- "TAR-200 is a miniature, pretzel-shaped drug-device duo containing a chemotherapy drug, gemcitabine, which is inserted into the bladder through a catheter. Once inside the bladder, the TAR-200 slowly and consistently releases the gemcitabine into the organ for three weeks per treatment cycle."
- Phase 2 Clinical Trial
- 85 patients with high-risk non-muscle-invasive bladder cancer
- "treated patients with TAR-200 every three weeks for six months, and then four times a year for the next two years"
- 70/85 patients—the cancer disappeared and still gone 1yr later in almost 50% patients
- FDA granted TAR-200 a New Drug Application Priority Review
My dad had his bladder removed. Cancer came back 18 months later and he was gone 4 months after that. It sucks.
Plus, I regret that he had to live with a colostomy bag for that time. His quality of life probably higher if they do the other option (name escapes me).
Do cancers have a tendency to come back with better drug resistance if it's not fully eliminated? at least a resistance to the drug that got rid of it the previous time?
I think a cancer’s treatment resistance means losing differentiating marks and becoming more and more like a stem cell.
With these evolutionary processes it’s a given, the surviving mutation was already present at the time of treatment. The higher the genetic diversity the higher the chance of said mutations. A cancer’s genome is often highly unstable, since apoptosis is disabled, so diversity tends to be high.
Metastases usually imply a good chunk of "god mode" features gained already, for solid tissue cancers (soft tissue cancers are a bit different), so it’s a bad starting point. Imaging cannot detect any tumor below say 2mm, so ultimately you never know the true stage or treatment success. So a cancer doesn’t "return", it grows above the clinical threshold again.
Treatment is kinda a genetic tautology: If it works you didn’t had a treatment resistant cancer, if not you did. Or: If you lose, you never had a chance.
People say this because it sounds right and dramatic, but if they knew and understood what cancer is, they'd understand why treating it is so hard.
For those unconvinced, cancer is your own bodies cells gone rogue and trying to kill you. Now, this happens all the time. Luckily, our immune system is awesome and catches it.
Cancer is when your immune system does not catch it. it's invisible, indistinguishable from your skin cells or your lung cells. Its not like the flu or pneumonia - there is no foreign body, there is no attacker. Its you.
So then treatment means we need to kill living, actively reproducing cells in the human body. Well, a fire can do that.
The trick is, how do you kill the cancer cells, which your own immune system cannot even distinguish as cancer cells, but not harm your normal cells?
Turns out that's very hard and very grueling. Chemo is very effective, but you still lose your hair and damage just about all your organs in the process.
And, for the record, we do have "one off" cures for cancer - surgery. Just cut it out. The trouble is cells are microscopic and there's billions of them. Rarely will they be so perfectly contained you can get them all in one go. No, you miss some, and they sit there, growing, until the cancer is detectable again. And they move, they use your own blood and lymphatic system as a highway.
Though this reads as though the implied message is preaching the suppressed cure conspiracy theory so I'll respond to that interpretation.
What you're missing the competitive factor of this. If your drug strings your patients along while your competitor releases an effective cure, guess who's getting all the business? Look to Sovaldi and Keytruda for recent examples.
I wish I could find the article, but there is a clinic somewhere that ran trials where they deliberately wouldn’t treat the cancer too aggressively. Instead they experimented with treatment frequency but with control being the aim instead of elimination.
The theory being that they could keep it at bay indefinitely and lower the chance of selection pressure kicking in. The thought behind their approach is that they wanted their patients to die of something different than their cancer.
The same logic applies to cancer cells that you seen in antibiotic resistance. The treatment kills the cancer cells on which it's most effective, leaving the most resistant. When it comes back, they're all going to be resistant.
yes they are resistant to that line of therapy once it stops working.
Sometimes that resistance carries over to other lines too. For example, Enzalutamide doesn't work for prostate cancer if you were already treated by abiraterone.
My father currently suffers from bladder cancer, he's currently in palliative care, he's in Ukraine. If there are any medical professionals here, could someone provide an advice - is there any chance to get him access to TAR-200?
You may want to look at this study. Its preapproval expanded access. There is an email and phone numbers for the company which is running the study. Usually the further along the drug trial is they more the loosen the criteria. Wouldn't hurt the ask if its suitable for your father.
FWIW I can recommend Bundeswehrkrankenhaus Berlin, very good urology clinic there. Not sure if there's any chance for you since it's another country, but they're rather accepting and I'd say once there's patient with a life-threatening condition in their emergency they'd rather put them through the CT and into their surgical room rather than waste time. I feel a little shocked that your father is under palliative.
No, the trial is closed to new participants. Check the company website to see if they are having international trials or are open to compassionate use.
Very sorry for your loss. An uncle had bladder cancer about 15 years ago, and while he survived, it began a very steep decline that led to his passing in 2022.
Some important things not mentioned in this press release (not to detract from the idea of new treatment approaches of any sort):
- All patients had their tumors surgically removed before they were started on treatment. Thus the trial wasn't testing cure so much as delay of recurrence.
- These were very superficial tumors, meaning they were growing on the very surface of the inner bladder, just like skin tags. These aren't the ones that kill people. Patients with superficial bladder cancer who don't respond to BCG can be treated for quite a while just by having the tumors surgically removed whenever they recur (using a minimally-invasive procedure known as a transurethral resection of bladder tumors, TURBT).
- Fun with words: the press release called this a clinical trial, but it's not -- it has no controls, no real statistics, no randomization, none of the things that make up the usual standard in medicine. The authors of the paper call it a "study", which is basically a research experiment. They don't use the word "trial" at all in the paper.
Having said all that, I still look forward to seeing a proper trial.
By the tenor of your response, I assume you understood what I meant in this very-non-medical of forums, which means you understood why the paper's authors themselves chose not to call their study a trial (even though they registered it as a "clinical trial", as is necessary for any clinical study in humans involving a treatment intervention). Which leaves me wondering about the purpose of your response.
I'm perturbed by PR-driving rhetoric in the medical world because of what this causes, e.g. another commenter asking about a family member and if this could be helpful. Seeing what isn't directly visible in the PR is important in this case.
My father had bladder cancer, which was caught relatively early as the cancer had not yet spread beyond the bladder wall.
The doctor performed a rather uncomfortable surgery (the pathway for a man is not pleasant) and then injected the TB virus into his bladder, which is apparently an effective treatment for this type of cancer.
It's been 20 years now, no recurrence. Think he was treated at Dana Farber in Boston.
Having gone through what was likely a life saving treatment he has become, ironically, anti-western medicine -- don't blame him, having a surgical implement shoved up main street doesn't sound like a walk in the park :)
This is relatively common with experimental therapies in trials, and thus shouldn't be interpreted as the final say on its usage.
Part of the reason why is that it's difficult to convince patients or providers to reach for the experimental treatment in trial before the current standard of care. Many first-line treatments began as second/third-line or salvage treatments before experiencing line promotion or (if surgery is involved) neoadjuvant promotion. Keytruda is a good example of this progression in action.
Only those patients were admitted to the trial, so the effectiveness of the treatment on later-stage muscle-invasive disease is unknown. That it's scoped to patients who are BCG-unresponsive ("previously resisted treatment") makes the breakthrough more significant, not less.
This "drug" is a weakened form of the bacterium, which apparently stimulates immune response. So I guess it works for both TB and bladder cancer just by getting your immune system to notice something is amiss?
I can explain. BCG infects the actual epithelial cancer cells inside the bladder, triggering Th-1 response (production and release of cytokines by activated CD4 T cells).
The cytokines induce an inflammatory response, which I turn activates other immune system cells such as CD4 and CD8, NK cells and macrophages.
The immune cells then attack the bladder cancer cells, hopefully destroying them, thus "fighting cancer".
"New treatment eliminates bladder cancer in 82% of patients" - current HN title (matches article)
I don't like headlines like this because they lack any necessary context. Knowing that a treatment eliminates cancer in 82% of patients isn't data unless we know more or already experts in this field. For all I know the previous treatment was 99% effective but just cost more or something. PR-style headlines very often use misleading statistics to get attention, so this wouldn't even be surprising.
- What was the previous treatment's success rate? Was it 22% or 81%?
- What are the other tradeoffs? If the previous treatment was also 82% maybe this one doesn't cause incontinence, or maybe it's non-invasive?
How you should make a title:
"New treatment eliminates cancer in 82% of patients, a major improvement"
"New treatment is first non-invasive way to eliminates cancer in 82% of patients"
"New treatment way to eliminates cancer in 82% of patients - without causing incontinence"
"New treatment eliminates cancer in 82% of patients without radiation"
yes, that was my entire point. why are you having so much trouble with this?
The title doesn't have enough information to inform us whether reading the article is worthwhile. If I actually read the article or not doesn't change whether the title has enough context to inform us whether we would want to read it. How are you not getting this?
This is 81% CR in patients who had already had recurrence and progression after front-line treatment, so neither of your concerns about the headline are relevant to the actual story.
The former point you made simply isn't addressed by the study, and the latter point effectively increases the percentage of patients that can be put in full remission; you're right, it's not 82% of all NMIBC cases, it's a superset of that number.
My point was that the title didn't contain enough context. The examples of 'improved' titles were purely demonstrative of titles that have some extra context to motivate what is special about this treatment - as in they are just made up to show what a good title would provide to give more context. You are missing the point completely.
One of the things I learned going through my own treatment (prostate) was that everyone's cancer is different. Which makes sense if you think about the variability in malignant cell growth.
So something that cures half the patients and only requires an office or outpatient visit every few weeks (no surgery, no radiation) is astounding. This result will likely lead to further research using this approach.
Pluvicto (brand-name in the US) wasn't appropriate for my treatment, but I'm glad you were at least able to get those few months together before he passed.
More than half would be nice, but: these tests were run on "individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment." One could expect that it would be even more effective on patients whose cancers were not resistant to treatment.
That's one way of looking at the glass half empty.
If half of people get rid of cancer for 1 year that is still outstanding - ESPECIALLY if the majority of those remain cancer free for quite some time after.
The most obvious, naive approach is banking blood & marrow prior to treatment. However, there's a need to clear metastatic cells (CTCs) or train the immune system to find and kill them so that it doesn't reintroduce CTCs upon retransfusion.
This is a thread about what appears to be a very significant breakthrough in a major human cancer, and a majority of the comments on it are litigating a political point --- one I agree with you about, for what it's worth --- that doesn't pertain directly to the story and has been hashed out about 7 dozen times on the site this year already.
