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Medicine Science

Doctors Hail World First as Woman's Advanced Breast Cancer is Eradicated (theguardian.com) 162

A woman with advanced breast cancer which had spread around her body has been completely cleared of the disease by a groundbreaking therapy that harnessed the power of her immune system to fight the tumours. From a report: It is the first time that a patient with late-stage breast cancer has been successfully treated by a form of immunotherapy that uses the patient's own immune cells to find and destroy cancer cells that have formed in the body. Judy Perkins, an engineer from Florida, was 49 when she was selected for the radical new therapy after several rounds of routine chemotherapy failed to stop a tumour in her right breast from growing and spreading to her liver and other areas. At the time, she was given three years to live. Doctors who cared for the woman at the US National Cancer Institute in Maryland said Perkins's response had been "remarkable": the therapy wiped out cancer cells so effectively that she has now been free of the disease for two years. "My condition deteriorated a lot towards the end, and I had a tumour pressing on a nerve, which meant I spent my time trying not to move at all to avoid pain shooting down my arm. I had given up fighting," Perkins said. "After the treatment dissolved most of my tumours, I was able to go for a 40-mile hike."
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Doctors Hail World First as Woman's Advanced Breast Cancer is Eradicated

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  • Great News (Score:5, Insightful)

    by CapeBretonIslander ( 2562053 ) on Monday June 04, 2018 @12:53PM (#56726252)
    What a horrible disease this is. I'm so proud of the scientists working on ways to fight it, and wish them all success.
  • by Anonymous Coward on Monday June 04, 2018 @01:16PM (#56726398)

    FTA: To create the treatment, doctors first cut small pieces of tissue from Perkins’s tumours and studied the DNA to find mutations specific to her cancer. They focused on mutations that disrupted four genes which produced an array of abnormal proteins in the tumours.

    Next, the doctors extracted immune cells known as tumour infiltrating lymphocytes, or TILs, from the tumour biopsies. These are cells from the patient’s immune system that have invaded the tumour in a bid to kill it, but which failed in the task by being either too weak or too few in number.

    After growing billions of these immune cells in the lab, the researchers screened them to find which ones would most effectively find and destroy the woman’s cancer cells by recognising their abnormal proteins.

    The doctors treated Perkins by injecting 80 billion of the carefully-selected immune cells into her body. The therapy was given alongside pembrolizumab, a standard drug that can help the immune system to attack cancers. Tests after 42 weeks showed Perkins was completely cancer free. She has remained so ever since.

    “It feels miraculous, and I am beyond amazed that I have now been free of cancer for two years,” Perkins said.

    “I had resigned my job and was planning on dying. I had a bucket-list of things I needed to do before the end, like going to the Grand Canyon,” she added. “Now, I have gone back to normal everyday life.”

    While the US doctors who developed the therapy cannot be sure how much the infused immune cells contributed to her recovery, the use of pembrolizumab alone has not been very effective for advanced breast cancer in the past. The infused T cells were found in Perkins’s system for at least 17 months after her treatment began.

    The success, reported in the journal Nature Medicine, is all the more remarkable because breast cancers, like prostate and ovarian cancer, have relatively few mutations, which makes them harder for the immune system to spot amid the body’s healthy tissues.

    Alan Melcher, professor of translational immunotherapy at the Institute of Cancer Research in London, who was not involved in the study said: “The work shows that even cancers like breast cancer, which don’t have many antigens, are amenable to this sort of treatment. It would certainly be applicable in principle to a range of tumours, and even those in which immunotherapy hasn’t worked so well yet.”

    • Comment removed based on user account deletion
    • by Eloking ( 877834 )

      Next, the doctors extracted immune cells known as tumour infiltrating lymphocytes, or TILs, from the tumour biopsies. These are cells from the patient’s immune system that have invaded the tumour in a bid to kill it, but which failed in the task by being either too weak or too few in number.

      After growing billions of these immune cells in the lab, the researchers screened them to find which ones would most effectively find and destroy the woman’s cancer cells by recognising their abnormal proteins.

