Category: Entrepreneurship

Rectal Cancer “Vanished” in All 18 in Clinical Trial: An “Astonishing” and “Unheard-Of” Result

(p. A18) It was a small trial, just 18 rectal cancer patients, every one of whom took the same drug.

But the results were astonishing. The cancer vanished in every single patient, undetectable by physical exam, endoscopy, PET scans or M.R.I. scans.

Dr. Luis A. Diaz Jr. of Memorial Sloan Kettering Cancer Center, an author of a paper published Sunday [June 5, 2022] in the New England Journal of Medicine describing the results, which were sponsored by the drug company GlaxoSmithKline, said he knew of no other study in which a treatment completely obliterated a cancer in every patient.

“I believe this is the first time this has happened in the history of cancer,” Dr. Diaz said.

Dr. Alan P. Venook, a colorectal cancer specialist at the University of California, San Francisco, who was not involved with the study, said he also thought this was a first.

A complete remission in every single patient is “unheard-of,” he said.

. . .

Dr. Kimmie Ng, a colorectal cancer expert at Harvard Medical School, said that while the results were “remarkable” and “unprecedented,” they would need to be replicated.

The inspiration for the rectal cancer study came from a clinical trial Dr. Diaz led in 2017 that Merck, the drugmaker, funded. It involved 86 people with metastatic cancer that originated in various parts of their bodies.

. . .

Tumors shrank or stabilized in about one-third to one-half of the patients, and they lived longer. Tumors vanished in 10 percent of the trial’s participants.

That led Dr. Cercek and Dr. Diaz to ask: What would happen if the drug were used much earlier in the course of disease, before the cancer had a chance to spread?

. . .

Perhaps, Dr. Cercek and Dr. Diaz reasoned, immunotherapy with a checkpoint inhibitor would allow such patients to avoid chemotherapy, radiation and surgery.

Dr. Diaz began asking companies that made checkpoint inhibitors if they would sponsor a small trial. They turned him down, saying the trial was too risky. He and Dr. Cercek wanted to give the drug to patients who could be cured with standard treatments. What the researchers were proposing might end up allowing the cancers to grow beyond the point where they could be cured.

“It is very hard to alter the standard of care,” Dr. Diaz said. “The whole standard-of-care machinery wants to do the surgery.”

Finally, a small biotechnology firm, Tesaro, agreed to sponsor the study. Tesaro was bought by GlaxoSmithKline, and Dr. Diaz said he had to remind the larger company that they were doing the study — company executives had all but forgotten about the small trial.

Their first patient was Sascha Roth, then 38.

. . .

Soon, she was scheduled to start chemotherapy at Georgetown University, but a friend had insisted she first see Dr. Philip Paty at Memorial Sloan Kettering. Dr. Paty told her he was almost certain her cancer included the mutation that made it unlikely to respond well to chemotherapy. It turned out, though, that Ms. Roth was eligible to enter the clinical trial. If she had started chemotherapy, she would not have been.

. . .

After the trial, Dr. Cercek gave her the news.

“We looked at your scans,” she said. “There is absolutely no cancer.” She did not need any further treatment.

“I told my family,” Ms. Roth said. “They didn’t believe me.”

But two years later, she still does not have a trace of cancer.

For the full story, see:

Gina Kolata. “Study on Rectal Cancer Results in Complete Remission.” The New York Times (Tuesday, June 7, 2022): A18.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date June 5, 2022, and has the title “A Cancer Trial’s Unexpected Result: Remission in Every Patient.” The online version of the article says that the title of the print version was “Rectal Cancer Drug Trial Results in Complete Remission.” But my National edition of the article had the title “Study on Rectal Cancer Results in Complete Remission.”)

The paper mentioned above in The New England Journal of Medicine is:

Cercek, Andrea, Melissa Lumish, Jenna Sinopoli, Jill Weiss, Jinru Shia, Michelle Lamendola-Essel, Imane H. El Dika, Neil Segal, Marina Shcherba, Ryan Sugarman, Zsofia Stadler, Rona Yaeger, J. Joshua Smith, Benoit Rousseau, Guillem Argiles, Miteshkumar Patel, Avni Desai, Leonard B. Saltz, Maria Widmar, Krishna Iyer, Janie Zhang, Nicole Gianino, Christopher Crane, Paul B. Romesser, Emmanouil P. Pappou, Philip Paty, Julio Garcia-Aguilar, Mithat Gonen, Marc Gollub, Martin R. Weiser, Kurt A. Schalper, and Luis A. Diaz. “PD-1 Blockade in Mismatch Repair–Deficient, Locally Advanced Rectal Cancer.” New England Journal of Medicine 386, no. 25 (June 23, 2022): 2363-76.