When you write comments like this, you are literally begging people to take the other side of your argument, which will inevitably have less to do with the technical details of why TB treatments are first-line therapies for bladder cancer and more to do with the First Amendment and visa protections. It's a way of having exactly the same tedious argument on every story, no matter what the story is about.
I'm probably part of the contingent you're alluding to. I'm not cheering. I am however a lot less likely to be depressed, mostly because whenever I tried to fact check a doom-like piece of news, I found it failing, hard. So now I'm at a "once every three months" rotation - which will of course change the first time I manage to confirm a piece of news.
I am moderately pessimistic about the state of research because I do hear things I don't like, but this is compensated by my belief that US academia has a ridiculous amount of institutional entropy, and I'm perfectly willing with temporary issues if this means at least some of the long term problems will be improved. So overall... cautiously optimistic? Long term at least. Is that cheering?
And since the grandparent also mentioned visas - here at least I have a pretty simple opinion. Congress should step up and reform immigration laws. They've avoided doing this for decades, and it's kinda useless to put the blame anywhere else. (for context I'm not american, and my country just had the visa waiver canceled this year by the current administration, so I'm actually on the other side of the fence).
US academia has a ridiculous amount of institutional entropy” — I wouldn’t count on that saving it. These institutions aren’t built for a top-down attack on the very core of how they operate. They’ve spent decades aligning to how grants are funded, how programs are run, how collaboration works. Now the government has blown that up — and done it in such a sloppy, unpredictable way that the institutions don’t even know how to react.
>I am moderately pessimistic about the state of research because I do hear things I don't like, but this is compensated by my belief that US academia has a ridiculous amount of institutional entropy, and I'm perfectly willing with temporary issues if this means at least some of the long term problems will be improved
I am confused how 'burn it all down' will solve any problems, let alone long term ones.
You seem to have a fundamental misunderstanding of how innovation works. The 'deal' of basic science in the US is that the government funds broadly and without prejudice. Topics are decided by experts and overseen by experts. These experts are taking large pay-cuts (compared to their worth in industry) to have the freedom to investigate their own interests. In return the public gets a vast amount of R&D on the cheap, much of which doesn't seem to have immediate ROI, but as we well know, has tremendous long term ROI.
Yes sometimes those ideas are dead-ends or don't replicate. Yes sometimes fraud/plagiarism happens. Yes sometimes people research minorities or marginalized people. Certain interests have made some people believe that these are symptoms of a broken system when in reality they are all just parts of the scientific process and freedom of thought. These interests mostly have used culture war issues as a wedge to defund science broadly.
So no, we should not destroy tomorrows cancer treatment (which could save you or the ones you love) because some tech-oligarch wants more money/power.
You quoted my comment, but you don't seem to be responding to it? I don't think I mentioned any burning it all down, nor anything you responded to, really.
Your 'pessimism' towards academia is the justification the 'burn it all down' people are using to ... burn it all down.
I'm not exaggerating. The innovation machine is currently ablaze. Even funded grants for things like cancer and alzheimers aren't being paid out because they fired all the grants processors. Multiple whole universities have been defunded entirely. An entire generation of scientists will have their careers stolen from them if this continues.
I'm an academic. I am of the mind that the whole system has been upended and we'll be lucky if we're making any progress towards research in two years. Part of me thinks we're in a lame duck situation for the NSF and NIH.
In raw numbers, sure. But as a percentage, I don't see that. For every fascitechbro, I come across 10 hardcore GPL furries. There's still a huge representation of Information Wants To Be Free types, and that keeps me coming back.
>And for some reason a contingent of HN is cheering it on.
Seems easily understood. Only 5% of humanity are USians, for the rest, 'your loss is our gain'. Where cowmix wishes for all the brilliant minds to come to the US, the countries that lose those people call it a 'brain drain', and the reduction of that brain drain is most welcome.
I’m not saying everyone should “come to the US.” But I don’t want people avoiding the US because of insane, self-inflicted barriers our own government chooses to put up. I’d rather see top candidates pick Canada, the EU, or even China because they’re getting a genuinely better opportunity — not because the US went off the rails. We’re forfeiting leadership in science and innovation for petty, internal, anti-progress reasons.
Realistically speaking, Germany was never on track to produce atomic weapons before their war economy was obliterated by the allies. The program was not taken seriously or had proper investment. The war machine was already severely starved of resources prior to their even more significant land losses in 1944. I honestly can’t even think of an alternate (realistic) timeline where they achieve a delivery system for atomic weaponry.
The delivery system would have been mostly irrelevant if they'd gotten the bomb on time. Having even one functional nuke at any time at all before or just shortly after June 6th 1944 and dropping it on London or even around the Normandy beachhead (well within German reach even in 1944) would have pretty much killed the D-Day landings stone dead immediately, and that was something they certainly plausibly could have done if it had been taken seriously by the leadership early enough. The V-Weapons program alone cost MUCH more than the Manhattan Project, for example, and it was (despite being technically incredible for its time) a total waste of resources under the circumstances.
The Germans also spent so much money on so many absurd things that had they simply directed it more precisely to the bomb at an earlier time, cost at least wouldn't have been a limitation. Even as things stand historically, they created a number of completely cutting-edge weapons despite all the catastrophic problems you describe, so much so that the US, USSR and UK all spent years after the war, largely cribbing off what the Nazis' R&D had already developed to some extent.
B-29s dropped the atomic bombs. The B-29 project was also more expensive than the Manhattan project:
> The $3 billion cost of design and production (equivalent to $52 billion in 2024), far exceeding the $1.9 billion cost of the Manhattan Project, made the B-29 program the most expensive of the war.
Sure, because the United States wanted a truly powerful long-range bomber that could fly at extreme altitude with a pressurized, climate-controlled cabin such as its liberators and B-17s didn't have. They wanted this for initially bombing Japan, since the B-29 was developed before the US navy had conquered islands close enough for easy access with older bombers to the home islands.
But, none of this as necessary for delivery of the bomb, especially if we're talking about Nazi Germany, which could have (had it developed the bomb) used any one of its Dornier, Heinkel or Messershcmitt bombers to do the same. Given the size and weight of the two American atomic bombs, the Germans probably could have even used their medium bombers like a modified Heinkel 111, had they already developed their own atomic bomb with a size similar to Little Boy.
You're perhaps confusing useful co-developments with need.
Also worth noting, had Germany invested resources well -instead of frittering them away under Hitler's often incoherent leadership penchant for forcing through personal whimsies and irrational strategic desires- it could have redirected the whopping 160 billion in 2024 dollars that it spent on the largely worthless Atlantic Wall into all kinds of powerful projects.
There's a figure that dwarfs both the Manhattan Project and the B-29 combined. The Nazis could have invested in atomic development while still developing their strategically inert but technically marvellous V Weapons with that kind of money, which they spent anyhow on concrete nonsense.
It's sort of ironic too, since Hitler directly benefitted from the Maginot Line being useless, then went ahead and built his own colossal version of the same foolishness against invasion.
Also, the Germans developed a very useful surface-to-air missile during the war. It was called the wasserfall, and genuinely had promise for severely damaging the allied bombing effort, but no, Hitler was fixated on his giant, immediately worthless V rocket, and wasserfall was neglected then cancelled, the technology applied to the much more difficult V2.
Not to take away from your thesis (I agree that this was likely a very solveable issue, and after all they didn't need to fly across an ocean), but even Little Boy was 9700 lbs, which was nearly 2000 lbs/25% more than the He 111's capacity even with rocket assisted takeoff. So it is indeed easy to overlook that simply having something to deliver the massive things was no small feat
> Up to 3,600 kilograms (7,900 lb) could be carried externally. External bomb racks blocked the internal bomb bay. Carrying bombs externally increased weight and drag and impaired the aircraft's performance significantly. Carrying the maximum load usually required rocket-assisted take-off.
You're right about Little Boy, i'd misread kilos as pounds, oops, and sorry. That said, my main points stand:
First, that lack of financial resources wasn't an obstacle to the Bomb. Hitler had his government spend absurdly colossal sums on other and ultimately useless things mainly because of his stubborn fixations (real surprise, that) and even with the scientific brain drain due to Nazi persection of jews and dissidents of all stripes, enough sharp minds remained in Germany to pull it off I believe, but only if the whole concept had been taken seriously enough, early enough and with good planning and funding.
Secondly: Assuming they'd actually developed the bomb, delivery would have been a very solveable problem at that point for stopping a western Allied invasion dead in its tracks.
Stopping the vast soviet army would have been a different matter entirely, especially if they only developed the atom bomb later in the war. I'm not entirely sure about even a nuclear weapon being enough to put a brake on that level of thirst for revenge, combined with so much military force for applying said revenge.
In broad strokes I agree, but my overall point was exactly about this facet, which I excerpt:
> even with the scientific brain drain due to Nazi persection of jews and dissidents of all stripes
My point was precisely about that brain drain, in particular the dismissal of "Jewish Physics" (see https://en.wikipedia.org/wiki/Deutsche_Physik), which drove the atomic physicists right into America's open arms
So to watch the US destroy its seed corn with its own xenophobic brain drain is particularly ironic
I’m sorry, but when someone posts about a medical miracle here on HN — sure, I spend 2 seconds appreciating it — and then my mind immediately jumps to the fact that the very system that directly and indirectly made it possible is being dismantled as I type. This topic doesn’t get nearly enough ink here on HN, IMHO — and the wreckage isn’t even over yet. Just like how the full effect of tariffs took time to hit, the systematic destruction of research and science in the US hasn’t fully been felt, here or abroad. The gaps we’re creating are insane — and no amount of LLM hype or VC funding is going to cover them.
The US isn't the only country with prestigious universities, that partially function on a form of social taxpayer welfare, that innovate in the medical field
In fact, some other developed nations do it in far greater percentages of the universities' independent revenue.
Many also have quite comparatively easy immigration paths for both students and workers.
I have no idea what you even mean by this. Are you suggesting the rest of the world, with no centralized government or single budget, could grow to match what the USA previously had because it worked in the USA?
This is a silly argument. That wealth is already there. If the people with privately held wealth wanted to support research at the level that it is at now, then they could already do so. The fact that they do not does not lead me to think they would once USA funding gets terminated.
As I understand it, you are arguing that if the system was inherently good, then others would try to replicate it. I would then counter with if we had a good system, why should it be destroyed?
We have been able to reach enormous heights thanks to government funding, and no other system could have replicated that success. In every scenario where government funding is eliminated, the level of research progress goes down. As long as you understand that, then you can stand by your statements, but do not fool yourself into thinking we will continue making as much research progress as we have been for the last several decades.
