Metastasis: Rude Awakening

2 great articles on nature.com. The first, "Metastasis, Rude Awakening" highlighted the tragic lack of progress on MBC treatment plus problem of long term relapse from hidden metastasis:
http://www.nature.com/nature/journal/v485/n7400_supp/full/485S55a.html#/ref 7

nature.com is not the most popular science magazine in america.   If even nature.com readers need a "rude awakening",  metastatic breast cancer patients have a real problem.   The public, including early breast cancer patients and other well educated people who should know better, have been lulled into a false sense of security and think metastatic breast cancer is a "chronic" disease like diabetes or AIDS.   When in fact, MBC patients life expectancy is measured in years, even months, while diabetes/AIDS patient can expect a normal life expectancy, which is 70-80 years old.

The other article explained why current clinical trial design fails so many potentially good drugs, and how clinical trial process itself should be changed:
http://www.nature.com/nature/journal/v485/n7400_supp/full/485S58a.html


Different clinical trials should be conducted, with different end-point. The ultimate goal is to make the turn-around-time fast. So scientists can try a drug, wait a few days/weeks for results; tweak it to improve it, wait a few days/weeks for results; repeat above.

Currently the scientists must wait years and years for results every single human related iteration of drug design. No wonder effective treatments are few and far in between and very very expensive.   

Imagine one day there is a CTC test similar to blood glucose test, where patients can poke their fingers in morning/lunch/dinner time and get 3 data points.    Patients/physicians can see in real time how CTC is changing with new treatment/exercise regimen, and this data can be used to forecast patients' real response to medication and used in clinical trials, which takes a few months to run, instead of years and years.    Patients need not put their lives on the line to join a randomized clinical trial.  And 100% advanced breast cancer patients can join a clinical trial that generate a valid data point without having to make a commitment for years till death (for the OS benefit) .  Then we can say truly, that MBC is a chronic disease, like diabetes.  And its cure would not be far off.