My father in law was diagnosed with stage 4 pancreatic cancer that's spread to his lungs about a month ago. This news today raised my wife's hopes immensely and had them immediately doused after hearing the oncologist say that although the drug is approved it will take months before they are able to prescribe it.
Father in law started chemo a few weeks ago and his condition deteriorated quickly, he's been at the hospital since; switching between ICU and general care. His abdomen fills up with fluid, around 6 liters every 5 days, draining the fluid plunges his blood pressure and he end up in ICU. They supply Albumin until blood pressure stabilizes and send him back to general. Only after the first chemo session the oncologists have stopped the treatment saying he's no longer eligible for chemo because of his over all health.
We're lucky enough to live an hour away from Johns Hopkins (though that's not the hospital he's currently at) and had an appointment scheduled but had to cancel since he's unable to walk.
The oncologist mentioned that daraxonrasib was available as an option when he first started chemo, but said he would only be eligible for it after trying chemo, so we know the drug is available.
Are there any tips from HN on how we can approach getting this medicine for my father in law?
I would suggest you have your physician submit a Expanded access request immediately, because the same page says that they will close this program after FDA approval as they transition to commercial use, but the timeline for that is unclear.
Ask the oncologist directly. Also, try contacting Revolution Medicines directly (the manufacturer), and/or go through their early access page: https://www.revmed.com/expanded-access-policy/
Thank you for sharing, the oncologists are saying that at this point in the diseases progression the same things that disqualify him from getting chemo also disqualify him from this drug. That in his current state it would do more harm.
I hope many others are helped by daraxonrasib, the key factor seems to be how early the cancer is detected, because it is an extremely fast acting disease.
I wonder if LLMs modify their output when they realize they are interacting with a famous person.
By famous I mean someone whose biography is in the training data. All models know a lot more about Terrance Tao than they know about me, when he's working on his projects do the models know they don't need to explain "Besicovitch sets".
Since the system prompt likely includes something about not insulting the user, does the LLM modify it's responses if it realizes it's talking to famous politician, like "dont mention the time $politician was cancelled".
Yes. I am NOT famous. But I am in the corpus. In my GPT3 beta tests, I asked it to be first Bill Bradley then Noam Chomski, (a parlor trick that's harder today due to RL), and Bill tried to butter me up based on some work history of mine. Chomsky then said "Man, I hate that guy."
>On the insurance front - expect your insurance to decline this forever unless you are at serious risk of diabetes.
I'm not understanding this part. If these drugs have solved obesity and the whole host of associated diseases, including the number one killer; heart disease, shouldn't the insurance companies be clambering over each other to cover these drugs and heavily encouraging their use considering the cost reduction on the overall health system.
And if the incentives are misaligned with insurance companies why are governments not handing out GLP-1s to anyone who asks?
For chronic diseases that tend to be caused by obesity, the expensive bits tend to be towards retirement aged people - or are so disabling that people drop out of the workforce early.
In either case the vast majority of those costs will be incurred by either Medicare or Medicaid. Or at least the next insurer in line as the typical worker doesn’t spend an entire career at the same firm with the same insurance provider.
By the time any cost savings benefits have been realized (call it a decade later), chances are that insured patient is long gone and all they were was an additional expense.
By the time government gets involved you have someone who has been obese all their life and the damage is largely already done. Even if you paid for the meds now, the savings are limited.
Given the market already though - these drugs will be affordable to the average working person within a few years
Your employer (large employers usually dictate what is covered by their insurance benefit offerings) may not care much about whether you end up with obesity-related diseases in your 60s and above.
> Recent studies have shown convincingly that vaccines against shingles (Herpes zoster) reduce the risk of dementia. The shingles vaccine now in widespread use (Shingrix) has more of an effect than the previous one (Zostavax). A key difference between these vaccines is that Shingrix contains an ‘adjuvant’, an ingredient designed to enhance the vaccine’s effect. It is therefore possible that the adjuvant contributes to Shingrix’ greater effect than Zostavax on reducing dementia.
This is something I've stuggled with for my site, I made https://aimodelreview.com/ to compare the outputs of LLMs over a variety of prompts and categories, allowing a side by side comparison between them. I ran each prompt 4 times for each model with different temperature values available as a toggles.
My thinking was to just make the responses available to users and let them see how models perform. But from some feedback, turns out users don't want to have to evaluate the answers and would rather see a leaderboard and rankings.
The scalable solution to that would be LLM as judge that some benchmarks already use, but that just feels wrong to me.
LM Arena tries to solve this with the crowd sourced solution, but I think the right method would have to be domain expert human reviewers, so like Wirecutter VS IMDb, but that is expensive to pull off.
I've suffered from dry eyes for many years and have tried all the over the counter options available in the US with no success, especially for overnight dryness. Could you please share a hint for the Irish pharmacy delivering to the US?
I believe you may correct; the final point is still absent (since the link chart predates the data in the story) and would (I think) continue the downward trend, but by how much is not clear.
Yes, they put this in footnote 1: "Throughout this article “training” can refer to either pre-training, or fine-tuning." But the article is just talking about fine-tuning.
Father in law started chemo a few weeks ago and his condition deteriorated quickly, he's been at the hospital since; switching between ICU and general care. His abdomen fills up with fluid, around 6 liters every 5 days, draining the fluid plunges his blood pressure and he end up in ICU. They supply Albumin until blood pressure stabilizes and send him back to general. Only after the first chemo session the oncologists have stopped the treatment saying he's no longer eligible for chemo because of his over all health.
We're lucky enough to live an hour away from Johns Hopkins (though that's not the hospital he's currently at) and had an appointment scheduled but had to cancel since he's unable to walk.
The oncologist mentioned that daraxonrasib was available as an option when he first started chemo, but said he would only be eligible for it after trying chemo, so we know the drug is available.
Are there any tips from HN on how we can approach getting this medicine for my father in law?