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Comment by evmar | Hacker News Reader

My layman's understanding of chemo is that it's meant to be systemic: surgeries and radiation are targeted at the tumor itself, while chemo is meant to hopefully wipe out cells that have reached other parts of the body.

But the description from this article suggests they're trying to make the chemo more targeted to the site of the tumor. That seems to counteract what I had understood to be the point of chemo.

Can you explain? (In case it wasn't obvious from the above, I have low knowledge in this area.)

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Your impression that chemo is only valuable for metastatic cancer is mistaken.

Chemo is effectively a poison that poisons the tumour faster than the rest of the body; the tumour’s cells are more susceptible to the poison than normal cells because they’re reproducing faster. As such, it doesn’t matter whether the tumour is large or small, localised or metastatic. It’s given systemically simply because of the nature of the drugs in question - because that’s generally how we get drugs into the body. Local administration of drugs is rare, and chemo especially so.

Historically, and probably the mainstream hypothesis, is that you need chemo to be systemic in order to take care of micrometastatic disease (tumors that you cannot see). However, with the advent of immunooncology (IO) therapies (drugs that help your body recognize the tumor) and the benefits of having chemo + IO drugs is challenging that dogma. Certain chemo drugs are known to trigger an immune response. Having a technology that gives intense amount of chemo at the tumor and without diminishing the persons immune system. Our technology opens the door to have this effect in humans. We have seen those effects in mice studies and presented the results in cancer conferences.

Thanks so much for answering! I think what I'm trying to understand is why you'd want to target chemicals if other options like surgery also are targeted. Is the application then for tumors that are hard to remove surgically?

Surgery is not a great option. It’s incredibly invasive, it’s risky, it costs valuable time to schedule, it’s expensive and at the point where you’re metastatic it’s not curative in any way.

I haven’t read the article, but if you can integrate this with regular chemo cadence to amplify effects at certain locations it seems like a no brainer.

Exactly. For us at Shasqi, it was about combining the spatial control of surgery with the temporal control (flexibility of dosing) of oral or intravenous drugs.

Chemo can be both curative or palliative. This means it can be used to cure the cancer, or simply prolong the life of a patient. Chemo can also be used in combination with surgical or used alone. Just because chemo affects most dividing cells doesn’t mean it is not a curative treatment. Targeted chemo therapies have less side effects and can be tolerated at higher doses.

I think all of the things you just wrote are true, but I don't see how they answer the question I asked... ?

1. Cancer is characterized as local tumor, locoregional or distant (metastasis). 2. Our approach can certainly help patients with local or locoregional disease. 3. As we have presented in multiple cancer conferences, our approach seems to also help with distant disease, because by focusing more powerful therapy to the tumor, sparing the rest of your body, we give the body the opportunity to recognize the tumor as foreign and fight it. https://cancerres.aacrjournals.org/content/80/16_Supplement/... https://www.biorxiv.org/content/10.1101/2020.10.13.337899v1

It's not uncommon to use chemo treatment to shrink the growth prior to removal.

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