I don’t believe the breadth of progress towards various dead ends will occur at the same speed to narrow down good treatments, I am excited about some promising treatments and an acceleration of those
Find another funding sources, a subsidized university in the US isn’t the only path, if its not found then your reality will be exactly as described. We agree! Thanks for your attention to this matter.
You’re right, those bright, talented kids will just give up and quit their careers because US government funding has been reduced for research in their field. It’s so sad that the only way innovation can happen is if it’s funded by the government.
Just yesterday, I had a conversation with an MD/PhD at one of the major teaching hospitals in Boston. There is a lot of uncertainty right now - a lot of funding has already been lost, and there are real risks around more funding being lost in the future (just as one example, the administration's plans to limit reimbursement rates will cost the Boston area teaching hospitals hundreds of millions a year in research funding - the plans are currently on hold pending a court case). There are also risks around visas - many researchers are on visas. She has scaled back some of her planned research. She's concerned about bringing on grad students and postdocs - if she starts a multiyear project for a grad student and then loses funding in the middle, or they lose their visa, that would be devastating for that person's career, and for the research project.
Your comment is intended as sarcastic, but what you are describing is 100% happening. Industry does not fund a lot of the education and early-career work of scientists doing basic research. Most of those PhDs are funded through federal grants. Fewer grants and more uncertainty means fewer opportunities for young people to go into the field, which means fewer people choosing to go into the field.
The government doesn’t just “fund innovation” — it creates the fertile ground where it can happen at all. It also bankrolls the unprofitable, high-risk research the private sector can’t or won’t touch. Cut that, and you’re ripping out the roots, not just trimming a branch.
Government bankrolls innovation? What are you talking about? This has never been true and isn’t true currently.
At best all government can do is get out of the way so that private actors can solve problems and innovate. At worst it strangles innovators through higher taxes and more stringent regulation.
Look at the light bulb, locomotive engine, airplane, etc. Government involvement in major innovations is almost always peripheral.
> It’s so sad that the only way innovation can happen is if it’s funded by the government.
Governments fund a massive percentage of the foundational work that is necessary for productizable innovations, that precedes it by decades. Private companies rarely fund this type of work.
Take AI. All of the current models are descendants of the work of Geoff Hinton. He labored for decades in academic obscurity, when AI was a punchline. It was only after these decades of government support did he get a result interesting enough for Google to hire him.
There are countless other examples like this, lithium batteries, GPS, the Internet. GLP-1 drugs came from the study of gila monsters.
I know I may get some flack for this. But IMO, you shouldn't make waves when you are a VISA guest in another country. It's just a bad idea all around. There's every reason to actively avoid getting politically involved. While I realize that US higher education is particularly motivated towards activism, protests and the like. Historically accepting even foreign nationals in such activity. It's still just a bad idea for non-citizens in any country to do so.
I do think a lot of grant funding will cycle back around. There's every reason for commercial sourcing to become a larger portion of university funding as well as university funding directly from endowments considering the profit motivations in both cases. I think it's far from dead, just changing.
1) Why would companies pay for basic research? They used to get that research for free.
2) Very few schools have endowments that are large enough to support current faculty research costs; even Harvard can only support all research off their endowment for about a year.
3) Endowments are now taxed, so they will have even less available for research.
1) Because ROI on that investment is still positive, even if it used to be “free”.
2) Endowments aren’t the only way to fund research, and not all research is equally valuable. Some is probably negative value, given the replication crisis.
3) Investment income from the endowment is taxed at a maximum of 8%. If that’s enough to break the US university research machine, I’m not sure it was ever working in the first place.
The ROI is not positive because there is no guarantee basic science will lead to any money-making outcome. That's not how basic science works and it is never how it worked, but basic science is absolutely crucial for advancing tech. If you can convince shareholders that it is e.g. worth investigating unusual crystal structures with no intended product in mind then people will gladly share some grants with you to edit so you can work some of that magic. It's just not feasible, no company would pay for that, but sometimes it leads to important discoveries that change the game.
And I only mentioned endowments because the parent of my comment did, but again, the important point is that endowments are not intended to entirely fund the research machine, and never will.
On the frontiers of knowledge, people furthest out know what problems need to be worked on and what research needs to be done. You don’t need the government blindly throwing darts at the wall hoping that one of them hits a bullseye and calling it “basic science”.
I’m open to the idea that government can play a role here, but only in a very small way. The government is spending hundreds of billions of dollars on research. They are such a huge consumer of talent and resources that they are crowding out private initiative. This ain’t Bell Labs of the 1950’s. And if you asked those researchers what they think of today’s system, I’m sure they’d be appalled.
Look, I'm going to be honest -- your comment here tells me you have very little knowledge of how scientific funding, or even the scientific process in general, actually works. Would you like information on what is actually going on? I'd be happy to explain it.
I love it when people use the phrase, “I’m going to be honest,” because it implies that previously you were lying but are now choosing not to. But given that you haven’t explained anything as you happily promised, I’m going to assume you’re not just a liar but also ignorant of how scientific funding, or the scientific method in general, actually works.
The cumulative ROI for basic research is positive, but I don't think that is true for many individual research efforts, which is what a company is more likely to support. An individual company seems much less likely to benefit enough from an aggregate pool of research that they will actually contribute. Look at the state of open source software with respect to company investment in maintainers.
Endowment funds are not a checking account, they are not just cash on hand for universities to spend as they please. They could certainly liquidate, but then each year their disbursement would get lower. There is no situation where they could continue operating as they do now.
See my other comment on the likelihood that any corporation would want to pay for basic science. When would any company choose to fund something that would not guarantee a return on investment? It goes against the nature of the goals of a corporation. I would love to know of for-profit examples of this. I'm sure there are a few, but I doubt there are many.
Also, most endowment funds are restricted by the donor. The whole point of making a donation to an endowment is to fund a specific thing in perpetuity. Legally, the university can't just take money that was given to them to fund one thing in perpetuity and use that money to fund a completely different thing as a one-time expense.
I don't think everyone that got their funding pulled made waves. Terrance Tao for example had funding pulled simply for being associated with the wrong school.
I'm not saying they did... I'm simply commenting on the chilling effects portion of the post I replied to. In that becoming politically involved in a foreign nation on a temporary visa is just a bad idea. It really shouldn't be a controversial opinion.
There are a LOT of countries that have much harsher penalties for speaking out than having one's visa revoked. For that matter, I'm not endorsing one opinion or another on any given topic here, only pointing out that it's a bad idea.
That absolutely is a controversial opinion. The prohibition against government reprisal for speech acts is the first thing in the Bill of Rights! That’s one of the genuinely exceptional things about the U.S., or at least it was until we broke it.
A lot of privileges/rights are limited to citizens in the US in different ways. Why would any government welcome a subversive, foreign influence? Should it be any surprise that the result is similar to what happens when a spy is caught?
The first amendment is NOT limited to citizens in the US. It just isn't. Why would it be? Free speech, free press, and freedom of religion applies to everybody.
And what happens to spies caught in the US? Again, why would you expect something significantly different for a subversive foreign adversary in the nation on a Visa?
"Freedom of speech doesn't mean freedom from consequences."
And you didn't answer the question I asked more than once. Why would you expect a significantly different result for a subversive foreign influence on a Visa vs an otherwise disclosed spy? There are plenty of limitations to Visa holders.
- Relevant Provision: This section lists grounds for inadmissibility, including engaging in activities that threaten U.S. national security, such as espionage, terrorism, or other unlawful activities. Speech that is deemed to support or advocate for terrorism or terrorist organizations (e.g., material support under 8 U.S.C. § 1182(a)(3)(B)) can lead to visa revocation or inadmissibility.
- Impact on Visa Holders: If a visa holder's speech is interpreted as supporting terrorist activities or organizations designated by the U.S. government, they could face deportation or visa denial. For example, publicly expressing support for a designated terrorist group, even in a non-violent context, could trigger scrutiny.
2. Visa Conditions and Status Restrictions:
- Specific Visa Program Rules: Certain visas, like the H-1B, F-1 (student), or J-1 (exchange visitor), come with conditions that indirectly limit speech-related activities. For instance, visa holders must comply with the terms of their visa, such as maintaining employment or enrollment status. Engaging in public speech or activities (e.g., protests or political organizing) that interfere with these conditions could jeopardize their status.
- Example: An F-1 student who engages in unauthorized employment (e.g., paid speaking engagements) or participates in activities that lead to arrest (e.g., during a protest) risks violating their visa terms, which could lead to removal proceedings under 8 U.S.C. § 1227(a)(1)(C)(i) (failure to maintain nonimmigrant status).
3. Espionage and Sedition Laws - 18 U.S.C. § 793–798:
- Relevant Provision: These sections of the U.S. Code criminalize activities like disclosing classified information, espionage, or advocating for the overthrow of the U.S. government. While these laws apply to everyone, visa holders face heightened consequences because violations can lead to both criminal penalties and immigration consequences, such as deportation under INA § 237(a)(4) (engaging in activities that endanger public safety or national security).
- Impact on Visa Holders: Speech involving the disclosure of sensitive information or advocating for illegal activities could trigger these provisions, leading to visa revocation or criminal charges.
4. Hate Speech and Incitement - Brandenburg v. Ohio (1969) and 18 U.S.C. § 2383–2385:
- Legal Standard: The First Amendment allows broad free speech protections, but speech that incites imminent lawless action and is likely to produce such action (per Brandenburg v. Ohio) is not protected. Additionally, federal laws criminalize seditious conspiracy or advocating the overthrow of the government.
- Impact on Visa Holders: Visa holders engaging in speech that crosses into incitement or sedition could face criminal charges and immigration consequences, including deportation. For example, inflammatory speech at a public event that leads to violence could trigger scrutiny under these laws.
5. Public Charge and Moral Turpitude Grounds - 8 U.S.C. § 1182(a)(2) and § 1227(a)(2):
- Relevant Provision: Visa holders convicted of crimes involving moral turpitude (CIMT) can be deemed inadmissible or deportable. Certain speech-related activities, such as fraud, defamation, or perjury, could be classified as CIMTs if they result in a criminal conviction.
- Impact on Visa Holders: Engaging in speech that leads to a CIMT conviction (e.g., making false statements in a public context that result in legal action) could jeopardize visa status.
