong with some of the three trillion amino acids (adenine, guanine, cytosine and thymine) that comprise your double helices and are responsible for mutating, Chernobyl-style, and wreaking such havoc in your body.
These new chemotherapy technologies go way beyond the hunt and peck model of old school treatment whose purpose is to drop napalm, kill everything and hope the good bits grow back nice and healthy. That just sounds plain stupid these days. What the new chemo technologies do is target your DNA and encourage it to self-repair, thus killing cancer cells while augmenting your body’s own natural immune defense system to function as if you were Wolverine from X-Men, so you heal faster.
In fact, these new drugs are also much less toxic so you may not have to lose your hair, your fertility and your marbles. Good news for all!
Where Are The Patients?
And yet none of these miracle drugs from the future can grow up to become real boys (just like Pinocchio, but the exact opposite) unless actual patients go on them. Sounds simple, you say? Well not really. That process is one of the most ridiculous, confounding, counter-intuitive and bureaucratic systems in the history of ever.
Drugs like these start out as little seeds in the ground (or labs), otherwise known as Phase I trials. They are a refining and retooling process that costs companies billions of dollars. When proven effective, seedlings become saplings then known as Phase II trials. If they continue to pass the muster, they are allowed to grow into a big tree, aka Phase III trials. But if it really shows potential, that tree may be ready to go off to college and join the rest of its friends as a prescribable drug—but it must first get permission from Dad (aka the FDA) to borrow the keys.
Once the FDA passes the bill into law, we have shiny new 21st century drugs on the market for all to benefit from, at least those who qualify for it, whose insurance will cover it, whose doctor knows about it and whose current chemo protocols, biomarkers and genetic profile will permit it to be prescribed.
And, now here’s the rub…
Fewer than 3% of all cancer patients take drugs that are in Phase I, II or III. Why? You’d think they’d be breaking down the doors for the latest and greatest. After all, we all downloaded iOS 7 on our iPhones the day it came out, essentially becoming public beta testers until the 7.1 update was released. Then our phones stopped crashing. We’re always first out of the gate to buy the brand new Nissan Pathfinder during its inaugural year before all the real bug fixes and kinks are worked out. And don’t get me started on GM.
Why are we so willing to be guinea pigs for these mindless lifestyle choices when there is such hesitance, stigma and outright ignorance toward medicine?
I’ll tell you why.
A Scary Proposition
It’s because these drugs are called clinical trials—and those are scary words. Booga booga! If Apple said, “Hey everyone, download this experimental version of our software!” no one would do it. But when they call it a “must-have game-changing revolution,” we’re all lemmings clicking on the terms of service “accept” button.
My next article will dive further down the rabbit hole of the convoluted nature of clinical trial verbiage, marketing, recruitment, awareness and literacy. I believe there is a solution—but you’re just going to have to wait.
For now, we can always rename the trials to iChemo7.