      Question, how do you "grow" lymphocytes? Are they like Bacteria that you grow in a Petri Dish?

  • People, and animals get cancer all the time. The immune system is constantly killing off those aberrant cells. It makes sense to use the existing cellular framework and improve that which already does a fantastic job.. Currrently there are HUNDREDS of drugs in stage III FDA clinical trials that work in a similar fashion. Unfortunately, every cancer is basically different - yes there are some common mutation points, but for example - there are many, many different types of breast cancer. There will be

  • by bjdevil66 ( 583941 ) on Monday June 04, 2018 @01:34PM (#56726508)

    The thought of a cure like this being validated and then made ready for the public, only to be priced out of reach for all but the top 10% and not covered by insurance would be a disgrace.

    • by DarkOx ( 621550 ) on Monday June 04, 2018 @02:35PM (#56726886) Journal

      The thought of a cure like this being validated and then made ready for the public, only to be priced out of reach for all but the top 10% and not covered by insurance would be a disgrace.

      Why would that be?

      If my understanding is correct this is not like a drug (chemical or compound) that one simply manufactures. Very specific cells from the individual have to be cultured and selected for genetically. The injection that cures you won't cure me; might very well kill me. To that end this all sounds like 100s of man hours that must be expended by some of the most highly talented, best, educated professionals our society produces and they need to utilize millions of dollars in capital equipment to do the work with to boot.

      Sorry to break it to you but this the very problem with universal health care. We as a society can't make this type of treatment ( until we invent automation and mass production around it ) available to all. We probably need to make it available to some in order for us to advance the state of the art and develop the technology in hopes of a future were everyone get as many of their cancer specific t-cells cloned up while they wait. In mean time how do we decide who gets it? Well you can let government decide and we bicker endless about who got it because of their skin color, gender, immigration status or whatever - or we can let the market fairly decide. Lets face it by and large the cream still rises to the top, society probably is better served by letting the 10% who can afford this spend their money on it. So money does not have to be taken from you and I and so the people who likely generate the most wealth for all live the longest. Its called allocation efficiency.

      Yes as an individual it feels unfair when you are not getting the outcome you'd like personally but remember the governments role is to promote the 'general welfare.' Not that it always does a good job of that given the power of certain special intrests.

      • right? Give it a few decades (less if we can get people to stop cutting research funds to make way for bigger tax cuts) and you'll see systems that make it so any college grad can whip one of these treatments up in a couple days.

        When the manufacturing jobs went away we were all promised jobs in bio-chem. This is what they meant. But of course, you can't have that if only the top 1% get healthcare. I suppose we can have more $8/hr jobs at insurance company call centers to explain why you can't have medic
      • by gijoel ( 628142 ) on Monday June 04, 2018 @03:25PM (#56727236)

        Sorry to break it to you but this the very problem with universal health care.

        I would have thought that this is the reason universal health care exist. To purchase health care that would be beyond the average person's reach. I'd also point out that government health agencies have greater bargaining power than an individual, and are able to knock down price gouging by massive corporations.

        Or let me put it another way. I have a cure for your fatal disease. You and everyone who loves you must give me everything they own, and take on crippling debt to get it.

        • You're missing the point, money doesn't grow on trees.

          The public cannot afford to finance an unlimited amount of treatments to prolong others' lives.

          I have a cure for your fatal disease. You and everyone who loves you must give me everything they own, and take on crippling debt to get it.

          Life is a terminal, sexually transmitted disease. There is no amount of healthcare that will save you from death.

          • While that is a valid point, so is his. It's reasonable to have some type of regulation on inelastic goods with monopoly protection. Do you really want an economy where a company can sell life and death at any price. This is part of why healthcare is such a difficult problem.
        • by Anonymous Coward
          He's pointing out that it isn't possible to do that. The math makes it impossible and the cost is part of the proof. 100s of highly trained people working for a long period of time to save one life. There isn't enough of them compared to the amount of people that need them. That's why it and costs so much.
          • To me, its more of an IT and Engineering problem and can be broken down to (as a rough outline):

