Additional plans:
- Sponsor high school science fairs or essay contests related to cancer
- Hire a research assistant to help create tables of malignant features for aggressive cancers
This quarter's "Agree or Disagree" feature is:
We propose that pancreatic adenocarcinoma, NOS and other aggressive cancers can be successfully treated using large combinations of partially effective treatments directed against the tumor's malignant traits because the behavior of the whole is greater than the behavior of the sum of the parts, see Combinations Of Therapy to Substantially Reduce Cancer Deaths. Of course, this will require the development of new treatments against some of these traits. Agree or disagree?
Email Dr. Pernick at Nat@PathologyOutlines.com with your opinion by 31 July 2021. He will reply to all serious responses and will post the best responses in August 2021. Please also advise how you want your name listed (full name, initials or anonymous).
This response is from Adam Palmer, PhD., Asst. Professor of Pharmacology, UNC Chapel Hill:
Partial disagree / agree:
Clinically successful combinations of cancer therapies are often pharmacologically additive. When combining therapies that are individually highly effective, additivity can be the basis for spectacular clinical benefits, such as the RCHOP regimen producing high cure rates in Diffuse Large B-Cell Lymphoma. One implication of drug additivity is that 'adding zeros' makes zero. This suggests that developing successful combination therapies for aggressive cancers will first require the development of more therapies that have good individual anti-tumor activity in these diseases. The standard for efficacy is not unattainably high. For example, before combination therapy became standard for pediatric Acute Lymphocytic Leukemia, single therapies could produce temporary remissions, around 3 to 6 months in duration, in a quarter of the patients (these 'remissions' meant multiple log-kills resulting in the absence of detectable disease, and should not be confused for temporarily stable disease or partial response). These therapies went on to become the constituents of curative combination regimens.
