Comments on the “nexus” meeting report regarding dementia and cancer

Comparing disease research in dementia and cancer provides ready similarities and contrasts, although one condition is generally thought of as tissue degeneration, and the other as tissue proliferation. Yet each disease can be devastating and fatal. Snyder et al. [1] provided a summary of the “Nexus” meeting, which explored those comparisons May 25, 2016, sponsored by the Alzheimer’s Association and the Alzheimer’s Drug Discovery Foundation. One stark contrast is the armamentarium of effective therapies available in the two conditions. Over the last 5 years, the US Food and Drug Administration has approved only one drug for Alzheimer’s disease (AD), a pill that basically combines 2 older agents; in the same time frame, 70 cancer agents or indications were approved [2,3]. The meeting agenda included a discussion of therapeutic implications; drug repurposing is mentioned in the review. However, the meeting may have missed an opportunity to explore how clinical research has been performed differently in the cancer and dementia arenas, and ways to improve AD outcomes by enhancing therapeutic, rather than basic, research. There is no doubt that the pace of cancer progression, concrete measures such as survival, consensus “biomarkers” in readily available routine laboratory work, and imaging, along with funding, have had positive impacts in oncology. Cancer clinical trials outnumber Alzheimer or dementia trials by almost 40-fold, but they are also effectively executed in oncology, relying on a vast infrastructure that does not have a parallel in dementia work. For example, the Children’s Oncology Group (COG), funded yearly at only $25M, coordinates nearly 100 clinical trials at 200 pediatric cancer units across 3 continents. These include Phase I, II, and III trials for relatively rare diseases. The group has a research portfolio that includes cancer biology, drug development, supportive care, and survivorship. COG’s history and success is documented; it has benefitted from strong leadership and bold, directed strategies [4].