This past weekend, I took an evening off to attend the Southern California Distinguished Speaker series featuring theoretical physicist and futurist Prof. Michio Kaku. After seeing the 2014 movie, “Interstellar,” I was hoping to find out if Prof. Kaku thought it was really possible to use wormholes to travel to distant galaxies.

But I was disappointed because, much to my surprise, his talk focused on future advances in medicine—particularly involving computers and robots! This ended up being a bit scary for many in the audience, which became quite hushed when he explained how computers could be taking over pretty much everything.

Echoes of the Black Swan Research Initiative

On the plus side, many ideas he mentioned will be very helpful. Wearing “super” Google-type glasses, the doctor will identify you by facial recognition and know your history and recent test results—very helpful indeed! Using advanced imaging and electronic probes, disease assessment can be accurate, sensitive and semi-automatic. Also, and of particular interest to me, he emphasized the importance of very early diagnosis and intervention, with monitoring at the lowest level of diseases such as cancer. This is exactly the concept of the IMF’s Black Swan Research Initiative® --early myeloma diagnosis, intervention, and monitoring at the lowest level of disease.  

Prof. Kaku predicts that in the future, most medical care will be dispensed using a DeepMind-type computer (which recently defeated the world Go champion), with little human intervention. This is very different than visiting your local general practitioner!

Medical care reality check

Although I appreciate the value of these high-level changes, I feel that the day-to-day reality of medical care cannot be ignored while we contemplate an idealized future. The news continues to be full of stories about high costs and, most recently, waste.

A recent article in the New York Times described how reducing drug waste could save billions of dollars. This is because vials of medication come in sizes that leave half (or sometimes more) of the drug left over, which is then thrown away. This waste has to stop, but it will take the concerted efforts of regulators, manufacturers, and insurers, aided by patient awareness of the problem.

Patients also need to be aware of changes afoot for Medicare beneficiaries. The Centers for Medicare and Medicaid Services proposes to test new Medicare Part B prescription drug models, which they claim could improve quality of care and deliver better value.

This brings me to another item, an editorial in the “Comments and Controversies” section of the Journal of Clinical Oncology written by Dr. Leonard B. Saltz of New York City’s Memorial Sloan Kettering Cancer Center. “The value of considering cost and the cost of not considering value” is a very thoughtful commentary on the current state of affairs. There are definitely no easy solutions for these current world problems.

So with all these immediate questions and concerns, it was mostly good to think about an idealized future, where we may confirm that we are one of multiple “bubble universes” potentially connectable by wormholes. I can only hope that one of the universes has people who have managed to solve our many problems and guide us forward!

IMF Newsroom: Read all about it!

This week, we begin a feature called “IMF Newsroom,” a digest of important research, treatment, and quality-of-life news for the myeloma community. Whenever possible, we will link to paywall-free sources.

1.      New class of drug for myeloma: STING agonists

This means that it is possible to induce (with agonists) powerful immune responses by boosting the body’s production of interferons. The acronym STING stands for Stimulator of Interferon Genes, in case you were wondering.

2.      Approval of panobinostat by NICE in the UK

Details of the review and approval process illustrate how negotiations on cost using “base-case incremental cost-effectiveness rations” (a new approach) can lead to success in gaining drug approval in the UK. (Paywall.) Additional discussion in Pharma Times may be found HERE.

3.      Serial cytogenetic and FISH testing

Illustrates that good-risk patients tend to stay that way. This study looked at what happens over time and noted that the good-risk t(11;14) patients tended to have a good outcome and did not acquire any new mutations. (Paywall.)

4.      T-cell pioneer Carl June acknowledges key ingredient wasn’t his

Corrections to three articles published in The New England Journal of Medicine have just appeared. The chimeric antigen receptor, the “CAR” in CAR-T cell therapy, was supplied by Dr. Dario Campana and Dr. Chihaya Imai, who worked at St. Jude Children’s Research Hospital.

5.      Should All Research Papers Be Free?”

This week, the New York Times published two articles highlighting the increasing protests against scholarly journals’ paywalls, the one above and an article describing how a “Handful of Biologists Went Rogue and Published Directly to the Internet.” Paywalls are something patients searching for information encounter regularly. The Journal of Clinical Oncology has a patient access program, but others charge substantial fees to read beyond a study’s abstract. The IMF Newsroom will make every effort to offer non-paywall articles when possible.

Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.

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