... than ... Can (Could) Hope to ....

[HSS]

Could anyone please paraphrase the sentences in bold for me? I guess I know the meanings of them, but I can't put them in words. My brain doesn't seem to lead me up to them easily.

According to the Pharmaceutical Research and Manufacturers Association, some 400 cancer drugs from 178 companies are now in clinical trials, and many oncologists complain that this is more cures than they can hope to keep track of.

Long story short, if Microsoft wants to take the slow road, that road is going to be a whole lot slower than Microsoft may want. Remember, it took 7-8 years for the XBox franchise to even turn a profit, and they sold them at far higher rates than they can hope to sell WinMo 7 phones, given these estimates.

Warmly,

Hiro

[Erik_Kowal]

The first sentence doesn't make sense to me, because a clinical trial is not equivalent to a cure. However, it does make sense if you substitute 'trials' for 'cures'.

#2: ... it took 7-8 years for the XBox franchise to even turn a profit, and Microsoft {sold many more of those / sold those far faster} [it's not clear which of these meanings is intended] than these sales projections for their WinMo 7 phones suggest will be possible.

[HSS]

Hi, Erik. How are you?

What if 'cures' were replaced with 'trials' then? Could you please paraphrase the part?

According to the Pharmaceutical Research and Manufacturers Association, some 400 cancer drugs from 178 companies are now in clinical trials, and many oncologists complain that this is more trials than they can hope to keep track of.

I think my difficulty seeing the phrase through relates to the insertion of 'can.' What difference would there be between [3] and [4]?

[3] Many oncologists complain that this is more trials than they hope to keep track of.

[4] Many oncologists complain that this is more trials than they can hope to keep track of.

Best,

Hiro

[Erik_Kowal]

What if 'cures' were replaced with 'trials' then?

Indeed. That's exactly what I thought I said. :-)

I think my difficulty seeing the phrase through relates to the insertion of 'can.' What difference would there be between [3] and [4]?

[3] Many oncologists complain that this is more trials than they hope to keep track of.

≈ Many oncologists complain that this is more trials than they want to keep track of.

[4] Many oncologists complain that this is more trials than they can hope to keep track of.

≈ Many oncologists complain that this is more trials than they {are able to / would be able to} keep track of.

The best option that still includes 'hope' would frame the statement in hypothetical terms:

"Many oncologists complain that this is more trials than they could hope to keep track of".

[russcable]

Having read the article, it seems that "treatments" is what is actually meant. Many of these trials will result in "valid treatments" (tumor size is reduced without killing the patient even though there may be no increase in actual lifetime or survival). Many of these treatments apply to more that one cancer so the approvals may result in a huge maze of treatments from which it will be hard to find the best ones as they certainly can't be expected to memorize all of them.

[HSS]

The number of trials talked about in [4] would most likely exceed that in [3], wouldn't it, then?

Hiro

[Erik_Kowal]

That seems like a purely speculative suggestion to me (i.e. one that cannot be proved or disproved on the basis of the evidence available), and Russ also made a very good point about it being 'treatments' rather than 'trials' (or 'cures', for that matter).

[PhilHunt]

The first article is correct in using cures. A definition of cure is 'a method or course of remedial treatment, as for disease'. Trials are of drugs and the drugs are a course of treatment. Italian has the same meaning.
I once had to produce an audio product for an oncologist convention and 'cure' was used as in the meaning above.

many oncologists complain that [there are] more [methods of treatment] than they can/could hope to keep track of.

Ie: there aren't enough minutes in the day to read all the literature on these treatments.

[Edwin F Ashworth]

My wife Catherine's prescription (against cholesterol, not anything more serious, thankfully) changed abruptly the minute she reached 60. There must be programs designed to take account of multiple patient factors which are available to GPs. These won't, of course, be infallible, and can I'm sure be overridden by a competent (including alert) GP, but must make his/her task far more manageable. Surely similar programs are used in the comparison of trialled drugs and other treatments, with different levels of results and flaggings (eg anti- Breast Cancer Top 10 /.../Not found suitable for pregnant ladies / Not recommended for patients with diabetes...)?

[PhilHunt]

Edwin,
After doing the audio for an oncologist convention on drug trials, I decided it was incredibly dangerous to take part in any drug trial for cancer. Most of the data talked about survival rates and mortality rates from the drugs themselves, not the cancer. The toxicity of the drugs was more often than not a cause of death. So a top 10 would be difficult because the number one drug that eliminates the cancer could also be responsible for killing the patient through long term toxicity. So, depending on how you read the data, a drug can look successful or lethal. An oncologist should be able to understand the risks and the advantages. For example, you wouldn't give a highly potent drug to an over 60s person as a younger person has more chance of surviving the drug and an older person less, but it would be impossible to build a system that took all variables into consideration (age, previous health, present health, family history, present medication etc...), I think.

[Edwin F Ashworth]

Phil,
Frightening.
I suppose any company coming up with a wonder drug will get the message through to oncologists - and the media - themselves, and until that happens, the clinicians can concentrate on current best practices.
At http://www.cancercenter.com/western-hos ... cology.cfm, which I arrived at by Googling body for identifying most effective anti-cancer treatments, for instance, tailored treatment programmes are mentioned. As you say, there are too many variables for the treatments to be guaranteeable, but some degree of estimation of the best treatment, with subsequent monitoring and tweaking, will generally be better than a universal-remedy approach.

[Erik_Kowal]

When new drugs are tested, the associated clinical studies focus on their safety (in other words, on establishing the degree of toxicity/safe dosage levels), and subsequently on their efficacy (how well the treatment combats the condition it is designed to address).

The greatest potential danger to trial participants will occur during the safety phases; once a safe dosage (if any) has been established, the worst that can happen to a participant is that he/she will experience some side effects from the drug, and that no significant improvement in their condition occurs.

In sum, some clinical trials are inherently riskier than others. One cannot generalize.

[PhilHunt]

Erik,
I'm not kidding when I say that the oncologist convention guide I did had two categories for mortality rates, one was mortality rate from cancer, the other was mortality rate from the drug administered.

[Edwin F Ashworth]

And I thought Scutari was bad.

[PhilHunt]

I was wondering what this discussion had to do with a lake on the border of Albania when I came across New Jersey Senator Scutari on google. Not knowing anything about him, I don't get the reference Edwin.

Remember, not everyone lives in the US. :)