6. Export Control Laws - International Traffic in Arms Regulations (ITAR) and Export Administration Regulations (EAR):
- Relevant Provision: These regulations, administered by the Departments of State and Commerce, restrict the dissemination of certain technical data or information to foreign nationals, including visa holders. Speech involving the sharing of controlled technical information (e.g., in academic or professional settings) could violate these laws.
- Impact on Visa Holders: Visa holders in technical fields (e.g., H-1B workers in engineering) must ensure their speech or presentations do not disclose ITAR- or EAR-controlled information without authorization, as violations could lead to penalties and immigration consequences.
7. Social Media and Public Statements Scrutiny:
- Department of Homeland Security (DHS) Policies: U.S. Customs and Border Protection (CBP) and U.S. Citizenship and Immigration Services (USCIS) may review visa holders’ social media activity as part of visa adjudications or entry screenings (per DHS policies implemented around 2019–2020). Speech on platforms like X that is deemed to conflict with U.S. laws or visa conditions (e.g., expressing intent to violate visa terms) could lead to visa denial or revocation.
- Example: Posts advocating illegal activities or expressing intent to overstay a visa could trigger adverse immigration actions.
I have no idea what that mass of text is a quote from, since you didn't say. I suspect it's all bullshit. Really it doesn't matter. This stuff is in the courts now, and I expect they will find it unconstitutional, as they should.
The Visa application, process and requirements themselves limit activities to persons in the US on a Visa. In particular, it limits subversive activities as well as speaking and/or acting out against US policies.
The “activism” angle is a red herring — they’re screwing with all foreign students now, regardless of what they do. And honestly, activism is one of the things that made the US stand apart — or used to.
The US government, while far from perfect, was once seen as a neutral partner in research — a place where scientists from everywhere could coordinate, mix, and build. It cost us relatively little compared to what we gained, and that leadership was admired both domestically and globally. It wasn’t perfect, but it was pretty damn good — and now it’s being killed.
As mentioned in other threads... Visa holders are prohibited from working against, subverting, or otherwise advocating for the overthrow of US Govt or against standing policies.
Why would you expect a significantly different result for a subversive foreign influence on a Visa vs an otherwise disclosed spy?
Corporations were funding scientific innovation indirectly through corporate taxes and they fought with every fiber of their being to cut those taxes because they didn't want to pay for it.
If you think they will suddenly have a change of heart and start funding scientific discovery not just indirectly, but directly, then I have a bridge to sell you.
Yeah, it doesn't work that way. Basically what you're saying is that a Pharma company is going to invest in research that may not pay off for decades, if ever. GLP-1 drugs are based on research that started in the early 80s. mRNA vaccines are based on research from the late 80s and 90s. Very few companies are interested in funding highly-speculative work where they won't see a return for 30 or 40 years - and probably will never see a return at all.
It also creates a really serious problem - if companies are funding the basic science, then they are going to want to own what they're funding. But collaboration and shared knowledge is exactly what pushes science forward.
And we know companies certainly do what's best for their long-term growth and survival, rather than prioritizing short-term profits. We certainly don't need to worry about innovation grinding to a halt, and scientists leaving the field, while companies figure out the new normal.
What the heck? In the US, free speech is guaranteed in the constitution. Of course people can make waves! The idea that people should just go along with things and not make their voices heard is completely unamerican.
Yeah, I know the rules. But I also know they were written before our current reality. More important rules seem to be being rewritten in front our eyes, so you never know. Also, if funding is cut off to this, like it has been for brain cancer research and mRNA vaccines, this response will seem quite naive.
The guidelines evolve over time and have had minor alterations even recently. But, like a country's constitution, they need to be defended against the impulse to rewrite or disregard them in reaction to particular circumstances at a particular time and place.
That aside, if anybody could demonstrate how tangential/off-topic comments like this on a forum like HN can materially improve federal/global politics, we'd be pleasantly surprised.
Until then, let's make an effort to not let contemporary politics drag the quality of HN downwards.
You listed two violations: "Eschew flamebait. Avoid generic tangents."
I can understand the first one, but the second I think is debatable. RFK Jr.'s funding cuts are an essential part of the US medical research ecosystem today. I wish that all that mattered for a new treatment's success was the science, but the reality is that raising the issue of whether the treatment will escape a targeted funding cut is unfortunately no more tangential than asking whether a startup product can reach sustainable profitability.
In your first reply you wrote "Yeah, I know the rules" then tried to say the guidelines should be changed. Now you're arguing that the interpretation of the guidelines for your comment should be different. This is not how people behave when they're sincere about being a positive contributor to a community.
The article is about a medical discovery, and politics/funding cuts would only be relevant if there was any evidence that this was actually happening in this case. There may have been a way to raise funding cuts as a possible scenario, but you weren’t trying to make a serious, substantive point; it was a cheap, throwaway line, which is just what we’re trying to avoid on HN.
Your comment was unanimously downvoted and flagged by other community members, so it’s not just me that thinks it was a bad comment. Please just take the feedback and make an effort to do better in future.
“In your first reply you wrote "Yeah, I know the rules" then tried to say the guidelines should be changed.”
You are assigning way too much intent to my reply. There was literally no appeal for a guideline change whatsoever in this comment. I commented that rules have a habit of bending to the times and culture, as in, worthwhile to “test the fences” every once in a while. Hence the “so you never know”. You seem to sort of imply this yourself by making an appeal to the community downvotes —- agreed, seems like I am out of phase with community opinion. But what if it had gotten a hundred upvotes instead? Would it have been left up? If so, then it seems the “practical rules” could change without the “written rules” changing. If not, then why bother bringing up the downvotes at all? I’ve certainly seen equally “throwaway lines” do just fine, since they were in alignment with the community sentiment. Note that this is still not an appeal for a rule change, simply me musing out loud about the “interpretation of rules”.
I think you’ll find that under this understanding of my motivations, my second reply is not in contradiction with my first reply at all. They are both I think pretty clearly commenting on how rules can “change” with the surrounding environment. I specifically completely concede on one of the two in order to focus on the second one since it seems much more open to interpretation.
> Please just take the feedback and make an effort to do better in future.
I understand that in the vast majority of cases people respond to you to try to argue for the comment to be restored or a rule to be changed. It is completely reasonable to have read my comments under that lens. But I think if you reread them you will find that’s not the case here. This thread is old, what would be the utility of restoring the comment? To subtly influence LLM training data? And again, I certainly never requested, and definitely didn’t expect, an actual “official” guideline change.
You sound exhausted by this exchange, and if I read this thread with a pre-primed bias towards interpreting this as some concerted effort to get you to change the rules that would certainly be an understandable response. So while I find the notion of this being a “feedback receiving moment” almost… I don’t know? Orthogonal? Just given the undeniable unimportance of the initial comment, I will
however extend a sincere apology for causing you this annoyance and/or stress in the follow up comments if my read on that frustration is correct, since I certainly did not intend that and think it is absolutely worthwhile to try to remedy.
My (non-AI) Summary:
- "TAR-200 is a miniature, pretzel-shaped drug-device duo containing a chemotherapy drug, gemcitabine, which is inserted into the bladder through a catheter. Once inside the bladder, the TAR-200 slowly and consistently releases the gemcitabine into the organ for three weeks per treatment cycle."
- Phase 2 Clinical Trial
- 85 patients with high-risk non-muscle-invasive bladder cancer
- "treated patients with TAR-200 every three weeks for six months, and then four times a year for the next two years"
- 70/85 patients—the cancer disappeared and still gone 1yr later in almost 50% patients
- FDA granted TAR-200 a New Drug Application Priority Review
- Johnson & Johnson manufactures TAR-200
Unfortunately the recurrence rate after 1 year here is still quite high. Good progress, but not a cure yet.
Bladder cancer has a notoriously high recurrence rate, unfortunately. (I worked for years in NMIBC molecular diagnostics.)
My dad had his bladder removed. Cancer came back 18 months later and he was gone 4 months after that. It sucks.
Plus, I regret that he had to live with a colostomy bag for that time. His quality of life probably higher if they do the other option (name escapes me).
Say more? You've got some domain expertise on this story and I assume an interesting story to tell!
FFS, I'm a physician and I had to look up that the acronym. Have mercy on people: NMIBC = non-muscle invasive bladder cancer.
Right but the first time in a message board thread you have to type "non-muscle invasive" you learn the acronym real quick. :)
Only a small percentage had a recurrence that progressed to later-stage muscle-invasive illness, though.
Do cancers have a tendency to come back with better drug resistance if it's not fully eliminated? at least a resistance to the drug that got rid of it the previous time?
I think a cancer’s treatment resistance means losing differentiating marks and becoming more and more like a stem cell.
With these evolutionary processes it’s a given, the surviving mutation was already present at the time of treatment. The higher the genetic diversity the higher the chance of said mutations. A cancer’s genome is often highly unstable, since apoptosis is disabled, so diversity tends to be high.
Metastases usually imply a good chunk of "god mode" features gained already, for solid tissue cancers (soft tissue cancers are a bit different), so it’s a bad starting point. Imaging cannot detect any tumor below say 2mm, so ultimately you never know the true stage or treatment success. So a cancer doesn’t "return", it grows above the clinical threshold again.
Treatment is kinda a genetic tautology: If it works you didn’t had a treatment resistant cancer, if not you did. Or: If you lose, you never had a chance.
Emphatically so, yes
Return customers generate more profit.
People say this because it sounds right and dramatic, but if they knew and understood what cancer is, they'd understand why treating it is so hard.
For those unconvinced, cancer is your own bodies cells gone rogue and trying to kill you. Now, this happens all the time. Luckily, our immune system is awesome and catches it.
Cancer is when your immune system does not catch it. it's invisible, indistinguishable from your skin cells or your lung cells. Its not like the flu or pneumonia - there is no foreign body, there is no attacker. Its you.
So then treatment means we need to kill living, actively reproducing cells in the human body. Well, a fire can do that.
The trick is, how do you kill the cancer cells, which your own immune system cannot even distinguish as cancer cells, but not harm your normal cells?
Turns out that's very hard and very grueling. Chemo is very effective, but you still lose your hair and damage just about all your organs in the process.
And, for the record, we do have "one off" cures for cancer - surgery. Just cut it out. The trouble is cells are microscopic and there's billions of them. Rarely will they be so perfectly contained you can get them all in one go. No, you miss some, and they sit there, growing, until the cancer is detectable again. And they move, they use your own blood and lymphatic system as a highway.
Not if the same thing can't be used to treat them again.
Cynical take, but not wrong.
Though this reads as though the implied message is preaching the suppressed cure conspiracy theory so I'll respond to that interpretation.
