gene therapy cures cancer

[andyandy]

wow.....pretty exciting possibilities....



Two men have been cleared of the deadly skin cancer malignant melanoma using genetically modified versions of their own immune cells.
Tests showed the modified T cells became specialised tumour fighters.

The National Cancer Institute team in Bethesda, the US, have also shown they can manipulate immune cells to attack breast, liver and lung cancers.

In the Science study, tumours shrank in many of the other 15 patients who had failed to respond to other therapies.

Although only two of the 17 people with advanced melanoma who received the treatment were completely free of cancer 18 months later, experts say the results are extremely exciting and proof that this new therapy can work.

Before the experiment, the patients were expected to only live for three to six months because their disease was so advanced.

How it works

Dr Stephen Rosenberg and his team isolated T cells from the cancer patients and multiplied them in the lab.

Next they used a virus to carry receptor genes into the T cells. These receptors are what enables the modified T cell to recognise specific cancers - in this case malignant melanoma.

When the modified T cells were transfused into the patients they began to attack the tumour cells.

For at least two months after the treatment the modified cells made up at least 10% of the patients' circulating T cells.

The scientists are now looking at ways to enable greater numbers of the modified T cells to survive.

Dr Rosenberg said: "We've identified T cell receptors that will now recognise common cancers." http://news.bbc.co.uk/1/hi/health/5304910.stm

[Hellbound]

Woohoo!

:)

[KingMerv00]

My woo alarm is silent. I anxiously await replication. Good luck to them on winning a Nobel Prize.

[headscratcher4]

Cure? 2 out of 17. This is progress, but using a word like "cure" is, well, so Fox/Cnn. There is a LONG way to go...not the least to figure out how to expand the technology and target other cancers, little less how to determine why the 2 were cured but the 15 weren't. It is good news. They have learned something very interesting and may be on the road to a real revolution in Cancer treatment, but cure? Don't hold your breath...but our kids might have a better shot at beating the disease (BTW...cancer deaths were down in 2003...the last year of record) for the first time in decades...that is a woohoo in my book...and, it isn't because of Treadau or any of the newage hokeypokey...it was good old research, hard work, improved healthcare and intervention technologies...like the one being studied and pionered in this story. Woohoo!

[KingMerv00]

Hey, even a 15% cure rate is great news.

[headscratcher4]

No argument...I said (or intended if I didn't) that it is major progress. Bravo. It will be in the NEJM next month for the world check out. It isn't a "cure" yet...it is a brilliant idea that shows much promise...it might one day be a "cure" or partial cure. Fingers crossed....

[Hellbound]

Definate progress.

What I find most promising is that, as with many of the experimental treatments, this was tried on people who were in the end stages of the disease. So it has that 2 of 17 rate in the worst cases (assuming there's no experimental error) :)

[headscratcher4]

Indeed, it is progress...potentially very important progress. But, keep in mind, any likely therapy to flow from this could take years....

[KingMerv00]

Indeed, it is progress...potentially very important progress. But, keep in mind, any likely therapy to flow from this could take years....

Years. Ugh...it is so tempting to just go woo and declare absolute success isn't it? Don't you just want to abandon the scientific method...a little? :D

[Eos of the Eons]

Oh, but these frankenT-cells could mutate and spread a mutated Frankenvirus to attack every healthy cell in our body and kill everyone around the world in two weeks!!.

Yeah, that's what some folks say about GM foods. Modifying a gene directly is far more threatening than trying to breed a trait in for some weird reason. /derail

I'm excited because two people are CANCER FREE, actually cancer free. No drugs, just modified super cancer killer cells were used. Wonder how the sCAM folks will object to the treatment?

Do we know why it wasn't as effective in the other 15 patients? Did the other 15 patients improve at all? Did the cells just not develop receptors, or were they unable to attack the tumour cells?

Yay genetics! Yay biology!

[Hellbound]

Eos:

I'd suspect the replication rate. As the article states, only 10% of their T-cells were the modified ones.

I'm cautiously optomistic about this. COnsidering that cancer is, at it's source, genetic, I've always suspected a genetic solution would be best. OF course, I always invisioned identifying the faulty gene(s) in the cancer, making a virus from the good genes of unaffected cells, and directly modifying the cancer cells with it. This was a bit unexpected, but makes a lot more sense than my ideas :)

[Eos of the Eons]

A cell or virus has to recognize the cancerous cells to address them, even a virus made to target them (hence the receptors). Then you also have to be able to target many small cancer cells. Trying to make a virus that just modifies cancer cells would be tough, so having a T-cell identify cancer cells with receptors and getting the T-cells to kill the cancer cell is very good technology! That is their job afterall!