Superworm Larvae Can Digest Styrofoam

(p. D2) The plump, glossy larvae of the darkling beetle, nicknamed “superworms” perhaps because of their size, are usually content to munch on wheat bran. But a number of the two-inch-long critters recently found themselves dining on much stranger fare in the service of science: polystyrene, the long-lived plastic packing material known sometimes by the brand name Styrofoam.

What’s more, the larvae that managed to choke down this peculiar feedstock did not, as you might expect, expire. As scientists documented in a paper published on Thursday [June 16, 2022] in the journal Microbial Genomics, they even gained a bit of weight and were able to metamorphose into beetles most of the time, prompting the researchers to check their digestive systems for microbes that could break down the polystyrene. If scientists can understand such microbes’ tool kits, they can devise a better way to recycle this tenacious substance, which, if left on its own, may persist in the environment for hundreds of years or more.

For the full story, see:

Veronique Greenwood. “Don’t Try This at Home: Styrofoam as a Snack Food? Superworms Just Pack It In.” The New York Times (Tuesday, June 21, 2022): D2.

(Note: bracketed date added.)

(Note: the online version of the story has the date June 10, 2022, and has the title “How Superworms Make Styrofoam Into a Healthy Meal.” The version quoted above is the online version that includes several words that are absent from the print version.)

The paper mentioned above is:

Sun, Jiarui, Apoorva Prabhu, Samuel T. N. Aroney, and Christian Rinke. “Insights into Plastic Biodegradation: Community Composition and Functional Capabilities of the Superworm (Zophobas Morio) Microbiome in Styrofoam Feeding Trials.” Microbial Genomics 8, no. 6 (2022).

The “Perceptually Divergent” Are Open to How Species Differ in Their Sensory Trade-Offs

(p. C1) That I found myself surprised at so many moments while reading “An Immense World,” Ed Yong’s new book about animal senses, speaks to his exceptional gifts as a storyteller — . . .

. . .

(p. C4) Yong’s book is funny and elegantly written, mercifully restrained when it comes to jargon, though he does introduce a helpful German word that he uses throughout: Umwelt. It means “environment,” but a little more than a century ago the Baltic German zoologist Jakob von Uexküll used it to refer more specifically to that sensory bubble — an animal’s perceptual world.

. . .

The human Umwelt will necessarily shape how we apprehend other Umwelten. “An Immense World” inevitably refers to the philosopher Thomas Nagel’s foundational essay on this struggle, “What Is It Like to Be a Bat?”

But some humans might be more open-minded than others. A number of the sensory biologists Yong meets are perceptually divergent, seeing color differently or having difficulty remembering familiar faces: “Perhaps people who experience the world in ways that are considered atypical,” he writes, “have an intuitive feeling for the limits of typicality.”

When it comes to sight, there’s a trade-off between sensitivity and resolution; humans tend to have extraordinary visual acuity during the day but have a much harder time seeing at night, while animals with better night vision don’t register the crisp images at a distance that we do. “Senses always come at a cost,” Yong writes. “No animal can sense everything well.” The world inundates us with stimuli. Registering some of it is taxing enough; fully processing the continuous deluge of it would be overwhelming.

For the full review, see:

Jennifer Szalai. “An Enthralling Tour Of Nonhuman Reality.” The New York Times (Thursday, June 23, 2022): C1 & C4.

(Note: ellipses added.)

(Note: the online version of the review has the date June 22, 2022, and has the title “‘An Immense World’ Is a Thrilling Tour of Nonhuman Perception.”)

The book under review is:

Yong, Ed. An Immense World: How Animal Senses Reveal the Hidden Realms around Us. New York: Random House, 2022.

Key Healthcare Issue Is Not How to Divvy Up a Fixed Pie, But How to Grow the Pie Through New Cures

(p. A23) . . . in the second phase of my illness, once I knew roughly what was wrong with me and the problem was how to treat it, I very quickly entered a world where the official medical consensus had little to offer me. It was only outside that consensus, among Lyme disease doctors whose approach to treatment lacked any C.D.C. or F.D.A. imprimatur, that I found real help and real hope.

And this experience made me more libertarian in various ways, more skeptical not just of our own medical bureaucracy, but of any centralized approach to health care policy and medical treatment.

This was true even though the help I found was often expensive and it generally wasn’t covered by insurance; like many patients with chronic Lyme, I had to pay in cash. But if I couldn’t trust the C.D.C. to recognize the effectiveness of these treatments, why would I trust a more socialized system to cover them? After all, in socialized systems cost control often depends on some centralized authority — like Britain’s National Institute for Health and Care Excellence or the controversial, stillborn Independent Payment Advisory Board envisioned by Obamacare — setting rules or guidelines for the system as a whole. And if you’re seeking a treatment that official expertise does not endorse, I wouldn’t expect such an authority to be particularly flexible and open-minded about paying for it.

