In short
This episode of Here and Now focuses mainly on two medical stories. Topic 1: An FDA-approved pancreatic cancer drug for patients with advanced disease.
Guest
Dr. Brian Wolpin, director of the Hale Family Center for Pancreatic Cancer Research at Dana-Farber, principal investigator of the phase three trial.
Key claims
the drug blocks a specific KRAS mutation; median survival was 13 months (about twice standard chemotherapy); five-year survival for pancreatic cancer is ~12%; it’s intended to extend and improve life, not cure metastatic cancer.
Notable examples
side effects include diarrhea and rash; drug cost reported as about $39,000/month; access expands because oncologists can prescribe it without clinical trials. Topic 2: CTE in former NFL players.
Guest
Chris Nowinski, former pro wrestler turned neuroscientist; CEO of the Concussion and CTE Foundation.
Key claims
at least 25% of studied deceased players had CTE (range estimated 25–98%); CTE causes dementia and likely affects at least a million former players. Examples: study used brains from players who died 2016–2021; he cites youth tackle football risks and supports rule changes like heading bans.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOOverview of Pancreatic Cancer
0:39 to 1:35
Introduction to the severity of pancreatic cancer and ongoing research.
“Today on the show, scientists studying football players' brains found at least a quarter of former NFL players had CTE.”
New FDA-Approved Drug
1:35 to 2:27
Discussion on the new drug's trial results and implications for patients.
“He was the principal investigator of phase three of the clinical trial, evaluating the drug, and he spoke to Robin Young about the results.”
Understanding Drug Access and Costs
2:27 to 3:47
Exploration of the drug's availability, insurance coverage, and cost implications.
“And it is not likely that drugs will cure the cancer in that setting, meaning patients had metastases to their liver or their lungs or other places.”
Mechanism of Action: Targeting KRAS
3:47 to 5:01
Explanation of how the drug works by targeting the KRAS mutation in pancreatic cancer.
“So it doesn't guarantee coverage by insurances, but that is really what the FDA approval sets up, which is now the opportunity for it to be covered by insurance.”
Potential for Broader Cancer Applications
5:01 to 7:01
Discussion about the possibility of similar drugs for other cancers and funding challenges.
“But might we see similar drugs for other cancers, or is this specific to pancreatic cancer, this that you've been targeting, KRAS?”
Transition to CTE Discussion
7:01 to 7:29
Brief transition to the next segment on chronic traumatic encephalopathy.
“Brian Wolpin with the Dana-Farber Cancer Institute.”
CTE Study Findings
8:07 to 9:10
Discussion on new research findings regarding CTE in former NFL players.
“A new study of former NFL players found at least a quarter of them had CTE.”
Implications for Youth Sports
9:10 to 10:30
Exploration of the implications of CTE findings for youth sports and safety measures.
“Because a lot of NFL players who died who are part of this math, their brains have not been looked at.”
Future of CTE Research and Diagnosis
10:30 to 13:30
Looking ahead at the future of CTE diagnosis and the importance of research.
“This is one of the most common brain diseases in the United States, and there are no efforts or very few efforts to find a treatment for this.”
Nepal's Catastrophic Flooding
14:00 to 14:48
Learn about the devastating effects of recent catastrophic floods in Nepal.
“the tumbling ice caused a fast-moving landslide and flash flooding, moving enough earth that the U.S.”
Show all 12 chapters
Impact and Response to the Disaster
14:48 to 17:48
Discover the on-ground impact of the flooding and the ongoing search and rescue efforts.
“He spoke to Scott Tong from the capital, Kathmandu, which thankfully was not hit by the floods.”
Personal Reflections of a Humanitarian Worker
17:48 to 19:24
Hear the emotional toll of disaster response on humanitarian workers in Nepal.
“You're a professional coordinating all this.”
Transcript
Automatic transcript. May contain errors.0:01Chris Nowinski:WBUR Podcasts, Boston.
0:07Chris Nowinski:We've desperately wanted to target this for many years now, but have been unable. It is now doing that. It is blocking that very specific mutation, and that's then leading to effectiveness in patients that we're seeing.
0:20Dr. Brian Wolpin:A new drug could extend the lives of people with one of the deadliest forms of cancer.
