Researchers Successfully Fight Colon Cancer Using Immunotherapy (nytimes.com) 40
Slashdot reader schwit1 quotes the New York Times:
The remarkable recovery of a woman with advanced colon cancer, after treatment with cells from her own immune system, may lead to new options for thousands of other patients with colon or pancreatic cancer, researchers are reporting. (Shorter non-paywalled version of the article here). Her treatment was the first to successfully target a common cancer mutation that scientists have tried to attack for decades... so resistant to every attempt at treatment that scientists have described it as "undruggable"... The researchers analyze tumors for mutations -- genetic flaws that set the cancer cells apart from normal ones. They also study tumor-infiltrating lymphocytes, looking for immune cells that can recognize mutations and therefore attack cancerous cells but leave healthy ones alone.
The patient, a 50-year-old database programmer in Michigan, is now cancer-free, according to the article. "Researchers twice denied her request to enter the clinical trial, saying her tumors were not large enough, she said. But she refused to give up and was finally let in."
The treatment ultimately eliminated six of her seven tumors, and because it targeted a cell mutation that's common in colon cancer patients, "Researchers say they now have a blueprint that may enable them to develop cell treatments for other patients as well."
The patient, a 50-year-old database programmer in Michigan, is now cancer-free, according to the article. "Researchers twice denied her request to enter the clinical trial, saying her tumors were not large enough, she said. But she refused to give up and was finally let in."
The treatment ultimately eliminated six of her seven tumors, and because it targeted a cell mutation that's common in colon cancer patients, "Researchers say they now have a blueprint that may enable them to develop cell treatments for other patients as well."
Ugh. (Score:2)
My dad just died of colon cancer back in September. This news makes me both happy and sad at the same time.
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I am sorry for your father. We just lost my neighbor and my wife's best friend last week to colon cancer. It hit us pretty hard. Everyone I had ever lost was sudden, here one minute, gone the next, from a heart attack, car accident, or such. Watching the slow, lingering, wasting away to nothing death was one of the hardest things I have ever went through. Cancer sucks, I hope this treatment proves beneficial so others do not have to go through what she did.
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My sympathies and I feel exactly the same. My Dad died of colon cancer back in 2012.
Side Note: Hope you're getting regular colonoscopies (?spelling). With my family history I get them every 3 years. 4 Polyps removed so far. If caught early, colon cancer is very treatable, even preventable.
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Other than the price of research this treatment should be cheaper than traditional cancer treatment.
Currently doesn't scale (Score:3)
This class of treatment is usually about growing some special-purpose "designer" white cells that are able to kill the cancer while leaving the almost similar looking rest of the body intact.
Growing such designer cells requires tremendous lab resources.
We still need some revolutions similar to how Oxford Minion and CRISPR/Cas9 brought their capabilities to the masses.
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Saddly, yes: elite-only for now. (Score:4, Informative)
Saddly,
that's currently what it seems.
(for the TL;DR version of people who don't want to plow through dozens of PubMed articles:
- basically these "cure any cancer" methods consist of growing specially designed immune cell that are specific for the cancer and only will attack it while leaving the body intact.
- Achieving it requires a whole university complex of genomics, proteomics, culture-cell growing and selection, etc. and is in the range of million-worth per cure.
- In addition the the cost and the facilities it doesn't even *scale* beyond a few experimental patients - even if 50 billionaires decided to throw the money, the could only be cured one at a time)
But the general proof of concept works.
And perhaps one day, after a few "Oxford Minion" and "CRISPR/Cas9"-like revolutions down the line, new technology might get developed that brings this out of the "designer medicine for the most outrageously wealthy elite" domain and bring it within reach of normal people.
(Well maybe "normal people who live in countries featuring a decent public health system". Sorry for you USA... maybe you could try to flee to one of those evil-communist countries like Canada or most of Europe ?)
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Remember, the ultimate reference of wealth is human effort. If an individual cancer cure gives the patient 10 extra years of life but costs 40 man-years of labor, there's a net loss involved for humanity. Under a capitalist system, that tradeoff may be made voluntarily. Under socialized medicine, those treated will be those with political pull and those believed to have most to offer the state. Choose wisely.
It only took a few years for DNA sequencing to go from being a multimillion dollar undertaking to be
Re:Old technology... (Score:5, Informative)
I'm pretty sure techniques very similar to this have been available in France for more than a decade. So maybe the story should be that the slow U.S. regulatory process for medical procedures is a decade behind as opposed to framing it as brand new cutting-edge technology.
Not true. I follow French medical science -- everybody in medicine does. Much of their work is excellent, but they don't hide it. They talk about it at international conferences and publish their results in major journals. Like everything else in medicine, when the French come up with a good idea, the rest of the world picks it up.
For that matter, when a French scientist comes up with a good idea, graduate students all over the world want to study in his lab, just like French grad students want to study in other labs worldwide. So a lot of the cutting-edge work is by international teams. You can see that by searching Youtube for Dance Your PhD http://www.sciencemag.org/news... [sciencemag.org]
Cancer immunology is a big field. Everybody's trying to make it work. Sometimes it works, sometimes it doesn't. Bone marrow transplants (actually blood cell transplants) are standard now for some leukemias, and fairly effective. This specific treatment has never been done before, not in France, or anywhere.
