When research results are not as expected, it can be challenging for the investigator, especially for those just starting out. However, as Dr. Thomas Kosten, professor and the Jay H. Waggoner Endowed Chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, reminds us, some of the best work can come from failed research.
“Most research projects have unexpected results and often the main hypothesis is not supported by the data collected. However, the most exciting new ideas are generated in failed experiments or clinical trials where, as you examine the data more and more carefully, you can develop new insights into the disease and its potential treatment,” said Kosten.
Kosten’s work focuses on addiction treatment and its human neurobiology and includes pharmacogenetics, immunology and neuroimaging. He and his collaborators have been working for the past 20 years on an anti-cocaine addiction vaccine. They have also developed nicotine, opiate and methamphetamine vaccines.
A previous study in 2008 found that about one-third of those who received the cocaine vaccine had antibody levels that were sufficiently high enough to block the euphoric effects of cocaine. His latest study of 300 patients at six sites across the United States found that more than 60 percent of those who received a cocaine vaccine reached antibody levels at a therapeutic range, had increased treatment retention and more patients attaining at least two weeks of abstinence, but the overall amount of cocaine use did not decrease compared to those who had lower antibody levels and those who received a placebo
“The fact that more than 60 percent of patients had antibody levels in the therapeutic range is promising,” said Kosten. “However, the fact that the cocaine use did not decrease reflected two problems. First these new study patients appeared to be significantly less motivated to stop using cocaine and most tried to override the antibody blockade by using more cocaine. Second, those who attained the robust antibody response were also the same patients who had substantially greater amounts of cocaine use during the baseline period of 10 weeks.”
Kosten hopes in his next trials to improve the vaccine with a new and better carrier protein and adjuvant. He also hopes to recruit a more motivated population of cocaine dependent patients who can remain abstinent from cocaine for at least two weeks before entering the study. Those in the most recent study had at least 30 percent of their urine samples test positive for cocaine during the month before starting the study, and none were cocaine-free for more than five days before starting the vaccination.
“As a researcher, you just keep trying to improve your product – in this case, the vaccine – and more carefully target your patient group,” said Kosten.
His advice for young scientists?
“Extract every possible insight from your data collection and remember that you can never analyze your data too much or be too careful in looking for new leads,” he said. “Do not be easily discouraged when results are disappointing. The glass is always half-full.”
Kosten is also with the Michael E. DeBakey Veterans Affairs Medical Center in Houston.