Yes, not going far enough. If we are doing a truly significant blockade of mTOR with rapamycin, ergo cell cycle growth arrest, we should be seeing MAJOR weight loss as a signal. This is what blunting mTOR does across mammalian species. You’d think at least some people would be reporting significant weight loss? Thus, my grand reservations.
Until I see tissue markers, gene expression, mTOR inhibition markers and in general, the recapitulation of the mechanistic pathways in mice, I am highly suspect. I continue to advocate we need a new paradigm…a NEW way of increasing “rapalog” tissue uptake with lesser side effects. I am under no illusion that current ORAL RAPAMYCIN is NOT going to be the ultimate lifespan enhancer in humans. It may deliver some level of healthspan, but I seriously question lifespan.
Getting these human markers is obviously extremely problematic, but human impediments are going to prevent the full biological reveal.
Here’s a paper on prostate cancer and ACTUAL mechanistic mTOR tissue markers from tissue.
Activation of the mammalian target of rapamycin signalling pathway in prostate cancer and its association with patient clinicopathological characteristics
https://sci-hub.se/10.1111/j.1464-410X.2009.08538.x
“Archival formalin-fixed paraffin-embedded specimens from RPs (radical prostatectomy) and prostate biopsies were obtained. We used immunohistochemistry to investigate the activation level of five important markers of the mTOR pathway, including PTEN, p-Akt, p-mTOR, p-p70S6K and p-4E-BP1, in tissues from 182 patients with prostate cancer, 20 with benign prostatic hyperplasia (BPH) and 10 with high-grade prostatic intraepithelial neoplasia (HGPIN). The expression levels of these five markers were associated with patient clinical and pathological characteristics. The p-4E-BP1and p-p70S6K expression levels in primary cancer lesions were statistically significantly correlated with patient T stage and distant metastases. These results confirmed the activation cascade of the Akt/mTOR/4E-BP1/p70S6K pathway in prostate cancer. In the present study, the increased expression level of these four markers was apparent in the preneoplastic lesion HGPIN, which suggested that activation of this pathway might be an early event in prostate carcinogenesis. All these findings suggest that phosphorylation of 4E-BP1 and p70S6K by Akt/mTOR pathway might lead to protein synthesis, cell proliferation, cell-cycle progression, and increased invasive and metastatic ability of various cancer cells, including prostate cancer. In conclusion, using simple and reproducible immunohistochemical staining, most patients with prostate cancer had at least one component of the mTOR signalling pathway activated. The notion of using mTOR inhibitors as an additional treatment for patients with prostate cancer and a highly activated mTOR pathway is reasonable, and should be evaluated in future clinical trials.”
So here we have actual tissue markers (albeit hard to obtain). But we’re talking of extending lifespan…by default it SHOULD be extremely difficult yes? Lifespan is not going to just reveal itself so easily by just popping a pill? Now that is wishful thinking.
A 2021 trial using low dose rapamycin:
Phase I Trial of Encapsulated Rapamycin in Patients with Prostate Cancer Under Active Surveillance to Prevent Progression
“No approved medical therapies prevent progression of low grade prostate cancer. Rapamycin inhibits cell proliferation and augments immune responses, producing an antitumor effect.”
Only 1st 6 months reported (safety study). But they are just going to measure disease progression likely by PSA, biopsies …but why not measure mTOR TISSUE markers with biopsy samples?
I’ll gladly sign up for a tissue biopsy for tissue marker analysis…IF I could peer inside and look at the efficacy of my rapamycin dosing protocol. But this is a gargantuan ask. But so is the objective.