It's also not true that the European regulatory agencies approve drugs faster than the US FDA:
http://www.nejm.org/doi/full/1... [nejm.org]
The 21st Century Cures Act â" Will It Take Us Back in Time?
Jerry Avorn and Aaron S. Kesselheim
N Engl J Med 2015; 372:2473-2475
June 25, 2015
DOI: 10.1056/NEJMp1506964
An underlying premise of the bill is the need to accelerate approval for new products, but this process is already quite efficient. A third of new drugs are currently approved on the basis of a single pivotal trial; the median size for all pivotal trials is just 760 patients. More than two thirds of new drugs are approved on the basis of studies lasting 6 months or less â" a potential problem for medications designed to be taken for a lifetime. Once the Food and Drug Administration (FDA) starts its review, it approves new medications about as quickly as any regulatory agency in the world, evaluating nearly all new drug applications within 6 to 10 months, an impressive turnaround for such complex assessments.
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Viva la France
Never understood some trial criteria (Score:5, Interesting)
I can't understand why clinical trials reject people who aren't in bad enough condition. What if the treatment only works before the disease gets really bad? Wouldn't you want to know this?
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We were able to get my mother into one of these after she performed suitably poorly during testing.
The thing is, a great number of side effects and adverse reactions are uncovered during human trials, and medical researchers prefer to reserve the high risk, experimental treatments for those without other, proven medical recourse.
Same reason late term cancer meds are so popular (Score:2)
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Sometimes the guys at Science Based Medicine blog about this subject. In general those guys object to "right to try" because:
a) patients who are desperate enough to try *anything* are potential victims for quacks to sell stuff under the guise of "clinical trials" (the results of those trials never being published is a good clue as to whether the trial was genuine in the first place)
b) pharmaceutical companies could use "exceptionally urgent trials" as a conduit to get products to the market earlier than nor
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Unfortunately the 21st Century Cures Act will encourage the FDA to approve treatments based not on randomized, controlled trials, but on weaker evidence, such as observational studies, case studies, anecdotes, and testimony by patient groups financed by the drug companies.
Here's an article that rounds up some of the other articles about it. http://www.healthnewsreview.or... [healthnewsreview.org]
Sometimes you read a medical case history and the doctor says, "There are no randomized, controlled trials to demonstrate effectiveness,
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Except that (a) right-to-try laws don't apply to quack medications. They just give terminal patients early access to compounds that are already in the FDA pipeline and which have passed Stage I toxicity. As for point (b) I suppose so, and more power to pharma on this point. We need to take a little more risk if we want to bring new cures to market faster.
It's called the Evidence Based Medicine movement, but what it really promotes is taking MDs out of the loop in medical decision making and replacing their
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> I can't understand why clinical trials reject people who aren't in bad enough condition. What if the treatment only works before the disease gets really bad? Wouldn't you want to know this?
A key reason is that there are already pretty good treatments for stage 1 or stage 2 colon cancer that significantly drop 5 year mortality. So the potential for doing more harm (by doing this instead of other treatments) or confusing the results and potentially creating harm (by offering this with existing treatment
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Particularly in colon cancer.
Colon cancer is curable with surgery in the early stages, but uncurable by anything after it metastasizes.
After metastases, they're trying to extend life for another 5 or 10 years.
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> Colon cancer is curable with surgery in the early stages, but uncurable by anything after it metastasizes.
Just a curious aside-- the survival / staging thing is probably somewhat misleading.
Some fraction of cancers are probably incapable of establishing themselves in other tissue; and aggressively-growing cancers tend to get diagnosed later in phase of disease progression. So in other words, there's a selection bias where the inherently nastier cancers show up with a worse staging.
A lot of attempts to
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You're basically right. I picked colon cancer because that is the one major cancer in which screening really can result in a cure.
The way I learned it, the cancers appear in the inner layer of the colon, and they progress to the outer layers and finally the surrounding tissue. Doctors can screen for them with colonoscopy, and the initial cancer can be removed, sometimes directly during the colonoscopy, and sometimes in a separate operation which might remove more of the colon. Once it spreads outside the co
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Okay, cancer is one thing but from my own perspective watching my parents deal with wet age-related macular degeneration, the ophthalmologist they see is THE top guy in the field. His practice conducts research studies all the time. In one instance, it wasn't a case of whether or not they might get a placebo. They were guaranteed to get at least the current method of treatment but they could be getting the new drug. They said, "Oh, you don't qualify because your vision is too good." Well, it will likel
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If the new drug is very possibly much worse than the current treatment, it's still a bit of an ethical conundrum.
Re:Never understood some trial criteria (Score:5, Informative)
In this case, they were surgically removing large tumors that were infiltrated with T cells.
The T cells normally attack cancer cells, but they couldn't do it because the cancer cells had established a defense mechanism.
They were trying to overcome the death mechanism and train the T cells to attack the cancer.
For that they needed big tumors with a lot of T cells.
At first, they did a biopsy of her tumors to see whether she had enough T cells to make the treatment work. She didn't have enough T cells. If they had tried it, even if their theory was correct, the treatment would have failed.
Then her x-rays showed that her tumor had grown, so her doctor sent them in to the researchers. They did another biopsy, and she had a lot of T cells infiltrating the tumor -- enough to make the treatment work. That's why they accepted her in the trial.
I'm writing this from memory. I read the paper and a few articles about it, but I'm not going to read it again.
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