Training an Immune System To Kill Cancer 209
NotSanguine sends in a story about William Ludwig, a 65-year-old leukemia patient who underwent a new, experimental treatment that draws upon two decades of advances in molecular biology. Quoting:
"Doctors removed a billion of his T-cells — a type of white blood cell that fights viruses and tumors — and gave them new genes that would program the cells to attack his cancer. Then the altered cells were dripped back into Mr. Ludwig’s veins. At first, nothing happened. But after 10 days, hell broke loose in his hospital room. He began shaking with chills. His temperature shot up. His blood pressure shot down. He became so ill that doctors moved him into intensive care and warned that he might die. His family gathered at the hospital, fearing the worst. A few weeks later, the fevers were gone. And so was the leukemia. ... In essence, the team is using gene therapy to accomplish something that researchers have hoped to do for decades: train a person's own immune system to kill cancer cells."
Re:Is there a drug? (Score:2, Insightful)
Actually insurance companies (and you know how they love money....) will decide its merits as an intervention. What is more expensive, spending months or years in and out of the hospital with expensive chemo (which is going through shortages at the moment), or doing this one procedure and a couple weeks in the hospital? If this works, insurance companies may cover it and refuse to pay for chemo if the patient is a candidate for this treatment.
Re:Okay, what about prevention? (Score:4, Insightful)
Maybe I am oversimplifying as I am not trained in this area... but I got that most of the side effects were due to how much cancer had taken over the body... two pounds of waste in one article I read. If you used a variant of this technique earlier, I was thinking that it might not be such a traumatic experience.
Re:Is there a drug? (Score:4, Insightful)
I did not know T cells underwent mitosis. I thought they were produced as needed by their progenitor cells in the bone marrow, similarly to red cells.
Yes, that's correct, there are T-cell progenitors in the bone marrow that generate new T-cells. However, experienced T-cells are maintained in a population of circulating "memory" cells that persist long-term, and undergo rapid expansion upon encountering their triggering antigen.
Indescriminate destruction of B cells is a very bad thing and would make the patient extremely immune suppressed following the initial "thermonuclear" immune response, as the patient's immune system would effectively be given a lobotomy and would forget every pathogen it had encountered, and would remain that way until new B cells are produced.
Yes, these patients are currently on IVIG (Intravenous Immunoglobulin - antibodies collected and pooled from donors), and will be for a long time, possibly for the rest of their lives. Very expensive.
This treatment could be adapted for other types of cancer besides this flavor of leukemia, just as long as there is a reasonably reliable target for the t cells to go after.
Yes, I believe one of the next targets they are going after with this technique will be mesothelin-expressing tumors (found in certain ovarian/mesothelioma/pancreatic tumors). Will probably be messy, as it is expressed in certain populations of normal mesothelial cells.