CRISPR Cancer Trial Success Paves the Way For Personalized Treatments (nature.com) 22
A small clinical trial has shown that researchers can use CRISPR gene editing to alter immune cells so that they will recognize mutated proteins specific to a person's tumours. Those cells can then be safely set loose in the body to find and destroy their target. It is the first attempt to combine two hot areas in cancer research: gene editing to create personalized treatments, and engineering immune cells called T cells so as to better target tumours. From a report: The approach was tested in 16 people with solid tumours, including in the breast and colon. "It is probably the most complicated therapy ever attempted in the clinic," says study co-author Antoni Ribas, a cancer researcher and physician at the University of California, Los Angeles. "We're trying to make an army out of a patient's own T cells." The results were published in Nature and presented at the Society for Immunotherapy of Cancer meeting in Boston, Massachusetts on 10 November.
Ribas and his colleagues began by sequencing DNA from blood samples and tumour biopsies, to look for mutations that are found in the tumour but not in the blood. This had to be done for each person in the trial. "The mutations are different in every cancer," says Ribas. "And although there are some shared mutations, they are the minority." The researchers then used algorithms to predict which of the mutations were likely to be capable of provoking a response from T cells, a type of white blood cell that patrols the body looking for errant cells. "If [T cells] see something that looks not normal, they kill it," says Stephanie Mandl, chief scientific officer at PACT Pharma in South San Francisco, California, and a lead author on the study. "But in the patients we see in the clinic with cancer, at some point the immune system kind of lost the battle and the tumour grew." After a series of analyses to confirm their findings, validate their predictions and design proteins called T-cell receptors that are capable of recognizing the tumour mutations, the researchers took blood samples from each participant and used CRISPR genome editing to insert the receptors into their T cells.
Ribas and his colleagues began by sequencing DNA from blood samples and tumour biopsies, to look for mutations that are found in the tumour but not in the blood. This had to be done for each person in the trial. "The mutations are different in every cancer," says Ribas. "And although there are some shared mutations, they are the minority." The researchers then used algorithms to predict which of the mutations were likely to be capable of provoking a response from T cells, a type of white blood cell that patrols the body looking for errant cells. "If [T cells] see something that looks not normal, they kill it," says Stephanie Mandl, chief scientific officer at PACT Pharma in South San Francisco, California, and a lead author on the study. "But in the patients we see in the clinic with cancer, at some point the immune system kind of lost the battle and the tumour grew." After a series of analyses to confirm their findings, validate their predictions and design proteins called T-cell receptors that are capable of recognizing the tumour mutations, the researchers took blood samples from each participant and used CRISPR genome editing to insert the receptors into their T cells.
Sounds expensive (Score:2)
Re:Sounds expensive (Score:4, Insightful)
i'm betting the actual work and materials going into this isn't all that expensive - but the liability mitigation costs - that will keep it out of reach of all but the uber rich.
Re: Sounds expensive (Score:1)
Re: Sounds expensive (Score:2)
Re: (Score:2)
It will initially be more expensive than conventional cancer treatment, but in the long run, it should be much cheaper than surgery and chemo. Especially surgery, which will normally run six figures easily.
Re: (Score:1)
But what do you want to bet that even after this, it will take even LONGER for the insurance companies to even start to contemplate covering this.....
Re: (Score:1)
Is this something that will be reasonable as a treatment for anybody but the uber-rich?
Eventually.
Re:Sounds expensive (Score:5, Insightful)
I'm calling it (Score:1)
Researchers release T-cells (Score:2)
2022: A cure for most cancer is discovered. I thought it would take 30 more years
No chemo. Less cool than radiation. Lame.
Re: (Score:1)
Be very careful here. Yes, the immune cells can be trained to attack the cancer, but each cancer is different. How certain are you that they will ONLY attack the cancer? What do you do if they pick too wide a target?
This is a very promising trial, but it's only one trial. There's an immense amount of work to be done before it's a treatment.
Re:I'm calling it (Score:4, Informative)
The probability of that is very low. However, there are ways to avoid even that if it becomes an issue:
Some background knowledge: ..it's a goner. The gene involved in that process is called AIRE.
1. Every cell of your body (that isn't mutated) contains the code to construct every protein your body can possibly make.
2. There is an organ called the thymus (T as in the "T" in T-cells); part of its function is to eliminate T-cells that would attack self-proteins. The way it does that is to show each T-cell the proteins that are found elsewhere in the body as a test to see if it attacks -- if it dares to attack
Therefore, if we wanted to reduce the chance of off-target even further .. we can create an artificial thymus, or at least the medulla region of it, and test T-cells there to see what they would do.
Btw, I think there are better ways than the T-cell approach to curing cancer. Of course, until we have a sure cure, we have to try everything, hoping one, or a combination works.
Re: (Score:2)
I *think* you're misunderstanding the problem. I was assuming that the CRISPR use was specializing lines of immune cells. (Probably T Cells, but I wanted to be more general.)
And that each cell CAN generate all proteins used by the body is irrelevant. What's relevant is which proteins it makes visible from outside the cell.
The problem is that cancers are HIGHLY variable. You need to pick a fixed way that they differ from all your other cells, and target that. But You've got lots and lots of different cr
Re: (Score:2)
And that each cell CAN generate all proteins used by the body is irrelevant. What's relevant is which proteins it makes visible from outside the cell.
Yes, I was speaking in the context of making an artificial thymus to address the concern as to whether the T-cell would go off-target. The T-cells can be tested against going off-target via an artificial thymus (or maybe even in-silico.) The thymus has to make all (or most) of the possible self-proteins a T-cell may encounter and then eliminate that T-cell if it reacts too much. You are right that the customization will have to be adapted for each cancer. This is a personalized treatment, it is not generali
Re: (Score:2)
Uh, no, we aren't there yet. We will get there but need about a decade, maybe two.
6 million dollar man (Score:2)
It may not take too long to reduce the cost (Score:2)
This is, indeed, quite complicated, and right now most of the costs associated with it come from two things: the ad hoc nature of it (it's labor intensive and can only be done by a small number of groups), and licensing of technology (mostly various things related to CRIPSR). Patents on a lot of the CRISPR tech are already half-way to expiration, but there's considerable desire to monetize it ASAP - so somewhat reasonable licensing fees are expected.
With regard to the ad hoc nature of it... It needs to be r
Baby steps (Score:1)
So, erm, these 16 people... (Score:2)
Only one u (Score:1)
Shame that an American journal (Nature) and researchers at an American university felt the need to use a pseudo-Brit spelling for "tumour". It's just "tumor" folks.
Taking bets (Score:1)
What happens first? Biden starting WW3 or cancer "cure" causing zombie apocalypse?