Quite the reverse, in fact, given the trade-off that often shows up in health policy, where more free-market systems yield more inequalities but also more experiments, while more socialist systems tend to achieve their egalitarian advantages at some cost to innovation. Thus many European countries have cheaper prescription drugs than we do, but at a meaningful cost to drug development. Americans spend obscene, unnecessary-seeming amounts of money on our system; America also produces an outsize share of medical innovations.

And if being mysteriously sick made me more appreciative of the value of an equalizing floor of health-insurance coverage, it also made me aware of the incredible value of those breakthroughs and discoveries, the importance of having incentives that lead researchers down unexpected paths, even the value of the unusual personality types that become doctors in the first place. (Are American doctors overpaid relative to their developed-world peers? Maybe. Am I glad that American medicine is remunerative enough to attract weird Type A egomaniacs who like to buck consensus? Definitely.)

Whatever everyday health insurance coverage is worth to the sick person, a cure for a heretofore-incurable disease is worth more. The cancer patient has more to gain from a single drug that sends the disease into remission than a single-payer plan that covers a hundred drugs that don’t.

. . .

. . ., the weakness of the liberal focus on equalizing cost and coverage is the implicit sense that medical care is a fixed pie in need of careful divvying, rather than a zone where vast benefits await outside the realm of what’s already available.

. . .

. . . once you’ve become part of the American pattern of trying anything, absolutely anything in order to feel better — and found that spirit essential to your own recovery — the idea of medical cost control as a primary policy goal inevitably loses some of its allure, and the American way of medical spending looks a little more defensible. To just try things without counting the cost can absolutely run to excess. But sometimes what seems like waste on the technocrat’s ledger is the lifeline that a desperate patient needs.

For the full commentary, see:

Ross Douthat. “Being Sick Changed My Views on Health Care.” The New York Times (Thursday, January 20, 2022): A23.

(Note: ellipses added.)

(Note: the online version of the commentary has the date January 19, 2022, and has the title “How Being Sick Changed My Health Care Views.”)

The commentary quoted above is related to the author’s book:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.

F.A.A. Can Take Many Years to Certify Innovative Aviation Technologies

(p. 6) Despite the excitement about e-planes, the Federal Aviation Administration has never certified electric propulsion as safe for commercial use. Companies expect that to change in the coming years, but only gradually, as safety concerns are worked out.

. . .

The consensus within the industry is that the F.A.A., which regulates half the world’s aviation activity, is several years from certifying urban air mobility.

“It’s a big burden of proof to bring new technology to the F.A.A. — appropriately so,” Mr. Clark said. Currently the certification process for a new plane or helicopter takes two to three years on average. For an entirely new type of vehicle, it could be considerably longer. (One conventionally powered aircraft that can take off and land without a runway had its first flight in 2003. It remains uncertified.)

For the full story, see:

Ben Ryder Howe and Tristan Spinski. “Covid Patient In Shanghai Describes Life In Isolation.” The New York Times, SundayBusiness Section (Sunday, April 17, 2022): 1 & 6-7.

(Note: ellipsis added.)

(Note: the online version of the story was updated April 18, 2022, and has the title “The Battery That Flies.”)

Elon Musk Is a “Free Speech Absolutist”

(p. A1) Twitter Inc. accepted Elon Musk’s bid to take over the company and go private, a deal that would give the world’s richest person control over the social-media network where he is also among its most influential users.

. . .

On Monday [April 15, 2022], a day after The Wall Street Journal first reported that a deal was close, Mr. Musk tweeted to indicate that he wants the platform to be a destination for wide-ranging discourse and disagreement.

. . .

(p. A6) Mr. Musk, a self-described “free speech absolutist,” said in a recent interview at a TED conference that he sees Twitter as the “de facto town square.”

For the full story, see:

Cara Lombardo, Meghan Bobrowsky and Georgia Wells. “Musk Strikes Deal to Buy Twitter.” The Wall Street Journal (Tuesday, April 26, 2022): A1 & A6.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story was updated April 25, 2022, and has the title “Twitter Accepts Elon Musk’s Offer to Buy Company in $44 Billion Deal.”)

Diamond to Teach Economics of Entrepreneurship Seminar in Fall 2022

Prof. Art Diamond, Economics
College of Business Administration
University of Nebraska Omaha
Seminar Meets in Mammel Hall 116
Fall 2022, Tuesdays, 6:00 – 8:40 PM
First Session: Aug. 23, 2022

ECON 4730-001, ECON 8736-001

Some Questions to Be Discussed:

• How can policies encouraging innovative entrepreneurship help us create a more dynamic growth economy with more and better jobs, more and better innovations, and more choice and opportunity?
• Are innovative entrepreneurs smarter, or more courageous, or less risk-averse, or more intuitive, or more determined, or more frugal, or more arrogant, or more hard-working, or greedier, than the rest of us?
• Can economic historian John Nye defend his claim that successful entrepreneurs are “lucky fools?”
• What is the role of entrepreneurship in the process of economic dynamism, and what is the role of economic dynamism in making our lives longer and better?
• Would labor be better off in an economy in which innovative entrepreneurship is encouraged?
• Why did economist Will Baumol believe that too much higher education can discourage successful innovative entrepreneurship?
• Can unbinding entrepreneurs in medicine bring us more cures and longer lives?