            - Patient diagnosed with cancer
            - Patient has piece of tumor taken out
            - Piece of tumor sent to ABC lab, which puts it in TumorComputerSystem
            - TumorComputerSystem identifies cells needed
            - Patient goes back in, gets hooked up to ImmuneCellSystem
            - ImmuneCellSystem extracts cells identified by TumorComputerSystem
            - ImmuneGrowthSystem grows new cells, separates needed patient cells
            - ImmuneCellSystem injects cells into p

            • by DarkOx ( 621550 )

              You've got it! That's the goal. When we get it there than everyone can have the cancers cured universal insurance coverage or no because it will be basically affordable the same way just about everyone can now afford a 42" TV which was considered a toy for rich folks just 25 years ago!

              However getting there means doing it some largish number of times to increase the amount of people with first hand expertise; trying labor saving techniques and assessing their results. Right now though its far to pricey to

      • by Anonymous Coward

        until we invent automation and mass production around it

        It should be entirely possible to do that though. DNA profiling of the biopsy is pretty straightforward and the costs have come way down. Identifying the best mutations should be something a computer program can achieve. Screening the cells for those that are effective should be automatable. The man-hours are involved in taking the biopsy and entering it into the system and collecting the cells and giving to the patient. Most of the rest should be leaving it processing in a machine for a few days.

        Or do you

        • Agreed. Once the technique has been worked out, the labor needed to produce and administer this treatment should amount to no more than would be needed to administer a standard course of chemotherapy to the same individuals. Less, probably, because I expect fewer sessions would be needed.
      • by Kjella ( 173770 ) on Monday June 04, 2018 @03:41PM (#56727328) Homepage

        In mean time how do we decide who gets it? Well you can let government decide and we bicker endless about who got it because of their skin color, gender, immigration status or whatever - or we can let the market fairly decide. Lets face it by and large the cream still rises to the top, society probably is better served by letting the 10% who can afford this spend their money on it. So money does not have to be taken from you and I and so the people who likely generate the most wealth for all live the longest. Its called allocation efficiency.

        I guess all the sane people have finally abandoned /. for this tripe to be at +5. Amazon makes wealth, Jeff Bezos profits. If he dies of cancer next year they'll continue to make money for his estate and heirs. He'd spend millions if not billions of dollars for a cure, but just because it's his own ass. If you think that's efficient allocation you're on so heavy drugs it's amazing you can write a whole sentence. Excuse me while I go to Breitbart for some quality commentary. Or even 4chan...

        • If the treatment saves Jeff's life and not getting the treatment results in his death, then yes it is an extremely efficient allocation of his money.

          Resources should go to those creating the most value. In this case Jeff's resources would be going to those who saved his life.

      • by bjdevil66 ( 583941 ) on Monday June 04, 2018 @04:15PM (#56727494)

        I agree that the government shouldn't force equal allocation for all. Better performers should get greater rewards.

        And I'm not saying it should be free to everyone just out of the goodness of our hearts. If it costs $30,000-$40,000 (to cover the "hundreds" of man hours + a healthy cut for the company), then that's good business.

        I am saying, however, that your "allocation theory" and modern capitalism have been corrupted. The "right" way to sell such a valuable treatment would be to immediately turn that $30-$40K tab into a $100K bill to get the "warrior class" of salespeople/CEOs golden parachutes. Then they charge $110K the next year, and $120K in the 3rd year, and so on - just to drive up a company's stock price in perpetuity above all other concerns.

        No matter what modern economic theories can be penned to support this modern version of business capitalism, it still FEELS wrong. It is innately wrong to put your profits first and your customers last - especially when human lives are what's being lost. In that scenario, are those people still behaving like society's "cream of the crop" that should reap the rewards? I'd say no.

        • Better performers should get greater rewards.

          Who judges what performance? Do we need to show our tax statements before we qualify or will it be available to then young too? For the young, do we then ask the opinions of their teachers as to if they will ever amount to anything? Because I agree we shouldn't allow people like Einstein who show no promise to survive. After all someone has declared them a poor performer.

      • This cure undoubtedly will evolve to be more efficient over time. Why do you expect it to stay the same?