0:33Dr. Brian Wolpin:It's Thursday, August 27th, and this is Here and Now, Anytime from NPR and WBUR. I'm Chris Bentley.
0:43Dr. Brian Wolpin:Today on the show, scientists studying football players' brains found at least a quarter of former NFL players had CTE.
0:51Chris Nowinski:It is causing dementia, and it probably affects at least a million former football players in this country. Let's get to work on a cure.
0:58Dr. Brian Wolpin:Also, an aid worker on the ground in Nepal says the landslide and flash flooding there was like a tsunami of mud. A tsunami happens in the ocean, but we have seen that waves, like 20 meters, 30 meters of wave in the mountainous area. Before we get to that story, though, some good news in medicine. The FDA approved a new drug that treats advanced pancreatic cancer. In a trial, the drug extended lives of people who took it a median of 13 months, about twice as long as standard chemotherapy. Dr. Brian Wolpin is director of the Hale Family Center for Pancreatic Cancer Research at the Dana-Farber Cancer Institute.
1:40Dr. Brian Wolpin:He was the principal investigator of phase three of the clinical trial, evaluating the drug, and he spoke to Robin Young about the results.
1:48Chris Nowinski:It feels like the culmination of many, many years of work for many, many people. And it is really quite exciting to see an advance in pancreatic cancer, which has been very long in coming.
2:01Dr. Brian Wolpin:Yeah. And yet, and it's exciting, but I just want to underscore so people don't miss here. The combined survival rate for pancreatic cancer five years after diagnosis is only about 12%. Pancreatic cancer has few symptoms. It's also been found too late when it's already spread. So when we say treat, which this drug does, are we talking about cure or extending life, which is also so valuable?
2:26Chris Nowinski:Yeah, I think the data from this clinical trial was in patients who already had spread of their cancer. And it is not likely that drugs will cure the cancer in that setting, meaning patients had metastases to their liver or their lungs or other places. So trials in this setting are usually trying to have people live longer and also to help them live better to prevent symptoms from the cancer and improve their quality of life. So for this trial, it really was living longer and living better. There are trials now that are underway to see whether we can also cure more patients using medicines like this around the time of surgery.
3:02Dr. Brian Wolpin:Oh, wow. From your lips. Hopefully that will happen. But what does it mean now with this trial and this drug? If you or someone you love has pancreatic cancer, Or can they take this drug? How do they get it? Is it covered?
3:16Chris Nowinski:Yeah, those are great questions. So I think the key with the FDA approval is it now allows oncologists to write a prescription for this medicine as you would do for any other medicine that you see your physicians for. It means you no longer need to be on a clinical trial or on some special program to receive the drug. So it really does broaden substantially the access to this medicine through your local oncology office because of this FDA approval.
3:46Dr. Brian Wolpin:And does the approval mean it's covered by insurance?
3:49Chris Nowinski:So that depends upon the insurance. So it doesn't guarantee coverage by insurances, but that is really what the FDA approval sets up, which is now the opportunity for it to be covered by insurance.
4:01Dr. Brian Wolpin:Yeah, because it's expensive. The Wall Street Journal is reporting that the drug costs$39 ,000 a month. So, yeah, that could be a roadblock for some. But there are also side effects, diarrhea, a rash. But can you very briefly, in layperson's words, tell us how this drug works?
4:20Chris Nowinski:Yeah, so I think the key for this drug is it's quite different than chemotherapy, which is what we've been using for many years, and works okay, but has quite a lot of side effects that come with it. This drug is really binding to and blocking a very specific mutated protein in pancreatic cancer called KRAS. And that protein is mutated in almost all pancreatic cancers. We've desperately wanted to target this for many years now, but have been unable because the chemistry hasn't been able to figure out how to make drugs that do that. But that's really what makes this drug special is it is now doing that.
4:56it is blocking that very specific mutation, and that's then leading to effectiveness in patients
5:01Chris Nowinski:that we're seeing.
5:02Dr. Brian Wolpin:Wonderful. But might we see similar drugs for other cancers, or is this specific to pancreatic cancer, this that you've been targeting, KRAS?
