This is a new paper by Joan Mannick and Dudley Lamming. It is a good review of the ongoing development in the area of mTOR inhibitors.
Both of these authors are involved in startup longevity biotech companies developing their own MTOR inhibitors that will be competitive to rapamycin. I suspect that having a significant financial benefit tied to these other compounds biases these authors (at some level) against rapamycin. Not that they would consciously misrepresent the science. Rather the issue is its hard for humans to be objective when your income/ or large stock payout is based on how well your new drug competes against the cheap generic drug. A skeptic might view the entire paper as a marketing pitch by these founders for their “new and improved” rapamycin-like drugs (mTOR inhibitors).
It will be perhaps another decade before these new mTOR inhibitors become available and are clinically validated at a level similar to that of rapamycin. Moreover, the cost-benefit analysis of these new drugs (likely to be priced very high) vs. rapamycin at $1/mg to $2/mg remains to be seen.
And of course, many people may be taking Acarbose or other drugs that can mitigate any side effects of rapamycin and further increase lifespan, so ultimately I suspect the key issue in longevity science is around the total cost and effectiveness of the entire set of longevity drugs that an individual is taking.
Mannick_et_al-2023-Nature_Aging.pdf (2.0 MB)