The world owes a big debt to the likes of Shirley Nolan.
I was young and dumb when she was doing her thing, and i was sick of the sight of her in the media.
But I have come to appreciate what an idiot i was and what a hero she was.
There was an incredible episode of "cautionary tales" that covered one of the first Drs to treat Leukemia and how he had to fight against the perceived "barbarity" of putting children on chemo. Was amazing and really insightful
One major success story has been in treating acute lymphoblastic leukemia, a common form of leukemia in children:
Researchers identified genetic mutations that caused the disease, making it possible to develop targeted chemotherapy drugs that have greatly improved survival.
As far as I know, most of the increased survival is due to optimisation of non-targeted chemotherapy agents over several decades and improved supportive care. A minority of kids with ALL at least are treated with targeted drugs e.g. CD19 or Imatinib. Most get same non-targeted chemo combos from...
...1990s, just the timings, dosings and supportive care has improved as well as stratification into risk groups based on karyotype, detectable MRD etc. The genetics have definitely improved the stratification for treatment intensity, but most still treated with 'untargeted' chemo.
Karyotype used to stratify treatments and intensity (along with other metrics at diagnosis/throughout) but still mostly regular chemo unless BCR-ABL (in some ALL) in which case Imatinib + newer generation TKI. CD19 targeted TX e.g. blinatumomab/CAR T mostly used at relapse if chemo fails I think.
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(Sorry for being a party pooper, but it's the truth).
I was young and dumb when she was doing her thing, and i was sick of the sight of her in the media.
But I have come to appreciate what an idiot i was and what a hero she was.
This progress reflects decades of collaboration between scientists, clinicians, and public health workers.
Researchers identified genetic mutations that caused the disease, making it possible to develop targeted chemotherapy drugs that have greatly improved survival.
CML survival rates seem to be driven more by targeted therapies?
Improvements in surgeries, bone marrow transplants, and other treatments also played a role.
Progress has been slower for cancers of the brain and nervous system.
She cheerfully said most the patients had good outcomes. That was 14 years ago. ❤️
RFJ Jr will sabotage all the treatment programs and we can get that rate up again! 😳
(Gallows humor. Sadly it may be much too accurate.)