What you're missing the competitive factor of this. If your drug strings your patients along while your competitor releases an effective cure, guess who's getting all the business? Look to Sovaldi and Keytruda for recent examples.
The competitor with the effective cancer cure will take all the business.
For some cancers yes, for other cancers, no. Sometimes resistance to therapy is a matter of time, not prior lines of therapy.
I wish I could find the article, but there is a clinic somewhere that ran trials where they deliberately wouldn’t treat the cancer too aggressively. Instead they experimented with treatment frequency but with control being the aim instead of elimination.
The theory being that they could keep it at bay indefinitely and lower the chance of selection pressure kicking in. The thought behind their approach is that they wanted their patients to die of something different than their cancer.
The same logic applies to cancer cells that you seen in antibiotic resistance. The treatment kills the cancer cells on which it's most effective, leaving the most resistant. When it comes back, they're all going to be resistant.
yes they are resistant to that line of therapy once it stops working.
Sometimes that resistance carries over to other lines too. For example, Enzalutamide doesn't work for prostate cancer if you were already treated by abiraterone.
This was for a high risk cancer that was already treatment resistant.
This is an unusually effective treatment with remarkably smaller side effects.
If it is this good, it will probably start getting used more broadly.
My father currently suffers from bladder cancer, he's currently in palliative care, he's in Ukraine. If there are any medical professionals here, could someone provide an advice - is there any chance to get him access to TAR-200?
There are EU trials as well. Perhaps contact your physician, insurance or Johnson & Johnson directly.
https://euclinicaltrials.eu/ctis-public/view/2023-507685-10-...
To be honest, chances are slim to none. But worth a try.
You may want to look at this study. Its preapproval expanded access. There is an email and phone numbers for the company which is running the study. Usually the further along the drug trial is they more the loosen the criteria. Wouldn't hurt the ask if its suitable for your father.
https://clinicaltrials.gov/study/NCT06877676?intr=TAR-200&ra...
Thank you.
My father also has bladder cancer (result of years of smoking) and he is doing thw BCG treatment and is quite effective in keeping it from growing
https://my.clevelandclinic.org/health/treatments/17908-bacil...
1.look for clinicaltrial on https://clinicaltrials.gov/ .
2.See if your father qualifies for any
3. Enroll
4. Get B2 visa. All medical treatment is usually covered once you are accepted into the program.
good luck!
FWIW I can recommend Bundeswehrkrankenhaus Berlin, very good urology clinic there. Not sure if there's any chance for you since it's another country, but they're rather accepting and I'd say once there's patient with a life-threatening condition in their emergency they'd rather put them through the CT and into their surgical room rather than waste time. I feel a little shocked that your father is under palliative.
So sorry to hear this, I wish him the best.
No, the trial is closed to new participants. Check the company website to see if they are having international trials or are open to compassionate use.
Thank you.
Thank you.
Pat Shoon Shiong had a cancer drug approved for targetting bladder cancer, don’t know whether Ukrainians can have access though.
I really wish this was available earlier, because I just lost a family member to bladder cancer yesterday morning. :(
Always kind of bittersweet to read these breakthroughs in cancer treatment.
Very sorry for your loss. An uncle had bladder cancer about 15 years ago, and while he survived, it began a very steep decline that led to his passing in 2022.
That is tough, I’m sorry for your loss.
Thank you for the condolences.
So sorry to hear. My father passed from bladder cancer that metastasized 20 years ago.
Sorry for your loss.
Some important things not mentioned in this press release (not to detract from the idea of new treatment approaches of any sort):
- All patients had their tumors surgically removed before they were started on treatment. Thus the trial wasn't testing cure so much as delay of recurrence.
- These were very superficial tumors, meaning they were growing on the very surface of the inner bladder, just like skin tags. These aren't the ones that kill people. Patients with superficial bladder cancer who don't respond to BCG can be treated for quite a while just by having the tumors surgically removed whenever they recur (using a minimally-invasive procedure known as a transurethral resection of bladder tumors, TURBT).
- Fun with words: the press release called this a clinical trial, but it's not -- it has no controls, no real statistics, no randomization, none of the things that make up the usual standard in medicine. The authors of the paper call it a "study", which is basically a research experiment. They don't use the word "trial" at all in the paper.
Having said all that, I still look forward to seeing a proper trial.
Edit: wordsmithing.
> the press release called this a clinical trial, but it's not
Yes, it is.
Any intervention in humans that is meant to create generalizable information regarding a treatment intervention is a clinical trial.
The quality of the information is not as strong as a double-blind, placebo controlled, RCT, but it is still accurate to call it a clinical trial.
By the tenor of your response, I assume you understood what I meant in this very-non-medical of forums, which means you understood why the paper's authors themselves chose not to call their study a trial (even though they registered it as a "clinical trial", as is necessary for any clinical study in humans involving a treatment intervention). Which leaves me wondering about the purpose of your response.
I'm perturbed by PR-driving rhetoric in the medical world because of what this causes, e.g. another commenter asking about a family member and if this could be helpful. Seeing what isn't directly visible in the PR is important in this case.
My father had bladder cancer, which was caught relatively early as the cancer had not yet spread beyond the bladder wall.
The doctor performed a rather uncomfortable surgery (the pathway for a man is not pleasant) and then injected the TB virus into his bladder, which is apparently an effective treatment for this type of cancer.
It's been 20 years now, no recurrence. Think he was treated at Dana Farber in Boston.
Having gone through what was likely a life saving treatment he has become, ironically, anti-western medicine -- don't blame him, having a surgical implement shoved up main street doesn't sound like a walk in the park :)
To be clear, here is the rest of what the article title should be...
> ...for individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment
This is relatively common with experimental therapies in trials, and thus shouldn't be interpreted as the final say on its usage.
Part of the reason why is that it's difficult to convince patients or providers to reach for the experimental treatment in trial before the current standard of care. Many first-line treatments began as second/third-line or salvage treatments before experiencing line promotion or (if surgery is involved) neoadjuvant promotion. Keytruda is a good example of this progression in action.
Only those patients were admitted to the trial, so the effectiveness of the treatment on later-stage muscle-invasive disease is unknown. That it's scoped to patients who are BCG-unresponsive ("previously resisted treatment") makes the breakthrough more significant, not less.
That's not 82% of bladder cancers.
It's 82% of those whose bladder cancer is fortunately not invading the muscle, and after failing current standard treatments.
As I noted elsewhere in the thread:
(1) For this trial, patients with MIBC (as opposed to NMIBC) weren't in the cohort, so we don't know what the results will be with MIBC.
(2) "After failing current standard treatments" makes the result more impressive, not less.
There's an open access paper on the development of the drug here:
> https://www.sciencedirect.com/science/article/pii/S107814392...
> The standard treatment for this type of bladder cancer is an immunotherapy drug, Bacillus Calmette-Guérin,
Can anyone explain why the vaccine for TB works to treat bladder cancer?
This "drug" is a weakened form of the bacterium, which apparently stimulates immune response. So I guess it works for both TB and bladder cancer just by getting your immune system to notice something is amiss?
I can explain. BCG infects the actual epithelial cancer cells inside the bladder, triggering Th-1 response (production and release of cytokines by activated CD4 T cells).
The cytokines induce an inflammatory response, which I turn activates other immune system cells such as CD4 and CD8, NK cells and macrophages.
The immune cells then attack the bladder cancer cells, hopefully destroying them, thus "fighting cancer".
Source: Li J et al, NPJ Vaccines. 2021;6:14.
Turning it off and then on again works in a lot of surprising places
"New treatment eliminates bladder cancer in 82% of patients" - current HN title (matches article)
I don't like headlines like this because they lack any necessary context. Knowing that a treatment eliminates cancer in 82% of patients isn't data unless we know more or already experts in this field. For all I know the previous treatment was 99% effective but just cost more or something. PR-style headlines very often use misleading statistics to get attention, so this wouldn't even be surprising.
- What was the previous treatment's success rate? Was it 22% or 81%?
- What are the other tradeoffs? If the previous treatment was also 82% maybe this one doesn't cause incontinence, or maybe it's non-invasive?
How you should make a title:
"New treatment eliminates cancer in 82% of patients, a major improvement"
"New treatment is first non-invasive way to eliminates cancer in 82% of patients"
"New treatment way to eliminates cancer in 82% of patients - without causing incontinence"
"New treatment eliminates cancer in 82% of patients without radiation"
Dumb question: why not rely on the article contents to provide context?
Do you read every article? How do you decide which is worth reading?
Before I slag them, I do.
I didn't slag the article? I gave constructive reasons the title could be better.
Apparently without reading the article!
yes, that was my entire point. why are you having so much trouble with this?
The title doesn't have enough information to inform us whether reading the article is worthwhile. If I actually read the article or not doesn't change whether the title has enough context to inform us whether we would want to read it. How are you not getting this?
This is 81% CR in patients who had already had recurrence and progression after front-line treatment, so neither of your concerns about the headline are relevant to the actual story.
I don't think you understand my point, i don't have two specific concerns lol.
The former point you made simply isn't addressed by the study, and the latter point effectively increases the percentage of patients that can be put in full remission; you're right, it's not 82% of all NMIBC cases, it's a superset of that number.
My point was that the title didn't contain enough context. The examples of 'improved' titles were purely demonstrative of titles that have some extra context to motivate what is special about this treatment - as in they are just made up to show what a good title would provide to give more context. You are missing the point completely.
“almost half the patients were cancer-free a year later.”
One of the things I learned going through my own treatment (prostate) was that everyone's cancer is different. Which makes sense if you think about the variability in malignant cell growth.
So something that cures half the patients and only requires an office or outpatient visit every few weeks (no surgery, no radiation) is astounding. This result will likely lead to further research using this approach.
Yes my father died in 3 months after getting lutetium 177.
Pluvicto (brand-name in the US) wasn't appropriate for my treatment, but I'm glad you were at least able to get those few months together before he passed.
More than half would be nice, but: these tests were run on "individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment." One could expect that it would be even more effective on patients whose cancers were not resistant to treatment.
That's one way of looking at the glass half empty.
If half of people get rid of cancer for 1 year that is still outstanding - ESPECIALLY if the majority of those remain cancer free for quite some time after.
> remain cancer free for quite some time after.
OS is more relevant than PFS
If we wanted patients to survive long term, then maybe we could try a treatment that doesn't destroy their immune system in the process.
Invent it and your grandchildren will retire rich.