5:13Chris Nowinski:Yeah, so it turns out, as you're noting, that KRAS is mutated in other cancer types too, quite a bit of lung cancer and colorectal cancer, GYN cancers, quite a number. This drug is also being tested in those settings, But there are also now multiple other drugs. This really has opened a floodgate of new medicines that are targeting KRAS and RAS more generally. And those medicines are also now coming to the clinic. They're not approved yet by the FDA, but they are in clinical trials. And I think we will likely see benefits for these other cancer types, either with Durexon RAS at this drug or some of these other compounds that are now being tested.
5:49Dr. Brian Wolpin:It's just wonderful. And we reported just last week on an mRNA vaccine that could help treat melanoma. By the way, you know, we also know that science and research funding is being slashed. So what do we make of these breakthroughs so close together? Was there one domino that fell? You know, why is this happening?
6:10Chris Nowinski:Yeah, I don't think there's one single domino. I think it really is a concerted effort over many years. with the story for RAS inhibitors. We've known about this mutation for several decades, and it's really been a large concerted effort from the scientific field to understand how it works and then ultimately design drugs that can bind to it and block it. I think it's really that persistence. It's sort of sticking to it, even when it's complicated, that allows you to ultimately make these breakthroughs. I think that's also true with the mRNA vaccines, but I'm not sure they're directly connected like that per se.
6:43Dr. Brian Wolpin:And I don't want to raise false hope, but this is why extending life is so valuable, isn't it? Because who knows what will happen. I totally agree.
6:53Chris Nowinski:I think the more you can extend life and help people feel better, the more science advances and the more opportunities there becomes over time.
7:01Dr. Brian Wolpin:Yeah. Well, congratulations.
7:04Chris Nowinski:Thank you. Dr.
7:05Dr. Brian Wolpin:Brian Wolpin with the Dana-Farber Cancer Institute.
7:12Dr. Brian Wolpin:Coming up next, another medical advancement, though there's no drug to treat this next condition, even though it's one of the most common brain diseases in the U.S. After the break, the findings of a new landmark study on football players with CTE. Stick around.
7:32Chris Nowinski:This message comes from Granger. This is the story of The One. As a procurement manager for a hospital system, she keeps every facility in her network stocked and ready. That's why she counts on Grainger to be her single source for thousands of products, from disinfectants to lighting, air filters, and more. And with fast, dependable delivery, Grainger helps her keep every facility stocked, safe, and running smoothly. Call 1-800-GRAINGER, click grainger.com, or just stop by. Grainger, for the ones who get it done.
8:06Dr. Brian Wolpin:Some more interesting news in the medical research department. A new study of former NFL players found at least a quarter of them had CTE. That's chronic traumatic encephalopathy, a degenerative brain disease. Researchers counted every player who had appeared in at least one NFL game since 1949 and then focused on those who died between 2016 and 2021. One of the study's co-authors, Chris Nowinski, is a former professional wrestler turned neuroscientist. He's also CEO of the Concussion and CTE Foundation. And he tells Scott Tong he's not exactly surprised by the new results.
8:46Chris Nowinski:We've been getting so many NFL brains and we really do struggle to find negatives. We're still over 90 % of the hundreds of NFL players we've studied have had the disease. But I was most surprised that the NFL community has been so supportive of this research that 27 % of NFL players who died over a six-year period donated their brain almost exclusively to Boston University's CT Center.
9:09Dr. Brian Wolpin:Yeah, and we should say this is a conservative number. Is that right? Because a lot of NFL players who died who are part of this math, their brains have not been looked at.
9:19Chris Nowinski:Correct. This study just proves that the range is somewhere between 25 % and 98%. It probably lies somewhere in the middle, and we're working on trying to give people the best estimate of that number.
9:30Dr. Brian Wolpin:How do you think this advances the public conversation? Does it give scientists like you, sports parents, coaches, leagues, more important information as they make decisions about sports and rules?
9:43Chris Nowinski:Yeah, I think there's two important things that should come from this study. One is that there are a lot of people, and including myself, because I played football, have been holding out, hoping that this might still be a rare disease and we're only seeing the worst of the worst. This is that definitive article to say, no, if this is affecting a minimum of a quarter and far more NFL players, it also affects a lot of college players and a lot of high school players. And to give you a window into that, I've already lost two of the starting 22 off my 1999 Harvard team that have died with CTE. The other part is that the debate over the last 20 years has been how many people, is it causal, all these things.
