Thread by @hankgreen

Look, I'm not an oncologist but I am frustrated by the way this dog cancer story is being interpreted from a bunch of different angles and I think basically all of this can be cleared up if people understood like...six things.

You should know these 6 things about cancer:

1. Cancers are different from each other. Dog cancers are often more genetically homogenous than human cancers because dogs live less time and are often bred into specific traits that pull cancer drivers along with them. This can make dog cancers more common but easier to treat.

2. Some cancers are well-suited for immunotherapy because the cells look different to the immune system. To be good candidates those differences need to be exclusive to cancer cells and homogenous across the whole cancer cell population. This is actually very unusual.

(Most cancers are bad candidates for immunotherapy. In this case we got the first two but not the last one, so this is a mediun-good candidate for immunotherapy so this dogwill still die from her cancer...but progression free survival is good!!)

3. This is the first time we've done this in dogs, but there are hundreds of similar trials in humans. If there is a treatment like this available for a person, they may get it on a trial, they may also get it if they are dying as "compassionate use."

4. Oncology is HUGE. mRNA tech + checkpoint inhibitors + existing cancer vaccine research + high-throughput sequencing + bioinformatics, etc are all bigger deals than the LLM part everyone is leading with in this case. We're just currently all anchored to LLMs.

5. Extremely personalized cancer medicine is hard. One of the hard parts is that you can't really have cheap AND fast and you /need/ fast in these cases. It's also really hard to compare outcomes because each treatment is different. This is legitimately hard!

6. Everyone who has ever been involved in medical research has already learned the lesson that one case study is interesting but not world-changing on its own. It's possible, for example, that the checkpoint inhibitor given alongside the vaccine did most of the cancer-shrinking.

(Perhaps the two were more effective together but in a case study like this we have no way of knowing that, and if it were just that drug, then all of the rest of it falls away as nothing.)

There's nothing wrong with just doing this stuff, though I also am like 90% sure that this guy is setting himself up for a start-up and it is unlikely that future treatments will be curative...just like this one wasn't.

Happy to have experts correcting me! Thanks for your time