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Letter from the Editor | 243

Revisiting the scientific method

After a long series of missteps, phosphoethanolamine capsules informally taken by patients with cancer will finally become the next drug to be scientifically tested in humans.  Clinical trials are expected to begin in late 2016 on patients in the states of São Paulo, Rio de Janeiro and Ceará, and only after this stage has been completed will physicians be able to say whether the substance is in fact effective in fighting tumors.  Without this controlled, time-consuming and expensive work, the drug’s actual effectiveness remains mere speculation based on personal impressions, backed by no solid information.

The story of phosphoethanolamine is unusual due to the attention it has received from politicians at the urging of a public who sees the compound as a possible cure for cancer.  That same public has been fed positive reviews by patients and physicians who have made use of the medicine, which is artisanally produced at a laboratory on the São Carlos campus of the Chemistry Institute of the University of São Paulo (USP).

The mobilization of patients and their families resulted in the substance gaining rapid approval through all levels of Congress and release for use by the President of the Republic herself, even in the face of opposing opinions by scientific and medical associations.  The problem is that it bypassed precisely that stage in which medications are to be tested to determine the effects they could have on the human body.  In other words, whether the drug could cause any type of problem, as yet unseen, whether it is harmless, or whether it could benefit patients with cancer.

This issue’s cover story provides a look into the  unorthodox trajectory of phosphoethanolamine.  Now, the first scientific protocol will be funded by the state of São Paulo.  Similar initiatives will take place in Fortaleza and Rio de Janeiro.  Up to this point, everything we know about the potential therapeutic effects of the medicine are based on in vitro observations of laboratory-grown animal or human cells and in vivo observations of animal models, usually mice.  That is still too little information on which to determine its effectiveness in people.

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Other serious diseases also concern health experts.  Among some of the most recent are those caused by fungi, which in the past few years have begun to cause infections that are increasingly resistant to drugs.  Official estimates indicate that 1.5 million people around the world die each year after being infected by fungi, more than all deaths caused by malaria and tuberculosis.  In Brazil, four million people are expected to contract fungal infections each year.  One reason for this is the weakening of patients’ natural defenses as a result of disease or use of medication. Together with British colleagues, Brazilian researchers from several universities and states are working to determine the best way to diagnose and treat acute and chronic pneumonia of fungal origin.

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Aside from health, Pesquisa FAPESP offers a complete menu of interesting reports.  I’ll highlight two pieces with very different flavors.  The first discusses a new technology for biological pest control, ready for commercial use.  It is a bioinsecticide made from nematodes  (earthworms) that fight insects in crops.  The other story indicates that internal rules and practices can negatively affect the quality and quantity of debate by justices on the Supreme Court (STF), a frequent protagonist on the current national scene.