Killing the cancer cells is easier than trying to modify their genes back to normal with some virus. Also, there would be a clump or lumps of modified tumor cells left to excise if you did manage to get them to stop acting like cancer cells with some virus. Killing the cancer cells allows the body to dispose of them. Might as well enhance T-cells, more practical.

Keeping these modified T-cells allows them to kill cancer cells before they become a threat is also great preventative medicine. Waiting for nature to come up with the T-cells for us in or bodies to pass onto our offspring is just not practical. Some people are that lucky, but most of us clearly aren't and are wide open to getting cancer.

Really really cool. Super T-cells! I'd love to be vaccinated with them. I think they have to use your own cells to make them, so for now you would have to be threatened by cancer to have this done for you even when the technology is improved. Getting every individual their own Super cancer killing T-cells would take a long time and lots of money.

[Hellbound]

A cell or virus has to recognize the cancerous cells to address them, even a virus made to target them (hence the receptors). Then you also have to be able to target many small cancer cells. Trying to make a virus that just modifies cancer cells would be tough, so having a T-cell identify cancer cells with receptors and getting the T-cells to kill the cancer cell is very good technology! That is their job afterall!

Well, my thought was that a virus wouldn't have to discriminate, because in good cells it would be replacing good code with good code (no change), in cancer cells it'd replace bad with good.

Of course, my knowledge of genetic manipulation is limited :p And your point about not getting rid of the cells, etc, yeah, that sort of kills my ideas :) (this is why I work with computers, not cancer research).

Now, being able to mnodify the T-cells in vivo would be a nice advancemenet, and possibly make a vaccine-type treatment feasible. I dunno.

Still, I'm excited to see where this leads.

[jmercer]

Well, no matter what - this is a demonstration that the fundamental concept is functional; that's a big step up from the years of theorizing that it can be done. :)

[Hellbound]

Well, no matter what - this is a demonstration that the fundamental concept is functional; that's a big step up from the years of theorizing that it can be done. :)

Well, let's wait for replication. Afterall, there may be one or two confounders (I learned a new word, ma!) that weren't controlled.

I mean, whatif the two cured were taking one of those highly effective homeopathic rememdies?









:dl:

[ponderingturtle]

No argument...I said (or intended if I didn't) that it is major progress. Bravo. It will be in the NEJM next month for the world check out. It isn't a "cure" yet...it is a brilliant idea that shows much promise...it might one day be a "cure" or partial cure. Fingers crossed....

One also needs to understand that there have been other proposed treatments that looked promising in early trials that did not pan out.

[Hellbound]

Ture, turtle :)

Also, found a bit more info in our newspaper's article about this. Apparantly, the two who were "cured" maintained high levels of the altered T-cells in their body for a long period of time. The other fifeteen apparantly did not replicate the mutated T-cells, and the levels in their systems dropped off quickly.

[Capsid]

Oncolytic virus technologies (http://www.biovex.com/index.html) are also under development.

[Eos of the Eons]

Well, my thought was that a virus wouldn't have to discriminate, because in good cells it would be replacing good code with good code (no change), in cancer cells it'd replace bad with good.

Of course, my knowledge of genetic manipulation is limited :p And your point about not getting rid of the cells, etc, yeah, that sort of kills my ideas :) (this is why I work with computers, not cancer research).

Now, being able to mnodify the T-cells in vivo would be a nice advancemenet, and possibly make a vaccine-type treatment feasible. I dunno.

Still, I'm excited to see where this leads.

A virus has to have specific access to a cell, especially a T-Cell. There are folks that are immune to HIV because they lack the receptors the HIV viruses need to identify and attach to their T-Cells. I find that vastly fascinating.
Some researchers believe that M-tropic virus is particularly successful at infecting mucosal surfaces, which would help explain why people who lack receptors for M-tropic virus do not become infected with HIV despite regular unprotected sex. However, an absence of these receptors also protects individuals from contracting HIV through sharing needles or transfusions of contaminated blood products. http://www.sfaf.org/treatment/beta/b32/b32chemo.html
If I remember correctly, most viruses stick to specific cell types that they identify via receptors. It's been a while since I took my science courses though.
Any input from those more knowledgeable is always appreciated :D

[Capsid]

