Reducing the number of cancer cells that survive the first round depends on how we encode the CRISPR enzyme. As long as we can identify a majority of oncogenic mutations - ideally 50+ - then the only limiting factor becomes dose size. With subsequent doses to catch the remaining cancer cells.

And yes theoretically a cancer could evolve to prevent lentivirus mediated transduction... luckily nature provides an near infinite number of viral vectors from which to choose, and we are already using directed evolution to breed specialized cancer-hunting viruses in massive quantities.

Edit: I appreciate you taking the time to point out limitations in the CINDELA method. It helps further improve.

Immunotherapies are very limited in their applicability. They only work for specific variations of specific cancers...

Transduction efficiency does not need to be 100% on the first attempt. Multiple treatments of even just 50% efficacy result in cure with just 7-8 treatments, without the devastation of chemo or radiation. Nobody requires 100% efficacy from one dose for other treatments, why people place such a high standard on transduction is a mystery to me. "If you can't cure it with one shot, then its not worth doing" is the logic of madness

Crispr has been demonstrates to act at cancer causing mutation locations. Target selection is vital to success and require targeting multiple different mutations simultaneously.

Bad targeting has been rare and inconsequential in the context of current treatment side effects i.e. chemo and radiation.

Crispr can by used more than once to mop ip stragglers.

A man can dream haha. I'm partial to multiple rounds of treatment personally. We ID the mutations to target, rip up those cancer cells, then target the remaining ones with different mutations. No chemo/ radiation side effects. It will not be a one-and-done. Will require multiple rounds to take down all of them. The goal is to avoid other treatment modalities completely to avoid their horrific side effects

Once a cell becomes cancerous, the rapid division facilitates further mutation, providing more targets.

Crispr has been shown to have very few off-target indels when coded correctly.

Nevermind other treatments - if we can get this scaled, this may be the silver bullet we stopped believing in

They're working on it in South Korea. Its called the CINDELA program. Not sure what the status is

You can easily code crispr to target specific strings of DNA. Just take a sample of a patients cancer, analyze which parts of DNA are driving that specific cancer, code your crispr enzyme accordingly, pack it into a virus, and away you go... its really not complicated. Even if the virus infects a healthy cell, the crispr enzyme is specific to cancer DNA and has no effect on healthy dna. The amount of off-target effect is negligible compared to current treatments i.e. chemo and radiation.

The system combines crispr with cancer bioinformatic analysis. Check out CINDELA in sourth korea

Because you coded the the virus enzyme to specifically target cancer DNA and not healthy DNA. Even if the virus infects a healthy cell, it will have no effect

Chemo is so toxic that the people administering it cannot even touch it.... and don't get me started on radiation.

These treatments are brutal, carcinogenic in their own rights, and are not even necessarily curative. Crispr enzymes coded specifically to attack cancer DNA has been proven to not affect ANY healthy cells, while selectively annihilating cancer cells in vivo.

We do have reliable methods of attacking cancer DNA. Its called CINDELA. The South Koreans beat you to it.

Using the immune system does not work reliably except in a very small subset of cases in a small subset of cancers...

Doesn't seem to be a concern when we're using chemo and radiation as the current standard of care lol. Today, ~10% of all new cancers are linked to prior cancer treatments

Exactly, redesigning immune cells is much harder than just vandalizing cancer DNA with the exact same tool...

Just inject a virus into the cancer directly that contains genetic material designed to disrupt cancer DNA.

Immunotherapy does not work for most people, or even most cancers today...

With crispr you can just attack the cancer DNA itself and shred it. No fancy reprogramming needed

If we can genetically change immune cells to fight cancer, why not simply change cancer cells to die instead? CINDELA got it right. Cut out the middle man

There are no demons. This is the Emperors Imperial Truth. All else is heresy.

This asteroid is locked in orbit around our sun.... it will literally never leave our solar system, and therefore can never threaten a single living thing ever. Hope you can finally stop worrying about this issue now