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Alzheimer's Disease Is Even Tougher Than Cancer
Posted: Wednesday, August 8, 2012 10:19 PM
Joined: 12/6/2011
Posts: 3326

From Alzheimer's Daily News:

(This one is depressing for me)

(Source: Forbes) - John LaMatttina, former president of Pfizer, writes: I was not surprised to learn about the failure of bapineuzumab, the drug Pfizer, Johnson & Johnson, and Elan were developing as a treatment for Alzheimer's disease. Alzheimer's is a very difficult area of R&D.

Like anyone else with a family history of AD, I am hoping that someone makes a breakthrough on this disease. But for those who are contrasting the clinical failure of bapineuzumab to the recent great successes with novel cancer agents, they really are misguided. The current wonders in novel cancer drugs had their roots in Nixon's "War on Cancer" which began in 1971. The basic research that was funded then (and continues to this day) led to tremendous advances in understanding the mechanisms that result in the different cancers that are now becoming treatable.


Oncology clinical trials are much easier to run that AD trials. When the new non-cytotoxic agents were discovered in the late 1980s/early 1990s, they were able to be tested rather quickly in cancer patients for whom all other treatment failed. These were not years in length, as many patients were quite ill and only had a short time to live. If any compound showed a hint of positive results in terms of shrinking tumors or extending patients' lives, it was given a high clinical priority. Rapid knowledge acquisition as to what mechanisms work allows for a rapid abandonment of hypotheses of less promise and a focus on those that were working.


On the other hand, AD is a slowly occurring disease. Furthermore, proof-of-concept with any new agent requires extensive studies in phase 2, involving a significant amount of patients for a long period of time (12 - 24 months). And even negative results provide reasons why the compound might have failed: perhaps these patients have AD that progressed too far; perhaps patients need to be dosed before the onset of severe symptoms; perhaps you need multiple types of mechanisms to truly impact the disease.


The point is that AD studies are harder to do than oncology studies and progress against AD is going to be slow as a result.


The bottom line is that we are at the early stages of what we understand about this insidious disease. Twenty years from now, we'll look back and shake our heads with the realization of how little we knew about AD in 2012. But for now, we need to continue to take the best shots we can and learn from each one.


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