Dreaming Often Is Nonlinear Problem-Solving

(p. A15) Antonio Zadra and Robert Stickgold, two of the world’s leading researchers in the science of sleep and dreams, have written a remarkable account of what we know and don’t know about this mysterious thing that happens during the night.

. . .

To many, dreams are prophecies, implanted in our brains by God or angels; to others, they exist to encode our memories of the previous day, to others they are simply random neural firings.

. . .

The weight of the evidence supports a more elaborate, nuanced and wondrous version of the memory-encoding hypothesis. Messrs. Zadra and Stickgold have designed a conceptual model they call Nextup (“Network Exploration to Understand Possibilities”), using it to describe the progression of dreams throughout the four sleep stages and their different functions. They debunk the common myth that we only dream during REM sleep and show that, in fact, we are typically dreaming throughout the night and in nonREM sleep states. They tie all of this into the brain’s “default mode network,” in which our minds are wandering and, often, problem-solving. When we’re awake, our brains are so busy attending to the environment that we tend to favor linear connections and thinking; when we allow ourselves to daydream, we solve problems that have distant, novel or nonlinear solutions.

For the full review, see:

Daniel J. Levitin. “Destination Anywhere.” The Wall Street Journal (Saturday, March 6, 2021): C7.

(Note: ellipses added.)

(Note: the online version of the review was updated March 5, 2021, and has the title “‘When Brains Dream’ Review: Night Shift.”)

The book under review is:

Zadra, Antonio, and Robert Stickgold. When Brains Dream: Exploring the Science and Mystery of Sleep. New York: W. W. Norton & Company, 2021.

Unknown Theodore Judah Mattered More Than Famous Leland Stanford in the Success of the Central Pacific

(p. A15) . . . Mr. De Wolk insists that his subject paved the way to a postindustrial revolution. “The way virtually every man, woman, and child in the world would live would be altered permanently,” the author writes. “All because of Leland Stanford’s life.” Nonsense.

The story that Mr. De Wolk tells is of an undistinguished man who had no success on his own as a young adult. But he did have the good fortune of having brothers who set him up with a wholesale grocery shop in Sacramento, Calif. More good luck came his way when Huntington, at the time a fellow shopkeeper, and two other local merchants hatched a railroad company—even though none of them had any railroad experience—and invited Stanford to join as a partner. The vast sums of capital that they would need would be mostly supplied by 30-year bonds issued by the federal government, which also awarded enormous grants of land, gratis.

. . .

The most important person in the company’s founding was altogether excluded from the quintet at the top: Theodore Judah, a young man in his early 30s and the only one among the leadership who had any real experience building railroads. Judah’s surveys of the Sierra Nevada led to the discovery of a feasible passage at Donner Pass. It was Judah’s presentation to prospective investors that emboldened the Sacramento shopkeepers to go into the railroad business.

For the full review, see:

Randall Stross. “BOOKSHELF; Leland Stanford: Life and Myth.” The Wall Street Journal (Monday, October 28, 2019): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date October 27, 2019, and has the title “BOOKSHELF; ‘American Disruptor’ Review: The Life and Myth of Leland Stanford.”)

The book under review is:

De Wolk, Roland. American Disruptor: The Scandalous Life of Leland Stanford. Oakland, California: University of California Press, 2019.

Crispr Gene-Editing Tried Against Cancer

(p. D4) Doctors have for the first time in the United States tested a powerful gene-editing technique in people with cancer.

The test, meant to assess only safety, was a step toward the ultimate goal of editing genes to help a patient’s own immune system to attack cancer. The editing was done by the DNA-snipping tool Crispr.

The procedure was feasible and safe, early results indicate, but whether it is fighting the disease is unclear. Only three patients have been treated so far, and the longest follow-up is nine months. All three patients are in their 60s, with very advanced cancers that had progressed despite standard treatments like surgery, radiation and chemotherapy.

“The good news is that all of them are alive,” said Dr. Edward A. Stadtmauer, the section chief of hematologic malignancies at the University of Pennsylvania Abramson Cancer Center. He added, “The best response we’ve seen so far is stabilization of their disease.”

For the full story, see:

Denise Grady. “Editing Genes in Bid to Fight Cancer.” The New York Times (Tuesday, November 12, 2019): D4.

(Note: the online version of the story was updated Oct. 7, 2020 [sic], and has the title “Crispr Takes Its First Steps in Editing Genes to Fight Cancer.”)