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Killing Cancer By Retraining the Patient's Immune System

An anonymous reader writes "There's an interesting story on CNN about the University of Pennsylvania's human trial results on curing intractable cancer by retraining the patient's own immune system. Quoting: 'Nick Wilkins was diagnosed with leukemia when he was 4 years old, and when the cancer kept bouncing back, impervious to all the different treatments the doctors tried, his father sat him down for a talk. John Wilkins explained to Nick, who was by then 14, that doctors had tried chemotherapy, radiation, even a bone marrow transplant from his sister. ... A few months later, Nick traveled from his home in Virginia to Philadelphia to become a part of the experiment. This new therapy was decidedly different from the treatments he'd received before: Instead of attacking his cancer with poisons like chemotherapy and radiation, the Philadelphia doctors taught Nick's own immune cells to become more adept at killing the cancer. Two months later, he emerged cancer-free. It's been six months since Nick, now 15, received the personalized cell therapy, and doctors still can find no trace of leukemia in his system. ... Twenty-one other young people received the same treatment at The Children's Hospital of Philadelphia, and 18 of them, like Nick, went into complete remission -- one of them has been disease-free for 20 months.'"

27 of 175 comments (clear)

  1. Obligatory by ezdiy · · Score: 5, Funny
    1. Re:Obligatory by botnick · · Score: 3, Informative

      I knew this was familiar, here's a similar article in ny times from 2011. The therapy isn't quite risk free, in the linked article it says that a 39-old woman died when the retrained T-cells targeted a protein in her lungs; just 15 minutes after the injection and she developed breathing problems which I guess goes to show how potent destroyers T-cells can be.

  2. Cancer cured! by transporter_ii · · Score: 3, Insightful

    Cancer gets cured about once a decade, sometimes by real doctors, sometimes by "quacks." I could show stats from real doctors with similar results to this one, which never saw the light of day once it was discovered (or rediscovered).

    People don't actually like creativity, even in medicine:

    http://www.slate.com/articles/health_and_science/science/2013/12/creativity_is_rejected_teachers_and_bosses_don_t_value_out_of_the_box_thinking.html

    Staw says most people are risk-averse. He refers to them as satisfiers. “As much as we celebrate independence in Western cultures, there is an awful lot of pressure to conform,” he says. Satisfiers avoid stirring things up, even if it means forsaking the truth or rejecting a good idea.

    In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.

    --
    Doctors destroy health, lawyers destroy justice, universities destroy knowledge, religion destroys spirituality
    1. Re:Cancer cured! by Stickerboy · · Score: 5, Informative

      Why do I even bother responding to this nonsense.

      Cancer gets cured about once a decade, sometimes by real doctors, sometimes by "quacks." I could show stats from real doctors with similar results to this one, which never saw the light of day once it was discovered (or rediscovered).

      Please, do show us the stats. I get tired of the false meme that "oh, we would have cured disease X already if the results weren't being suppressed in a big conspiracy"! Medical research is hard work, and frustrating. Not only do you have to cure the disease in the test tube, but then you have to cure the disease in a living patient, and make sure it doesn't do something equally or more horrible to the patient in the process.

      On top of that, the public has been oblivious to the fact that real progress in cancer treatment, and yes, even cures, are being made. Many leukemias and lymphomas are now curable through chemotherapy and radiation. This boy in the article is in the small minority that standard treatment did not work. Solid tumor cancers are getting better early detection and treatment. Mortality from many cancers has been dropping over the last 2 decades. What was once usually a consistent death sentence doesn't have to be.

      People don't actually like creativity, even in medicine:

      http://www.slate.com/articles/health_and_science/science/2013/12/creativity_is_rejected_teachers_and_bosses_don_t_value_out_of_the_box_thinking.html

      Staw says most people are risk-averse. He refers to them as satisfiers. “As much as we celebrate independence in Western cultures, there is an awful lot of pressure to conform,” he says. Satisfiers avoid stirring things up, even if it means forsaking the truth or rejecting a good idea.

      In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.

      Most of us physicians try to live up to our creed: "First, do no harm." This includes not jumping to try every crazy-ass, untested treatment that some would-be genius cooked up and put in a syringe on the patients under our charge, if there are other treatment options that are still available. And here's a crazy thought: some diseases are better off untreated. I have an 85 year-old with dementia that was recently diagnosed with a lung tumor, likely malignant cancer but slow growing. Am I going to recommend putting her under general anesthesia, the knife, follow-up chemotherapy and possible radiation? Hell no.

      If you truly think the standard of care in medicine is the same as 1952, I invite you, when you get sick, to turn down any or all recommendations for an MRI or a CAT scan. No heart catheterizations. No minimally invasive or laparoscopic surgery. No joint replacements. Very few blood pressure, cardiac, or autoimmune treatments. None of the advances for asthma and other lung diseases. If you're infected and allergic to penicillins and sulfa medications, good luck! I certainly wouldn't want the alternatives: veritable bleach in the veins or antibiotics toxic to the kidneys and ears.

      tl,dr: You're full of it.

      --
      Light a fire for a man and he'll be warm for a day. Light a man on fire and he'll be warm for the rest of his life.
    2. Re:Cancer cured! by camperdave · · Score: 4, Insightful

      Ridiculous. All one pharmaco has to do is say "We've got the cure!" and everyone will come to them, cash in hand. Perpetual treatments require two things that companies are not good at:
      - giving up short term gains for long term gains.
      - cooperating.

      --
      When our name is on the back of your car, we're behind you all the way!
    3. Re:Cancer cured! by jiriki · · Score: 5, Insightful

      In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.

