How so? While I'm sure the Mayo Clinic will be attempting to patent and license this therapy, the research was apparently funded by the US government and various philanthropies.

[Quoting relevant sections of the paper since the full text is paywalled.]

"Grant Support: This work was supported by funds from the National Institutes of Health/National Cancer Institute (grants R01CA125614 and R01CA168719), Al and Mary Agnes McQuinn, the Harold W. Siebens Foundation, and the Richard M. Schulze Family Foundation. The National Cancer Institute RAID (Rapid Access to Intervention Development) Program supported MV-NIS manufacture and toxicology/pharmacology studies.

Potential Competing Interests: Drs Russell, Federspiel, and Peng and Mayo Clinic have a financial interest in the technology used in this research."

Slightly tangential, but I wonder where the IP in this discovery is? If there is nothing to sell but injecting cancer patients with standard lab-grade measles, I think it is particularly open to being copied. Granted the measles used is genetically tweaked, but nothing I believe to enhance the therapeutic effectiveness.

If public funds and private donations could actually cover the research costs getting all the way to FDA approval, I would think you would see more doctors and researchers creating nonprofit partnerships to attract the funds and do the research. Sounds like it would be a dream come true to be funded to do research you cared about and better the lives of millions without the corporate suits getting in your way. But I think the reality is the facilities alone cost hundreds of millions if not billions, so just for Mayo to give you the lab space to work for a couple years is a major investment.

I don't know why we go through this kabuki process of pretending there is a functioning market in places where the government is such a dominant player (see also defense contractors). Why not just cut out the middleman?

At this point I risk conflating not just two but three arms of the government: the NIH (funding), FDA (approval), and Medicare (payment).

> Why not just cut out the middleman?

Medicare has hinted at doing this, using its purchasing power to drive down the cost of drugs and refusing to pay for treatments approved to work but who have a low cost-to-efficacy ratio. A recent example is the fight over Hepatitis C medication[0]

[0] http://www.npr.org/blogs/health/2014/05/12/307747798/boomers...

Is Walmart paying for the QA testing?

The government pays for the early research, sets all the ground rules for the drug trials, and -- as the drug companies' biggest customer -- ends up ultimately shouldering much of the cost of those trials whether successful or not. The government certainly has the financial wherewithal to fund stage 3 trials, $100M a pop is a rounding error on federal spending or even on just federal medical spending. So why not just go ahead and do so? Why the farce with pretending there's a healthy drug market when the government is driving so much of the process? Let's just admit this is a market failure of the public good variety, like firefighting and roads, and have the government provision it.

We started with Lenalidomide and was on it until end of last year with breaks of up to 6-8 months where there was no specific meds.. He's now on a Bortezomib cycle which will end in a couple of months and we hope to have some months free of meds again..

We never did the bone marrow transplant considering his age and stress/recovery he would have to go through.. MM is sympathetic in the sense that people who respond to meds can have a high quality of life even while undergoing treatment (my dad is still a practising medical Doctor). Lenalidomide is a tablet that you take at home while you go in once every week or two for Bortezomib shots.. The treatment is also considerably cheaper in India (still not inexpensive by any measure)..

The overarching fear for MM patients is the fact that its indeed incurable and how far/long we can go on before running out of treatment options.. Personally, seeing such trials and success gives us hope and comfort.. OV looks a promising approach and I hope my dad and others will be able to benefit from it..

If coming to the US is an option, there is a treatment center (Myeloma Institute for Research and Therapy MIRT) that is part of the University of Arkansas and is probably one of the best places in the world to get myeloma treatment. I know quite a number of people that have gone there and gotten good results.

It is based in Little Rock (of all unlikely places) I think because it was founded by a grant from Sam Walton, founder of WalMart. He died from MM in 1992.

They mentioned the second patient in the article:

The trial included two patients. Russell said the treatment worked in Erholtz, whose tumors were mostly in her bone marrow. However, it was unsuccessful in the other patient, whose tumors were mainly in her leg muscles, the Star-Tribune reported. He said more research is needed to know how the nature of the tumor affects the virus.

http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

Editorial Article: http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

Yes, the key point to watch next is to see if the MM does not come back after a couple of years.

EDIT, addendum: If you have a few treatments that each can kill 9999/10000 cancer cells. It seems the current approach is apply treatment a. Not detectable yay! They grow back to original numbers. Apply treatment b! etc. If you did them all at once, they wouldn't have time to grow back in-between treatments giving a larger chance you get them all.

At some point the risks of the treatments outweigh the risks of leaving some cells.

http://www.cancer.org/cancer/breastcancer/detailedguide/brea...

That's general audience information that discusses treatments before and after surgery that are intended to work along with the surgery. If you click through to the various therapies, there is lots of discussion of combining them.

Source: video/source article at http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

Edit: Accompanying editorial to go along with the paper and video: http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

I think the curative approach will ultimately come from immunotherapy, training the body to attack the cells. OV could certainly have it's place, for example as an alternative to ASCT.

As i know, just killing the cancer cells is not enough. The real curative treatment is to kill cancer stem cells using drugs.

http://www.survivingmesothelioma.com/news/view.asp?ID=001532

I think all this investment has been bolstered by the market success that Revlimid and Velcade are seeing. These drugs are cheap to produce, sell for about $5k per weekly or biweekly dose, and that a large and growing number of people are very happy to pay for, because they are well tolerated for as long as they work. Revlimid is just a pill you take, Velcade is a shot in the arm, so both are very cheap to administer.

There is huge incentive to keep producing more of these MM treatments, because the MM becomes refractory to each successive therapy over time. If you can make a good first-line treatment which is effective for 3 years on average, that's more than $100k per patient, at what, 90% gross margin?

I don't mean "free market" in the libertarian sense. I mean it in the sense that investment capital follows investment opportunity, and we are definitely seeing that here.

Well Fleming (who discovered antibiotics) was working for the (British) government, so if the above is in any way an indication of "the free market working well", then his extremely more important results were an example of public sponsored research working great.