10:21Chris Nowinski:We've now proven it hits the head of causing this, it is causing dementia, and it probably affects at least a million former football players in this country. Let's get to work on a cure. That conversation is not happening. This is one of the most common brain diseases in the United States, and there are no efforts or very few efforts to find a treatment for this.
10:40Dr. Brian Wolpin:So I guess let me ask about youth sports and how you think about what needs to happen. You know, my boys, they're in their 20s now. They played travel soccer. My older son, they were hitting the ball from day one. But my younger son, as the science advanced, he was in these leagues where they had these rules. You have to be like 10 or 11 right before you do headers in practice. So some of the sports started to change, and yet there's still tackle football for little kids. What are the most important changes you think need to happen in youth sports?
11:11Chris Nowinski:Yeah, I mean, our campaign at the Concussion CT Foundation is called Stop Hitting Kids in the Head. We fought for that heading ban in 2015. I'm glad your son benefited from that. We worked with USA Hockey to raise the checking age from 11 to 13. The only sport in America that is refusing to even consider an age minimum for getting CTE is tackle football. And I worry about those kids because we've shown your odds of getting CTE increase every year you play. The average youth football hit is the same acceleration as a college hit because they're tiny bobbleheads. And so I do hope parents hear this and say a flag is a wonderful way to get into the game of football.
11:51Chris Nowinski:And the fewer miles your child has on their brain before they get to high school football, the better off they're going to be.
Read the full transcript
11:57Dr. Brian Wolpin:What, if anything, changes as far as pro football? I mean, the NFL provided statements to news organizations reporting on this saying the league is doing more work to reduce head injuries, to reduce concussions. Will science like this bring appreciable change to professional football?
12:14Chris Nowinski:I guess the question is, does it have to? And so we have a very strong dialogue with the NFL Players Association, and it's a choice. We're trying to tell them what we know when we know it, and they can choose what they want to fight for for safety. The kids playing don't have that choice, and that's where the focus needs to be. So I do hope the NFL and NFL Players Association put their muscle behind getting a cure. You mentioned you played college football, became a professional wrestler, retired after
12:41Dr. Brian Wolpin:severe post-concussion syndrome. Do you wonder more, wonder in a different way about the guys you played with, the guys you played against, about yourself and your own future?
12:51Chris Nowinski:No, it's always in the back of my mind whether or not I have this. and I try to put that anxiety into not compromising and pushing forward so that we have a cure. If I need it in 10 years, I hope there is a treatment and I hope to be part of the team that creates it.
13:08Dr. Brian Wolpin:And what is the future of being able to diagnose CT in people while they're still alive?
13:15Chris Nowinski:The great thing is this is very depressing news and sobering news on NFL players, But because all of their involvement in this research, a diagnosis during life we think is right around the corner, and we can get to work on real clinical trials to stop this thing.
13:30Dr. Brian Wolpin:Wow. We've been talking to Chris Nowinski, CEO of the Concussion and CTE Foundation. Chris, always good to have you. Thanks so much.
13:38Chris Nowinski:Thank you, Scott.
13:46Dr. Brian Wolpin:Coming up, we hear from an aid worker in Nepal responding to the catastrophic flooding there. That's in just a minute.
13:59Dr. Brian Wolpin:At least 300 people are dead on the border of Nepal and China after part of a glacier collapsed Wednesday. the tumbling ice caused a fast-moving landslide and flash flooding, moving enough earth that the U.S. Geological Survey initially picked it up on their sensors as an earthquake. The deluge destroyed villages and bridges in the region. If you've seen any of the video online, it is hard to believe how catastrophic it looks. It's making it difficult for first responders to find survivors. And while Nepal's prime minister said emergency responders rescued almost 600 people today alone, more than 900 people are still reported missing, including some Americans.
14:44Dr. Brian Wolpin:Siraj Sigdel is in Nepal. He's the country director for Mercy Corps. He spoke to Scott Tong from the capital, Kathmandu, which thankfully was not hit by the floods. But he said even people far from the disaster area are in shock. It was massive. It was unexpected. And it was unprecedented. Nepal, you know, like it lies under the Himalayas, which is the source of water for the South Asia subcontinent. And we have been seeing this type of like flash floods, small, medium size regularly. So we are kind of Nepalese prepared. But this one, this one was quite massive. and even being so massive, it was not captured by our early warning systems in the right time.