      • Comment removed based on user account deletion
      • I am sure that the whole process, which indeed currently involves a lot of manual highly technical and specialized work can some day be automated. Take a biopsy and put a sample in a machine. It will isolate the T cells, divide them by type(there are several) and receptor (just the most common receptors - there are quite many as each receptor targets different disease/antigen ). Then test each isolated T cell/receptor against the tumor cells to find the most successful one and finally grow billions of them.
      • Sorry to break it to you but this the very problem with universal health care. We as a society can't make this type of treatment ( until we invent automation and mass production around it ) available to all.

        No. That's the very problem with your view on universal healthcare. The whole point of socialising the cost is that it becomes trivial to spread across a population. The reality of social healthcare is exactly the opposite: ONLY a society can make that kind of treatment available to all. If left up to individuals you will get non empathetic asshats who think only the rich deserve to live.

      • by jabuzz ( 182671 )

        You clearly have no idea how expensive *ANY* cancer treatment is. Google tells me that in the USA breast cancer will cost $24k for the initial treatment and then $2.2k for continuing treatment and this is one of the less expensive cancers to treat.

        Right now it is expensive because it is experimental. Don't expect it to stay that way. Heck 10 years ago the analysis of the DNA in the tumor would have cost millions and would have made even the experimental treatment impossible now it would cost around $1k.

        The

      • If I have to do a task a few times, it isn't worth my time or trouble to try and automate it, I will just continue to do it in an ad hoc fashion.
        If I have to do a task a thousand times, I will spend the time to automate it because, it is difficult to do in an ad hoc fashion.

        The reality is somewhere in between without Universal health care, in that there will still be plenty of patients with the money to do it. However with Universal, not only do you increase that amount by a magnitude, but also involve a go

    • by k6mfw ( 1182893 )

      ...priced out of reach for all but the top 10% and not covered by insurance would be a disgrace.

      I second that. There's all these medical miracles but if you can't afford them, then they don't exist. Like if you can't afford a Ferrari then it doesn't exist (yes, a silly analogy). Reminds me the other weekend a cyclist took a bad spill at a race, helmet had a good size gash but cyclist's head is ok. EMTs examined him, ask questions like what day it is, where he is at. Cyclist first questions are how much is this medical response going to cost? No cost to race participants. But yet some will probably dec

  • Instead of the scientists who did all of the hard work?

    • Maybe the OP wanted someone to praise god for creating the cancers that cause so much pain and suffering?

      Some people re into weird sh!#.

    • Instead of the scientists who did all of the hard work?

      Give credit where due. If it weren't for "God" creating cancers and other diseases these scientists wouldn't get the glory of curing them.

      • by jwhyche ( 6192 )

        I love how we are more than happy to give the glory to God for creating a cure, but some how we over look that it was God that created the cancers in the first place.

    • by Anonymous Coward

      So you went out of your way to make up something to complain about when you didn't find it on your own? This speaks more of you than anything you were going to complain about.

    • How do you know that there wasn't a bit of Divine Inspiration involved?
  • There have been successes like this in the past. It should be normal by now to do a DNA analysis of the cancer cells and the normal cells to isolate the combination of mutations causing any particular cancer. In some cases, they've developed vaccines that cause the immune system to target specific mutations. I've seen before and after photos of an amazing recovery. The problem is that a few months later, the cancer came back, and the patient soon died.

    So why did the cancer come back?

    Well, when you get c

    • by Ungrounded Lightning ( 62228 ) on Monday June 04, 2018 @03:55PM (#56727386) Journal

      In some cases, they've developed vaccines that cause the immune system to target specific mutations. I've seen before and after photos of an amazing recovery. The problem is that a few months later, the cancer came back, and the patient soon died.

      As I understand it:

      The (or a) problem with vaccine-initiated attacks on cancers is that there are cell-surface markers that tell the immune system:
      "I'm really a cell type that starts producing a surface protein AFTER the immune system is deployed - or maybe a placental cell in a new baby. Don't kill me!" Normally these are only expressed by things like the cells forming myelin sheaths (to keep EVERYBODY from getting Multiple Sclerosis - like symptoms while still a toddler). But wIth a lot of cells in a tumor living beyond the hayflick limit and accumulating mutations, some of them t;urn one one of these markers. The vaccine-induced immune cells knock back the tumors, time out, and when the tumors start to grow back the cells with the markers convince the immune system not to attack any more.

