What Is To Be Done?

Epistemic status: loose and speculative

This is the last post in my cancer series. On reflection, there’s a lot I want to edit and expand here, and I think the right format for this  is a book rather than a blog. So, over the next several months I’ll be working on that.

In the meantime, I want to draw some conclusions given what I’ve found out about cancer so far. What are the next steps? Where do we go from here? The world I see is one where the “efficient market hypothesis” doesn’t hold in cancer research. Just because an idea is promising doesn’t mean it’ll be tried, particularly in human clinical trials.

So what can you, a reader, do to cure cancer?

1. Do cancer research

This one’s kind of a no-brainer, but I put it here because I see a lot of young EA’s wondering what to do with their lives, and the most frequent ideas are things like “make a lot of money to give to charity” or “work at an EA organization”, but I really believe a broader range of object-level skills could be useful for bettering the world. Doctors and biologists are important. Ultimately, the things that kill the most human beings today are the noninfectious diseases of aging.  If your heroes are the people who eradicated smallpox, maybe you should take up the cause of ending another disease.

2. Invest in or donate to organizations doing undervalued cancer work

In my blog series, I pointed out some researchers that I thought were doing unusually promising early-stage research.  Getting preclinical studies to clinical trials takes funding.

I haven’t investigated any of these organizations as organizations — I don’t claim to know that they’re likely to be profitable investments or efficient charities. I’m just looking at the drug candidates that I’ve found promising and seeing which existing organizations are involved in researching them.

3-bromopyruvate, the glycolysis inhibitor I’m bullish on, is being developed by PreScience Labs.

The Cancer Research Institute, a nonprofit that accepts donations, has funded a great deal of important immunotherapy research, including most of the recent work on mixed bacterial vaccine by the late renowned immunologist Lloyd J. Old.

The Fibrolamellar Cancer Foundation, which focuses on the rare liver cancer fibrolamellar hepatocellular carcinoma, has Sanford Simon on its advisory board and funded his research on anti-IgG antibodies to precisely detect and potentially destroy cancer cells.

I expect that there are other avenues to funding particular lines of scientific research, from creating novel grant-giving foundations to crowdfunding experiments.

I’m also interested in institutions like IndieBio, which try to bring a radical, Silicon Valley spirit to the biotech industry, and get funding for biomedical startups working on hard problems.

3. Political reform

It would be easier to innovate in cancer research if the regulatory challenges were less onerous.  Lobbying and activism, in the US or elsewhere, could probably be helpful.

This is an area where think tanks and patient advocacy groups are relevant.  I don’t have a clear idea of which precise policy goals are the most useful and attainable, but people with more of a policy bent can probably answer that question.

A different kind of “political” approach is regulatory arbitrage — trying to find or negotiate a favorable political climate to research somewhere outside the US.

4. Further meta-research

We clearly need more evaluative work done on the questions “What types of cancer research are most promising? Where is the low-hanging fruit, if any?”  I’ve been doing that, but I’m only one perspective.  This seems valuable in the context of something like the Open Philanthropy Project, which tries to evaluate the tractability of entire goals.



2 thoughts on “What Is To Be Done?

  1. Thanks for your work on this series. I will look forward to your book (be sure to plug it here) and will probably make some small-ball donations towards the orgs you mentioned.

  2. Thanks for all these posts. Some of it I’ve heard many times before (for example: Gleevac was a fluke that’s been treated as a paradigm), but seeing lists of all the trials with short quantitative summaries gives me a feeling of stronger confidence. Some of it was completely new to me (anti-IgG for detection & treatment). I’m really happy to have been able to benefit from the attention to detail that characterizes your secondary research. Also the connections of all these facts to big-picture heuristics for success were really interesting and I’ll be thinking more about those.

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