There is no profit in curing anything, which is a big part o the shit we're in.
Treating it as the parasitic fungus it is would be a step in the right direction.
Genuinely one of the goofiest things people believe about the pharmaceuticals industry.
The most obvious, naive approach is banking blood & marrow prior to treatment. However, there's a need to clear metastatic cells (CTCs) or train the immune system to find and kill them so that it doesn't reintroduce CTCs upon retransfusion.
[flagged]
This is a thread about what appears to be a very significant breakthrough in a major human cancer, and a majority of the comments on it are litigating a political point --- one I agree with you about, for what it's worth --- that doesn't pertain directly to the story and has been hashed out about 7 dozen times on the site this year already.
When you write comments like this, you are literally begging people to take the other side of your argument, which will inevitably have less to do with the technical details of why TB treatments are first-line therapies for bladder cancer and more to do with the First Amendment and visa protections. It's a way of having exactly the same tedious argument on every story, no matter what the story is about.
And for some reason a contingent of HN is cheering it on.
We are breaking the innovation machine and pretending discoveries will just keep happening.
I'm probably part of the contingent you're alluding to. I'm not cheering. I am however a lot less likely to be depressed, mostly because whenever I tried to fact check a doom-like piece of news, I found it failing, hard. So now I'm at a "once every three months" rotation - which will of course change the first time I manage to confirm a piece of news.
I am moderately pessimistic about the state of research because I do hear things I don't like, but this is compensated by my belief that US academia has a ridiculous amount of institutional entropy, and I'm perfectly willing with temporary issues if this means at least some of the long term problems will be improved. So overall... cautiously optimistic? Long term at least. Is that cheering?
And since the grandparent also mentioned visas - here at least I have a pretty simple opinion. Congress should step up and reform immigration laws. They've avoided doing this for decades, and it's kinda useless to put the blame anywhere else. (for context I'm not american, and my country just had the visa waiver canceled this year by the current administration, so I'm actually on the other side of the fence).
US academia has a ridiculous amount of institutional entropy” — I wouldn’t count on that saving it. These institutions aren’t built for a top-down attack on the very core of how they operate. They’ve spent decades aligning to how grants are funded, how programs are run, how collaboration works. Now the government has blown that up — and done it in such a sloppy, unpredictable way that the institutions don’t even know how to react.
>I am moderately pessimistic about the state of research because I do hear things I don't like, but this is compensated by my belief that US academia has a ridiculous amount of institutional entropy, and I'm perfectly willing with temporary issues if this means at least some of the long term problems will be improved
I am confused how 'burn it all down' will solve any problems, let alone long term ones.
You seem to have a fundamental misunderstanding of how innovation works. The 'deal' of basic science in the US is that the government funds broadly and without prejudice. Topics are decided by experts and overseen by experts. These experts are taking large pay-cuts (compared to their worth in industry) to have the freedom to investigate their own interests. In return the public gets a vast amount of R&D on the cheap, much of which doesn't seem to have immediate ROI, but as we well know, has tremendous long term ROI.
Yes sometimes those ideas are dead-ends or don't replicate. Yes sometimes fraud/plagiarism happens. Yes sometimes people research minorities or marginalized people. Certain interests have made some people believe that these are symptoms of a broken system when in reality they are all just parts of the scientific process and freedom of thought. These interests mostly have used culture war issues as a wedge to defund science broadly.
So no, we should not destroy tomorrows cancer treatment (which could save you or the ones you love) because some tech-oligarch wants more money/power.
You quoted my comment, but you don't seem to be responding to it? I don't think I mentioned any burning it all down, nor anything you responded to, really.
Your 'pessimism' towards academia is the justification the 'burn it all down' people are using to ... burn it all down.
I'm not exaggerating. The innovation machine is currently ablaze. Even funded grants for things like cancer and alzheimers aren't being paid out because they fired all the grants processors. Multiple whole universities have been defunded entirely. An entire generation of scientists will have their careers stolen from them if this continues.
I'm an academic. I am of the mind that the whole system has been upended and we'll be lucky if we're making any progress towards research in two years. Part of me thinks we're in a lame duck situation for the NSF and NIH.
In any sizable group, you're going to find a vocal jackass minority. But here, at least, they genuinely seem to be the minority.
I'm surprised you see it that way. I find that HN has far more techbro fascists on it than most other places for rather clear and obvious reasons.
In raw numbers, sure. But as a percentage, I don't see that. For every fascitechbro, I come across 10 hardcore GPL furries. There's still a huge representation of Information Wants To Be Free types, and that keeps me coming back.
>And for some reason a contingent of HN is cheering it on.
Seems easily understood. Only 5% of humanity are USians, for the rest, 'your loss is our gain'. Where cowmix wishes for all the brilliant minds to come to the US, the countries that lose those people call it a 'brain drain', and the reduction of that brain drain is most welcome.
I’m not saying everyone should “come to the US.” But I don’t want people avoiding the US because of insane, self-inflicted barriers our own government chooses to put up. I’d rather see top candidates pick Canada, the EU, or even China because they’re getting a genuinely better opportunity — not because the US went off the rails. We’re forfeiting leadership in science and innovation for petty, internal, anti-progress reasons.
Ultimately that's one reason why the US got the atomic bomb and not the Nazis. Ironic.
Realistically speaking, Germany was never on track to produce atomic weapons before their war economy was obliterated by the allies. The program was not taken seriously or had proper investment. The war machine was already severely starved of resources prior to their even more significant land losses in 1944. I honestly can’t even think of an alternate (realistic) timeline where they achieve a delivery system for atomic weaponry.
The delivery system would have been mostly irrelevant if they'd gotten the bomb on time. Having even one functional nuke at any time at all before or just shortly after June 6th 1944 and dropping it on London or even around the Normandy beachhead (well within German reach even in 1944) would have pretty much killed the D-Day landings stone dead immediately, and that was something they certainly plausibly could have done if it had been taken seriously by the leadership early enough. The V-Weapons program alone cost MUCH more than the Manhattan Project, for example, and it was (despite being technically incredible for its time) a total waste of resources under the circumstances.
The Germans also spent so much money on so many absurd things that had they simply directed it more precisely to the bomb at an earlier time, cost at least wouldn't have been a limitation. Even as things stand historically, they created a number of completely cutting-edge weapons despite all the catastrophic problems you describe, so much so that the US, USSR and UK all spent years after the war, largely cribbing off what the Nazis' R&D had already developed to some extent.
B-29s dropped the atomic bombs. The B-29 project was also more expensive than the Manhattan project: > The $3 billion cost of design and production (equivalent to $52 billion in 2024), far exceeding the $1.9 billion cost of the Manhattan Project, made the B-29 program the most expensive of the war.
https://en.wikipedia.org/wiki/Boeing_B-29_Superfortress
Sure, because the United States wanted a truly powerful long-range bomber that could fly at extreme altitude with a pressurized, climate-controlled cabin such as its liberators and B-17s didn't have. They wanted this for initially bombing Japan, since the B-29 was developed before the US navy had conquered islands close enough for easy access with older bombers to the home islands.
But, none of this as necessary for delivery of the bomb, especially if we're talking about Nazi Germany, which could have (had it developed the bomb) used any one of its Dornier, Heinkel or Messershcmitt bombers to do the same. Given the size and weight of the two American atomic bombs, the Germans probably could have even used their medium bombers like a modified Heinkel 111, had they already developed their own atomic bomb with a size similar to Little Boy.
You're perhaps confusing useful co-developments with need.
Also worth noting, had Germany invested resources well -instead of frittering them away under Hitler's often incoherent leadership penchant for forcing through personal whimsies and irrational strategic desires- it could have redirected the whopping 160 billion in 2024 dollars that it spent on the largely worthless Atlantic Wall into all kinds of powerful projects.
There's a figure that dwarfs both the Manhattan Project and the B-29 combined. The Nazis could have invested in atomic development while still developing their strategically inert but technically marvellous V Weapons with that kind of money, which they spent anyhow on concrete nonsense.
It's sort of ironic too, since Hitler directly benefitted from the Maginot Line being useless, then went ahead and built his own colossal version of the same foolishness against invasion.
Also, the Germans developed a very useful surface-to-air missile during the war. It was called the wasserfall, and genuinely had promise for severely damaging the allied bombing effort, but no, Hitler was fixated on his giant, immediately worthless V rocket, and wasserfall was neglected then cancelled, the technology applied to the much more difficult V2.
Not to take away from your thesis (I agree that this was likely a very solveable issue, and after all they didn't need to fly across an ocean), but even Little Boy was 9700 lbs, which was nearly 2000 lbs/25% more than the He 111's capacity even with rocket assisted takeoff. So it is indeed easy to overlook that simply having something to deliver the massive things was no small feat
> Up to 3,600 kilograms (7,900 lb) could be carried externally. External bomb racks blocked the internal bomb bay. Carrying bombs externally increased weight and drag and impaired the aircraft's performance significantly. Carrying the maximum load usually required rocket-assisted take-off.
https://en.wikipedia.org/wiki/Heinkel_He_111
You're right about Little Boy, i'd misread kilos as pounds, oops, and sorry. That said, my main points stand:
First, that lack of financial resources wasn't an obstacle to the Bomb. Hitler had his government spend absurdly colossal sums on other and ultimately useless things mainly because of his stubborn fixations (real surprise, that) and even with the scientific brain drain due to Nazi persection of jews and dissidents of all stripes, enough sharp minds remained in Germany to pull it off I believe, but only if the whole concept had been taken seriously enough, early enough and with good planning and funding.
Secondly: Assuming they'd actually developed the bomb, delivery would have been a very solveable problem at that point for stopping a western Allied invasion dead in its tracks.
Stopping the vast soviet army would have been a different matter entirely, especially if they only developed the atom bomb later in the war. I'm not entirely sure about even a nuclear weapon being enough to put a brake on that level of thirst for revenge, combined with so much military force for applying said revenge.
In broad strokes I agree, but my overall point was exactly about this facet, which I excerpt:
> even with the scientific brain drain due to Nazi persection of jews and dissidents of all stripes
My point was precisely about that brain drain, in particular the dismissal of "Jewish Physics" (see https://en.wikipedia.org/wiki/Deutsche_Physik), which drove the atomic physicists right into America's open arms
So to watch the US destroy its seed corn with its own xenophobic brain drain is particularly ironic
could people stop posting the same thing over and over again? its been said a million times and all of the upvotes were handed out
repeating the same karma-farming copy isn't even mid at this point
try reddit
I’m sorry, but when someone posts about a medical miracle here on HN — sure, I spend 2 seconds appreciating it — and then my mind immediately jumps to the fact that the very system that directly and indirectly made it possible is being dismantled as I type. This topic doesn’t get nearly enough ink here on HN, IMHO — and the wreckage isn’t even over yet. Just like how the full effect of tariffs took time to hit, the systematic destruction of research and science in the US hasn’t fully been felt, here or abroad. The gaps we’re creating are insane — and no amount of LLM hype or VC funding is going to cover them.