A virus has to have specific access to a cell, especially a T-Cell. There are folks that are immune to HIV because they lack the receptors the HIV viruses need to identify and attach to their T-Cells. I find that vastly fascinating.
http://www.sfaf.org/treatment/beta/b32/b32chemo.html
If I remember correctly, most viruses stick to specific cell types that they identify via receptors. It's been a while since I took my science courses though.
Any input from those more knowledgeable is always appreciated :D
This is not about virus receptors but cancer specific T cell receptors. The T cells (of the patient are infected with a virus (which yes, has a receptor to identify and infect T cells). This modified recombinant virus carries the human T cell receptor gene that then can integrate this gene into the T cell DNA permanently. The T cells express the receptor gene which is then able to identify the antigens on cancer cells and kill them. The beauty of it is that only the relevant killer T cells are infected and their gene expression altered by the specific virus.

[ponderingturtle]

This is not about virus receptors but cancer specific T cell receptors. The T cells (of the patient are infected with a virus (which yes, has a receptor to identify and infect T cells). This modified recombinant virus carries the human T cell receptor gene that then can integrate this gene into the T cell DNA permanently. The T cells express the receptor gene which is then able to identify the antigens on cancer cells and kill them. The beauty of it is that only the relevant killer T cells are infected and their gene expression altered by the specific virus.

ALso in this case the genetic alteration of the T cells was done external to the body.

[Eos of the Eons]

This is not about virus receptors but cancer specific T cell receptors. The T cells (of the patient are infected with a virus (which yes, has a receptor to identify and infect T cells). This modified recombinant virus carries the human T cell receptor gene that then can integrate this gene into the T cell DNA permanently. The T cells express the receptor gene which is then able to identify the antigens on cancer cells and kill them. The beauty of it is that only the relevant killer T cells are infected and their gene expression altered by the specific virus.

Oh, I get that. The T-cells had to be infected with a virus that allowed them to develop the ability to gain the receptor that allowed them to identify the cancer cells via their antigens. So my point was that is how viruses identify their hosts, just like the virus that infected our T-Cells. I know HIV has receptors to infect T-cells as well, just like these modified viruses in this case.

So my question is: Do all viruses all have to have this ability to seek out all their host cells this way? Do they all have host specific receptors? I know HIV does for sure, and it seems all others do as well. Or are there some viruses that can randomly infect whatever cells they come across?

[Capsid]

Oh, I get that. The T-cells had to be infected with a virus that allowed them to develop the ability to gain the receptor that allowed them to identify the cancer cells via their antigens. So my point was that is how viruses identify their hosts, just like the virus that infected our T-Cells. I know HIV has receptors to infect T-cells as well, just like these modified viruses in this case.

So my question is: Do all viruses all have to have this ability to seek out all their host cells this way? Do they all have host specific receptors? I know HIV does for sure, and it seems all others do as well. Or are there some viruses that can randomly infect whatever cells they come across?
I don't know of any. When HIV was first discvered there was a race to find out what it's receptor was.

[mamapajamas]

Well, let's wait for replication. Afterall, there may be one or two confounders (I learned a new word, ma!) that weren't controlled.

I mean, whatif the two cured were taking one of those highly effective homeopathic rememdies?

I agree. We need to see replication... and we also need to understand that it will take a LONG time for that. After all, a cancer patient isn't considered "cured" for general purposes until he or she has been in remission for five years.

I had cancer back in 1999-2000, and even though my oncologist told me that if the specific type of cancer I had did not reappear within two years it was not going to come back at all (except possibly as a new illness completely unrelated to the first), for insurance purposes and other medical records, I was not pronounced "cured" until five years of remission passed.

I think they're starting to abandon that "five year" thing, I've heard through cancer group channels, because there are so many different kinds of cancer with varying remission records, but I honestly don't know who would make the final "pronouncement" on that ;).

[casebro]

Cure? 2 out of 17. This is progress, but using a word like "cure" is, well, so Fox/Cnn. There is a LONG way to go...not the least to figure out how to expand the technology and target other cancers, little less how to determine why the 2 were cured but the 15 weren't. (SNIP)

If you re-read the OP, you'll see that that this experiment was performed on 17 hopeless patients. Many of whom had some shrinking of the tumors. There's no question in my mind that if the next trial is on milder cases, there would be a much higher "cure" rate. The OP didn't say anything about the average survival time of those who died, but they were treated when expectations were 3-6 months to live. Sounds kinda late to expect any life extension... 11% is phenominal at that late date.