      The trick discovered a few years back is to clone the immune cells OUTSIDE the body, where they don't see that signal, until they're past the point of paying attention to it, then injecting a massive army of such cells. The tumor cells say "I'm OK, don't kill me!" The soldiers say "ORLY?" and kill them anyway.

      There have been several attempts at this: They worked fine at killing the tumors. But injecting a big army of immune cells kills enough cancer tissue at once that the fallout inflammatory chemicals tended to kill the patient with something akin to toxic shock syndrome. Recently the medical community tried doing this and then keeping the patient in the hospital and giving them treatments for the toxic shock until the tumors were knocked back far enough that the patient was past the crisis. With a little tuning they got to a regime where THAT worked nicely.

      So now they're doing variants against more cancer types - starting, of course, with metastatic, previously incurable (especially in late stages), types that hit a lot of people. Bingo: An advanced breast cancer cure, based on the approach, also succeeds.

      Expect this to be the start of a flood of similar treatments for a range of cancers, as they work their way down the list, while tuning and generalizing the procedures.

  • by gachunt ( 4485797 ) on Monday June 04, 2018 @01:39PM (#56726546)

    “I had resigned my job and was planning on dying. I had a bucket-list of things I needed to do before the end, like going to the Grand Canyon,” she added. “Now, I have gone back to normal everyday life.”

    Hopefully, going back to the routine mundane'ness of life won't delay the completion of her bucket-list or stop her from adding more items. (Enjoy this spinning rock in the vast galaxy while you can.)

    • by Memnos ( 937795 )

      Agreed. She is very fortunate to have gotten a reprieve from a horrible disease, but she didn't get an immortality pill. She's still dying, like all the rest of us, and should make the most of the time she has left.

    • EVERYBODY is dying. We all need a bucket list.

  • Is this another successful treatment with CAR-T, similar to previous work? Or is it something completely new?

    Research doctors have been using the immune system to fight cancer for 5-10 years now. It would be nice to know if this in an adaptation of existing techniques or something truly innovative.

    The article indicates "we are on the ‘cusp of a major revolution’ in being able to target cancer with immunotherapy", but there is nothing that puts this particular treatment in context.

    • They're similar. CAR-T is one form of ACT (Adoptive Cell Transfer), which the article names as their method. CAR-T employs CAR (chimeric antibody receptors) toward reengineering T cells only. The variant of ACT used here was TIL (tumor infiltrating lymphocytes) rather than T cells, apparently because this target involves a smaller number of target mutations than is suitable for CAR-T.

      (I hope I've interpreted this correctly.)

      And yes, this form of ACT should be just as expensive as CAR-T -- about a half milli

    • by Smiddi ( 1241326 )
      I agree, it sounded like a CAR-T cell variant??
  • Is this not a variation of the "common" CAR-T cell treatment used for some Leukemia patients?
  • I knew a girl who thought she had her breast cancer beaten, clean bill of health for the doctors. 5 years later it returned with a vengeance, the second time it finished her.
    Sadly I hear stories like this alot for many different types of cancer too. Beating it once is doable quite a bit, and fantastic news advanced stage breast cancer can be beaten too, that gives hope that other real killers like pancreatic cancer can be treated too (claimed the life of my cousin, that one sadly there is no coming back f
    • Fundamentally you can't "cure" something until you know the root cause.

      For cancer we're not there yet.

      Not within lightyears. (for almost all cancers)

      Also the same goes for most-if-not-all auto-immune diseases.

      The word you're looking for is "remission" (ie "free of disease symptoms").

      A bit like stepping out of the ISS in a space-suit and starting to fall.

      You're ALMOST CERTAINLY going to die from the disease (because we haven't cured it) but it's THEORETICALLY possible for you to die of Other Causes. (O

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