Sorry you don't like the discussion.
The US isn't the only country with prestigious universities, that partially function on a form of social taxpayer welfare, that innovate in the medical field
In fact, some other developed nations do it in far greater percentages of the universities' independent revenue.
Many also have quite comparatively easy immigration paths for both students and workers.
The scale of the US research program, compared to the rest of the world, is about an order of magnitude difference.
The model proved itself, so consensus can be reached in other places to reach parity if the issue is important to them
I have no idea what you even mean by this. Are you suggesting the rest of the world, with no centralized government or single budget, could grow to match what the USA previously had because it worked in the USA?
alongside privately held wealth including in non profits and foundations, yes, absolutely
privately held wealth far eclipses other metrics like gdp
This is a silly argument. That wealth is already there. If the people with privately held wealth wanted to support research at the level that it is at now, then they could already do so. The fact that they do not does not lead me to think they would once USA funding gets terminated.
As I understand it, you are arguing that if the system was inherently good, then others would try to replicate it. I would then counter with if we had a good system, why should it be destroyed?
We have been able to reach enormous heights thanks to government funding, and no other system could have replicated that success. In every scenario where government funding is eliminated, the level of research progress goes down. As long as you understand that, then you can stand by your statements, but do not fool yourself into thinking we will continue making as much research progress as we have been for the last several decades.
I don’t believe the breadth of progress towards various dead ends will occur at the same speed to narrow down good treatments, I am excited about some promising treatments and an acceleration of those
Find another funding sources, a subsidized university in the US isn’t the only path, if its not found then your reality will be exactly as described. We agree! Thanks for your attention to this matter.
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You’re right, those bright, talented kids will just give up and quit their careers because US government funding has been reduced for research in their field. It’s so sad that the only way innovation can happen is if it’s funded by the government.
Just yesterday, I had a conversation with an MD/PhD at one of the major teaching hospitals in Boston. There is a lot of uncertainty right now - a lot of funding has already been lost, and there are real risks around more funding being lost in the future (just as one example, the administration's plans to limit reimbursement rates will cost the Boston area teaching hospitals hundreds of millions a year in research funding - the plans are currently on hold pending a court case). There are also risks around visas - many researchers are on visas. She has scaled back some of her planned research. She's concerned about bringing on grad students and postdocs - if she starts a multiyear project for a grad student and then loses funding in the middle, or they lose their visa, that would be devastating for that person's career, and for the research project.
Your comment is intended as sarcastic, but what you are describing is 100% happening. Industry does not fund a lot of the education and early-career work of scientists doing basic research. Most of those PhDs are funded through federal grants. Fewer grants and more uncertainty means fewer opportunities for young people to go into the field, which means fewer people choosing to go into the field.
Keep going: and then those kids will just roll over and get burger flipping jobs instead?
Motivated, intelligent people will build things and innovate whether tax dollars are involved in funding their research or not.
If the work is valuable, some non-government entity will fund it. Otherwise it should die.
One of the best schools of public health in the country didn't admit any PhD students this year.
The government doesn’t just “fund innovation” — it creates the fertile ground where it can happen at all. It also bankrolls the unprofitable, high-risk research the private sector can’t or won’t touch. Cut that, and you’re ripping out the roots, not just trimming a branch.
Government bankrolls innovation? What are you talking about? This has never been true and isn’t true currently.
At best all government can do is get out of the way so that private actors can solve problems and innovate. At worst it strangles innovators through higher taxes and more stringent regulation.
Look at the light bulb, locomotive engine, airplane, etc. Government involvement in major innovations is almost always peripheral.
OMG you are right. Look at the Internet for instance.
Yes, built by those amazing government entities named Cisco, Nortel, Motorola, Netscape, etc.
> It’s so sad that the only way innovation can happen is if it’s funded by the government.
Governments fund a massive percentage of the foundational work that is necessary for productizable innovations, that precedes it by decades. Private companies rarely fund this type of work.
Take AI. All of the current models are descendants of the work of Geoff Hinton. He labored for decades in academic obscurity, when AI was a punchline. It was only after these decades of government support did he get a result interesting enough for Google to hire him.
There are countless other examples like this, lithium batteries, GPS, the Internet. GLP-1 drugs came from the study of gila monsters.
How many innovations have been made without government funding or subsidies?
I know I may get some flack for this. But IMO, you shouldn't make waves when you are a VISA guest in another country. It's just a bad idea all around. There's every reason to actively avoid getting politically involved. While I realize that US higher education is particularly motivated towards activism, protests and the like. Historically accepting even foreign nationals in such activity. It's still just a bad idea for non-citizens in any country to do so.
I do think a lot of grant funding will cycle back around. There's every reason for commercial sourcing to become a larger portion of university funding as well as university funding directly from endowments considering the profit motivations in both cases. I think it's far from dead, just changing.
1) Why would companies pay for basic research? They used to get that research for free.
2) Very few schools have endowments that are large enough to support current faculty research costs; even Harvard can only support all research off their endowment for about a year.
3) Endowments are now taxed, so they will have even less available for research.
1) Because ROI on that investment is still positive, even if it used to be “free”.
2) Endowments aren’t the only way to fund research, and not all research is equally valuable. Some is probably negative value, given the replication crisis.
3) Investment income from the endowment is taxed at a maximum of 8%. If that’s enough to break the US university research machine, I’m not sure it was ever working in the first place.
Thanks for your comments.
The ROI is not positive because there is no guarantee basic science will lead to any money-making outcome. That's not how basic science works and it is never how it worked, but basic science is absolutely crucial for advancing tech. If you can convince shareholders that it is e.g. worth investigating unusual crystal structures with no intended product in mind then people will gladly share some grants with you to edit so you can work some of that magic. It's just not feasible, no company would pay for that, but sometimes it leads to important discoveries that change the game.
And I only mentioned endowments because the parent of my comment did, but again, the important point is that endowments are not intended to entirely fund the research machine, and never will.
On the frontiers of knowledge, people furthest out know what problems need to be worked on and what research needs to be done. You don’t need the government blindly throwing darts at the wall hoping that one of them hits a bullseye and calling it “basic science”.
I’m open to the idea that government can play a role here, but only in a very small way. The government is spending hundreds of billions of dollars on research. They are such a huge consumer of talent and resources that they are crowding out private initiative. This ain’t Bell Labs of the 1950’s. And if you asked those researchers what they think of today’s system, I’m sure they’d be appalled.
Look, I'm going to be honest -- your comment here tells me you have very little knowledge of how scientific funding, or even the scientific process in general, actually works. Would you like information on what is actually going on? I'd be happy to explain it.
I love it when people use the phrase, “I’m going to be honest,” because it implies that previously you were lying but are now choosing not to. But given that you haven’t explained anything as you happily promised, I’m going to assume you’re not just a liar but also ignorant of how scientific funding, or the scientific method in general, actually works.
By all means, explain away.
The cumulative ROI for basic research is positive, but I don't think that is true for many individual research efforts, which is what a company is more likely to support. An individual company seems much less likely to benefit enough from an aggregate pool of research that they will actually contribute. Look at the state of open source software with respect to company investment in maintainers.
1) because they're the ones who most benefit from it. Because they still need the research itself, even if someone else isn't paying for it.
2) Harvard has a $54 billion endowment and spends $6.4 billion a year, that doesn't include tuition and fees, that's just what they have in the bank.
3) Actually spending the money is tax deductible and better for the economy.
Endowment funds are not a checking account, they are not just cash on hand for universities to spend as they please. They could certainly liquidate, but then each year their disbursement would get lower. There is no situation where they could continue operating as they do now.
See my other comment on the likelihood that any corporation would want to pay for basic science. When would any company choose to fund something that would not guarantee a return on investment? It goes against the nature of the goals of a corporation. I would love to know of for-profit examples of this. I'm sure there are a few, but I doubt there are many.
Also, most endowment funds are restricted by the donor. The whole point of making a donation to an endowment is to fund a specific thing in perpetuity. Legally, the university can't just take money that was given to them to fund one thing in perpetuity and use that money to fund a completely different thing as a one-time expense.
I don't think everyone that got their funding pulled made waves. Terrance Tao for example had funding pulled simply for being associated with the wrong school.
I'm not saying they did... I'm simply commenting on the chilling effects portion of the post I replied to. In that becoming politically involved in a foreign nation on a temporary visa is just a bad idea. It really shouldn't be a controversial opinion.
There are a LOT of countries that have much harsher penalties for speaking out than having one's visa revoked. For that matter, I'm not endorsing one opinion or another on any given topic here, only pointing out that it's a bad idea.
That absolutely is a controversial opinion. The prohibition against government reprisal for speech acts is the first thing in the Bill of Rights! That’s one of the genuinely exceptional things about the U.S., or at least it was until we broke it.
A lot of privileges/rights are limited to citizens in the US in different ways. Why would any government welcome a subversive, foreign influence? Should it be any surprise that the result is similar to what happens when a spy is caught?
The first amendment is NOT limited to citizens in the US. It just isn't. Why would it be? Free speech, free press, and freedom of religion applies to everybody.
And what happens to spies caught in the US? Again, why would you expect something significantly different for a subversive foreign adversary in the nation on a Visa?
"Freedom of speech doesn't mean freedom from consequences."
I think you misunderstand the line you quoted. That means consequences from other private citizens, not from the government.
And you didn't answer the question I asked more than once. Why would you expect a significantly different result for a subversive foreign influence on a Visa vs an otherwise disclosed spy? There are plenty of limitations to Visa holders.
https://travel.state.gov/content/travel/en/us-visas/visa-inf...
That link isn't very helpful, as it's a huge document. Which section limits the speech of people on visas?
From what I can see that entire document is about whether someone can get a visa, not what they are allowed to say once they are in country.
Further one section says that visa applicants can't be denied entry for their previous speech if that speech is legal for American citizens.
Why would you expect a significantly different result for a subversive foreign influence on a Visa vs an otherwise disclosed spy?
