New Treatment Trains Immune System To Kill Cancer 62
Al writes "A vaccine in clinical trials at the University of Pittsburgh School of Medicine triggers the human immune system to attack a faulty protein that's often abundant in colorectal cancer tissue and precancerous tissue. If it works as hoped, it could remove the need for repeated colonoscopies in patients at high risk for developing colorectal cancer. The vaccine has already proven safe in patients with advanced pancreatic cancer. It works by spurring the body to manufacture antibodies against the abnormal version of a mucous protein called MUC1. While moderate amounts of the protein are found in the lining of normal intestines, high levels of a defective form of MUC1 are present in about half of advanced adenomas and the majority of colorectal cancers."
Re:please sign me up! (Score:5, Informative)
You go here: http://clinicaltrials.gov/ [clinicaltrials.gov]
And find the trial you are interested in, and see if you meet the requirements.
In the case of this one:
http://clinicaltrials.gov/ct2/show/NCT00773097?term=colorectal+vaccine&rank=2 [clinicaltrials.gov]
Inclusion Criteria:
Age 40 - 70 years of age.
History of any of the following conditions (operative notes, endoscopy reports, and/or pathology reports must be reviewed locally to confirm that the candidate meets at least one of the following entry criteria).
1. Colorectal adenoma(s) 1 cm in maximal diameter
2. Colorectal adenoma(s) with villous or tubulovillous histology
3. Colorectal adenoma(s) with high-grade dysplasia
o Willingness to avoid pregnancy or impregnate (see below) for the period of active study (1 year).
o ECOG performance status 0 or 1
o Hemoglobin greater than 95% of the lower limit of institutional normal. Platelets 100,000/L.
o AST (SGOT), ALT (SGPT), alkaline phosphatase, total bilirubin, BUN, creatinine 1.5x upper limit of institutional normal.
o ANA 1:160
Exclusion Criteria:
* Receiving any other investigational agents.
* Presence of an active acute or chronic infection
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study agents.
* History of heritable cancer syndrome (FAP, HNPCC)
* Patients with a history of auto-immune disease such as, but not restricted to, inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, scleroderma, or multiple sclerosis.
* History of malignancy 5 years prior to the Registration/Randomization evaluation, excluding non-melanoma skin cancer.
* Any use of oral corticosteroids 12 weeks prior to Registration/Randomization.
* Current or planned use of immunomodulators including: Remicade, 6-MP (Mercaptopurine), Methotrexate, cyclosporine, or other immunomodulatory drugs.
* Pregnant women, because the teratogenic or abortifacient effects of the study agents remain incompletely defined. Breastfeeding women, because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with the study agents.
I hate these "We've cured cancer!" headlines (Score:3, Informative)
Disclaimer: My wife is a therapeutic radiographer. She treats cancer patients all day long. What I've posted here is what I understand from her, which may be completely wrong because I'm not qualified to understand everything she says.
If you were to believe the press, a cure for cancer is found on average 2-4 times a year. Except it isn't, for a number of reasons:
1. The "cure" is usually in the early stages of trials. Sometimes it hasn't even been taken out of the test tube and put into any living creature. (This is one of the better articles in that respect - it seems like the initial clinical trials to test whether or not it'll do any harm in humans have been passed)
2. There's no such thing as a generic cure for cancer because there's no such thing as a generic cancer. There are dozens, if not hundreds of different types. Some tend to grow very quickly, others more slowly. Some tend to spread to other parts of the body, others don't. Some we know the main causes of, others we have no idea. Some are easy to treat and have a high success rate, others rather less so.
This is good news because by and large the cancers which are easy to detect (and therefore tend to get treated early) are the ones which are fairly easy for a lay person to spot something wrong - think skin, breast, testicle. Cancers of internal organs which are able to function for some time with little noticeable impairment (eg. liver) are far more likely to be detected too late.
Hence a more effective treatment for something like bowel cancer is definitely a Very Good Thing.
Re:Natural Selection (Score:2, Informative)
Yes is does provide selective pressure, just like the immune system does by itself. The pressure is against overexpressing MUC1. Since it is presented as a vaccine, not a therapy, the thinking is that there are no cells yet that overexpress MUC1. Once one does, it will be quickly eliminated. Since it is quick growing cells (like cancer) that mutate at a higher rate, picking off the cells with cancerous signs will reduce this mutation rate, thus hopefully prevent this type of cancer in the lifetime of the (potential) patient.
You are right in assuming that the chance of a mutation in patients that already have cancer would be much higher, making it less effective as a treatment. But who knows, maybe it works good enough as a combination therapy?
Re:Natural Selection (Score:3, Informative)
Cancer doesn't have a global evolution process like bacteria. Even if a particular person's cancer does express another variant of Muc1, that genetic quirk dies with the patient.