15:30Dr. Brian Wolpin:So that has impacted in the huge casualties, as well as, you know, like around 40 kilometers of the river side, both sides of the river is washed away. So, you know, like people are calling it a tsunami, you know, like tsunami happens in the ocean. But like we have seen that waves, like 20 meters, 30 meters of wave in the mountainous area. 90 feet of wave, that's what you mean? Yes, in certain places where the river is stiff and it has hit in that level. So people, you know, like the people in the mountainous side, they felt that, okay, we are safe, but no one is safe. Yeah. Let me ask you about search and rescue efforts right now in this steep mountainous area.
16:20Dr. Brian Wolpin:How do you reach survivors? How do you find them? Oh, that's the critical part. You know, like so far, the government has mobilized like quite a dozen of helicopters. And that's the only way, because the highway that was connected to those areas is all washed. So we don't have the access by road. So only thing is using the helicopters. But we are afraid there are so many people, maybe they might have lost their phones or they are in the high mountains. They are still waiting for the rescue. And what are your team members hearing? What are they learning from the survivors? What are they telling you?
17:03Dr. Brian Wolpin:Yeah, survivors, they are still in shock. basically nobody thought about it you know like it's just like you know like we have Nepal has seen a big earthquake but that was a different story generally flood flash flood is something that people could predict or sometimes even see okay what would be the disaster and all that but this one is is quite humongous and it has impacted not just the life of people but the property their livelihoods, their houses, in just five minutes or ten minutes, it's gone. Even if it's standing, it's not livable now. So people are in shock. That's what we see. Suraj, you are based in Nepal as country director there.
17:52Dr. Brian Wolpin:You're a professional coordinating all this. But can I ask if you've begun to process some of this personally? How are you yourself reacting to what you're seeing and hearing? Actually, we were discussing in my office this morning, and I think we have to be very careful. Because with the social media, it is quite good, but sometimes it's overwhelming. And when we look at the videos and when we look at the stories of people, it is disturbing for ourselves as well, even though we want to contribute. But psychologically, we are human beings, and then it has impacted us. and basically won a few videos.
18:35Dr. Brian Wolpin:I mean, like the one with the checkpoint of the border. I mean, we see that people were running for their lives and then like suddenly everything burst. I mean, like how disheartening it is. So yes, I think we ourselves, even though we are the social workers and we work for the humanitarian cause, it is not easy for us to take it. So we need kind of counseling within our team. And then we support each other, you know, like not to take it personally, but. And then not to forget, I mean, like a few of my colleagues, their relatives or, you know, like distance cousins are also trapped or like unaccounted.
19:21Dr. Brian Wolpin:A few of them, that's the situation there. So it's quite a horrible situation in the past. We've been talking to Suraj Sigdel, the Nepal Country Director for Mercy Corps. Suraj, take good care of yourself and your team. Thank you very much. Thank you, Scott, for having me and letting me share the situation here in Nepal that we are going through. That's it for the show today. Here and now, anytime comes from NPR and WUR Boston. Today's stories were produced by Kalyani Saxena, Hafsa Qureshi, and Ashley Locke. Our editors were Todd Munt, Chico Theori, and Micaela Rodriguez. Technical direction from Caleb Green and Nick Dusall.
20:05Dr. Brian Wolpin:Our theme music is by Mike Moschetto, Max Liebman, and me, Chris Bentley. Our digital producers are Alison Hagen and Grace Griffin. And here at Now's executive producer is Alan Price. Thanks for listening. We'll be back with you tomorrow.
20:30Thank you.
From the publisher
Then, a recent study found that at least a quarter of former NFL players who died had chronic traumatic encephalopathy, or CTE. Chris Nowinski, CEO of the Concussion Legacy Foundation shares more about the findings and how they could impact the upcoming football season.
And, in Nepal, first responders are searching for survivors after a massive flash flood killed at least 300 people. Suraj Sigdel, Nepal Country Director for Mercy Corps, describes the work he and others are doing on the ground.
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