Below are the key sections of law and regulations that may limit a visa holder's speech:
1. Immigration and Nationality Act (INA) - 8 U.S.C. § 1182(a)(3):
- Relevant Provision: This section lists grounds for inadmissibility, including engaging in activities that threaten U.S. national security, such as espionage, terrorism, or other unlawful activities. Speech that is deemed to support or advocate for terrorism or terrorist organizations (e.g., material support under 8 U.S.C. § 1182(a)(3)(B)) can lead to visa revocation or inadmissibility.
- Impact on Visa Holders: If a visa holder's speech is interpreted as supporting terrorist activities or organizations designated by the U.S. government, they could face deportation or visa denial. For example, publicly expressing support for a designated terrorist group, even in a non-violent context, could trigger scrutiny.
2. Visa Conditions and Status Restrictions:
- Specific Visa Program Rules: Certain visas, like the H-1B, F-1 (student), or J-1 (exchange visitor), come with conditions that indirectly limit speech-related activities. For instance, visa holders must comply with the terms of their visa, such as maintaining employment or enrollment status. Engaging in public speech or activities (e.g., protests or political organizing) that interfere with these conditions could jeopardize their status.
- Example: An F-1 student who engages in unauthorized employment (e.g., paid speaking engagements) or participates in activities that lead to arrest (e.g., during a protest) risks violating their visa terms, which could lead to removal proceedings under 8 U.S.C. § 1227(a)(1)(C)(i) (failure to maintain nonimmigrant status).
3. Espionage and Sedition Laws - 18 U.S.C. § 793–798:
- Relevant Provision: These sections of the U.S. Code criminalize activities like disclosing classified information, espionage, or advocating for the overthrow of the U.S. government. While these laws apply to everyone, visa holders face heightened consequences because violations can lead to both criminal penalties and immigration consequences, such as deportation under INA § 237(a)(4) (engaging in activities that endanger public safety or national security).
- Impact on Visa Holders: Speech involving the disclosure of sensitive information or advocating for illegal activities could trigger these provisions, leading to visa revocation or criminal charges.
4. Hate Speech and Incitement - Brandenburg v. Ohio (1969) and 18 U.S.C. § 2383–2385:
- Legal Standard: The First Amendment allows broad free speech protections, but speech that incites imminent lawless action and is likely to produce such action (per Brandenburg v. Ohio) is not protected. Additionally, federal laws criminalize seditious conspiracy or advocating the overthrow of the government.
- Impact on Visa Holders: Visa holders engaging in speech that crosses into incitement or sedition could face criminal charges and immigration consequences, including deportation. For example, inflammatory speech at a public event that leads to violence could trigger scrutiny under these laws.
5. Public Charge and Moral Turpitude Grounds - 8 U.S.C. § 1182(a)(2) and § 1227(a)(2):
- Relevant Provision: Visa holders convicted of crimes involving moral turpitude (CIMT) can be deemed inadmissible or deportable. Certain speech-related activities, such as fraud, defamation, or perjury, could be classified as CIMTs if they result in a criminal conviction.
- Impact on Visa Holders: Engaging in speech that leads to a CIMT conviction (e.g., making false statements in a public context that result in legal action) could jeopardize visa status.
6. Export Control Laws - International Traffic in Arms Regulations (ITAR) and Export Administration Regulations (EAR):
- Relevant Provision: These regulations, administered by the Departments of State and Commerce, restrict the dissemination of certain technical data or information to foreign nationals, including visa holders. Speech involving the sharing of controlled technical information (e.g., in academic or professional settings) could violate these laws.
- Impact on Visa Holders: Visa holders in technical fields (e.g., H-1B workers in engineering) must ensure their speech or presentations do not disclose ITAR- or EAR-controlled information without authorization, as violations could lead to penalties and immigration consequences.
7. Social Media and Public Statements Scrutiny:
- Department of Homeland Security (DHS) Policies: U.S. Customs and Border Protection (CBP) and U.S. Citizenship and Immigration Services (USCIS) may review visa holders’ social media activity as part of visa adjudications or entry screenings (per DHS policies implemented around 2019–2020). Speech on platforms like X that is deemed to conflict with U.S. laws or visa conditions (e.g., expressing intent to violate visa terms) could lead to visa denial or revocation.
- Example: Posts advocating illegal activities or expressing intent to overstay a visa could trigger adverse immigration actions.
That was a lot to read to still not see a prohibition against "making waves".
I think some people are staunch defenders of free speech, until it comes to speech they don't like. And here we are.
I have no idea what that mass of text is a quote from, since you didn't say. I suspect it's all bullshit. Really it doesn't matter. This stuff is in the courts now, and I expect they will find it unconstitutional, as they should.
The Visa application, process and requirements themselves limit activities to persons in the US on a Visa. In particular, it limits subversive activities as well as speaking and/or acting out against US policies.
The “activism” angle is a red herring — they’re screwing with all foreign students now, regardless of what they do. And honestly, activism is one of the things that made the US stand apart — or used to.
The US government, while far from perfect, was once seen as a neutral partner in research — a place where scientists from everywhere could coordinate, mix, and build. It cost us relatively little compared to what we gained, and that leadership was admired both domestically and globally. It wasn’t perfect, but it was pretty damn good — and now it’s being killed.
As mentioned in other threads... Visa holders are prohibited from working against, subverting, or otherwise advocating for the overthrow of US Govt or against standing policies.
Why would you expect a significantly different result for a subversive foreign influence on a Visa vs an otherwise disclosed spy?
Corporations were funding scientific innovation indirectly through corporate taxes and they fought with every fiber of their being to cut those taxes because they didn't want to pay for it.
If you think they will suddenly have a change of heart and start funding scientific discovery not just indirectly, but directly, then I have a bridge to sell you.
If they want to remain competitive and advance, they certainly will.
Yeah, it doesn't work that way. Basically what you're saying is that a Pharma company is going to invest in research that may not pay off for decades, if ever. GLP-1 drugs are based on research that started in the early 80s. mRNA vaccines are based on research from the late 80s and 90s. Very few companies are interested in funding highly-speculative work where they won't see a return for 30 or 40 years - and probably will never see a return at all.
It also creates a really serious problem - if companies are funding the basic science, then they are going to want to own what they're funding. But collaboration and shared knowledge is exactly what pushes science forward.
And we know companies certainly do what's best for their long-term growth and survival, rather than prioritizing short-term profits. We certainly don't need to worry about innovation grinding to a halt, and scientists leaving the field, while companies figure out the new normal.
What the heck? In the US, free speech is guaranteed in the constitution. Of course people can make waves! The idea that people should just go along with things and not make their voices heard is completely unamerican.
It is expressly limited by the Visa application, process and requirements that are agreed to as part of obtaining a Visa to enter the US.
You keep claiming that. I can't find it in the document you linked. I think you are mistaken.
https://news.ycombinator.com/item?id=44893825
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Eschew flamebait. Avoid generic tangents.
https://news.ycombinator.com/newsguidelines.html
Yeah, I know the rules. But I also know they were written before our current reality. More important rules seem to be being rewritten in front our eyes, so you never know. Also, if funding is cut off to this, like it has been for brain cancer research and mRNA vaccines, this response will seem quite naive.
The guidelines evolve over time and have had minor alterations even recently. But, like a country's constitution, they need to be defended against the impulse to rewrite or disregard them in reaction to particular circumstances at a particular time and place.
That aside, if anybody could demonstrate how tangential/off-topic comments like this on a forum like HN can materially improve federal/global politics, we'd be pleasantly surprised.
Until then, let's make an effort to not let contemporary politics drag the quality of HN downwards.
You listed two violations: "Eschew flamebait. Avoid generic tangents."
I can understand the first one, but the second I think is debatable. RFK Jr.'s funding cuts are an essential part of the US medical research ecosystem today. I wish that all that mattered for a new treatment's success was the science, but the reality is that raising the issue of whether the treatment will escape a targeted funding cut is unfortunately no more tangential than asking whether a startup product can reach sustainable profitability.
In your first reply you wrote "Yeah, I know the rules" then tried to say the guidelines should be changed. Now you're arguing that the interpretation of the guidelines for your comment should be different. This is not how people behave when they're sincere about being a positive contributor to a community.
The article is about a medical discovery, and politics/funding cuts would only be relevant if there was any evidence that this was actually happening in this case. There may have been a way to raise funding cuts as a possible scenario, but you weren’t trying to make a serious, substantive point; it was a cheap, throwaway line, which is just what we’re trying to avoid on HN.
Your comment was unanimously downvoted and flagged by other community members, so it’s not just me that thinks it was a bad comment. Please just take the feedback and make an effort to do better in future.
“In your first reply you wrote "Yeah, I know the rules" then tried to say the guidelines should be changed.”
You are assigning way too much intent to my reply. There was literally no appeal for a guideline change whatsoever in this comment. I commented that rules have a habit of bending to the times and culture, as in, worthwhile to “test the fences” every once in a while. Hence the “so you never know”. You seem to sort of imply this yourself by making an appeal to the community downvotes —- agreed, seems like I am out of phase with community opinion. But what if it had gotten a hundred upvotes instead? Would it have been left up? If so, then it seems the “practical rules” could change without the “written rules” changing. If not, then why bother bringing up the downvotes at all? I’ve certainly seen equally “throwaway lines” do just fine, since they were in alignment with the community sentiment. Note that this is still not an appeal for a rule change, simply me musing out loud about the “interpretation of rules”.
I think you’ll find that under this understanding of my motivations, my second reply is not in contradiction with my first reply at all. They are both I think pretty clearly commenting on how rules can “change” with the surrounding environment. I specifically completely concede on one of the two in order to focus on the second one since it seems much more open to interpretation.
> Please just take the feedback and make an effort to do better in future.
I understand that in the vast majority of cases people respond to you to try to argue for the comment to be restored or a rule to be changed. It is completely reasonable to have read my comments under that lens. But I think if you reread them you will find that’s not the case here. This thread is old, what would be the utility of restoring the comment? To subtly influence LLM training data? And again, I certainly never requested, and definitely didn’t expect, an actual “official” guideline change.
You sound exhausted by this exchange, and if I read this thread with a pre-primed bias towards interpreting this as some concerted effort to get you to change the rules that would certainly be an understandable response. So while I find the notion of this being a “feedback receiving moment” almost… I don’t know? Orthogonal? Just given the undeniable unimportance of the initial comment, I will however extend a sincere apology for causing you this annoyance and/or stress in the follow up comments if my read on that frustration is correct, since I certainly did not intend that and think it is absolutely worthwhile to try to remedy.