      That is just wrong. If you look at breast cancer 10-year survival rates (Figure 3.4): http://www.cancerresearchuk.org/cancer-info/cancerstats/types/breast/survival/

      They have come up from 41% in 1970 to 77% in 2007. While cancer is not cured, survival rates are a lot better.

      When talking to the doctor three years ago, when my girlfriend had a breast-cancer operation, they had the latest studies and decided for a treatment based on them. The doctor only worked 4 days a week and took 1 day "off" to keep up with current research.

      The chemicals used for chemo-therapie are updated all the time and also genetical fingerprinting of the tumor cells is used to decide which treatment makes sense. So there are lots of differences even compared to the treatment 10 years ago.

    4. Re:Cancer cured! by Anonymous Coward · · Score: 5, Insightful

      Hate to break it up to you, but not all countries use a for-profit system for health coverage.

      In many countries, like mine for example, health-care costs come out of the pockets of governments.

      In other words, if those cures work, it might not be in the interests of the american, for-profit system to use them, but it would be in the interests of the countries where health-care is run in a sensible manne to use them.

      Which is the best illustration of why health insurance should never be run for profit, and should be run as a public service the same way fire department and the police are.

      If your comment about Obamacare is any indicator of your political affiliation and opinion on private health insurance, your comment shoots your opinion in the foot.

    5. Re:Cancer cured! by DrXym · · Score: 3, Insightful

      Cures are not perpetually profitable. Only treatments are.

      Well that's a particularly cretinous argument. Purely from a profit perspective which is better for doctors, hospitals, "big pharma" and insurers - a dead kid or someone who is cured and goes on to live another 70 years, requiring all kinds of medical interventions during that time not just for himself but for any children he may have?

    6. Re: Cancer cured! by JWW · · Score: 4, Insightful

      In the long run what will make the drug companies more money. Drugs that treat the patient for a few months and then they die, or a working treatment that the patient has to receive over their entire (longer now) life?

      A cure for cancer would be a gold mine for a pharmaceutical company.

    7. Re:Cancer cured! by mark-t · · Score: 5, Insightful

      Cures are never welcome in the industry

      That would be false.

      First of all, the industry has cured many diseases. It just happens to be the case that no significant additions have been made to the list of fully curable diseases for several decades.

      At most, this might suggest to the layman that current trends seem to indicate that the current health industry may no longer be interested in curing diseases, but in practice, to actually adopt the premise as genuinely true requires conspiracy theories which are not logically sustainable in a rational debate, and most notably fails to consider the possibility that actually curing diseases could be a really hard thing to do and may not be something that can be reasonably expected to happen regularly in the absence of any breakthroughs happening, which are not something that can generally be anticipated beforehand anyways.

    8. Re:Cancer cured! by sandytaru · · Score: 5, Informative

      Oh, your insurance company will cover it if it's a genuine cure. A lifetime of leukemia treatments sets them back a cool million bucks. Half of that to make you healthy so they never have to pay another cent except for checkups? They'll jump right on top of it.

      Don't forget that insurance companies and pharmaceutical companies are at odds with each other. Pharma makes their money charging people as much as they can for stuff. Insurance companies make their money paying out as little of that as they can, so they'll negotiate with the pharm company to pay less than retail (often much less.)

      What insurance companies won't pay for is "experimental" treatments - stuff that is still in Phase I-IV human trials - because they're not proven to work and are as liable to permanently injure you as they are to cure you. Or have no effect at all in the long run.

      --
      Occasionally living proof of the Ballmer peak.
    9. Re: Cancer cured! by segedunum · · Score: 3, Informative

      Drugs that treat the patient for a few months and then they die, or a working treatment that the patient has to receive over their entire (longer now) life?

      A cure for cancer would be a gold mine for a pharmaceutical company.

      That is not a cure.

    10. Re:Cancer cured! by rjh · · Score: 4, Informative

      I'm reminded that when President Truman had his heart attack in 1956, the official prescription from his physician was bed rest accompanied by Mrs. Truman to keep him warm.

      That was the whole, complete prescription.

      Anyone who says medicine hasn't improved since 1952 simply isn't paying attention.

    11. Re:Cancer cured! by rjh · · Score: 4, Informative

      The reason why progress has been so slow is because there is no one single disease, "cancer." Instead we have a few thousand different diseases which we collectively call cancer. Many of them look extremely similar, even to professional oncologists. First we have to identify all of these different cancers, and then we have to discover effective treatments against them. Some cancers will have common weaknesses; many (most?) do not.

      There's a reason why cancer is called "the Emperor of Maladies". Cancer is probably the hardest scientific problem the human race has ever wrestled with. It makes the moon shot and the internet look like pikers by comparison.

      Cancer is hard, and every day we don't have a cure more people are going to die in horrible ways. The first part makes us want to give up on cancer research, or to say that it's too hard, or to say that we haven't made any progress... but the second part will always keep us coming back to do more research and make another attempt.

      My dream is that cancer might be cured in 100 years. I think it's a dream worth working for.

    12. Re:Cancer cured! by rjh · · Score: 3, Interesting

      Thank you for being a physician. Seriously. It's appreciated.

      (-- would've been dead in the '90s except for someone like you)

    13. Re:Cancer cured! by Idarubicin · · Score: 5, Informative

      In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.

      I don't know why I'm even bothering to respond to someone who writes down such utter bollocks, but I'll bite.

      The very first cancer patient was treated with cobalt-60 irradiation in late 1951, in London, Ontario--so I suppose that slips into your 1952 window (though the instruments used in those preliminary 1951 tests bear very little resemblance to those used today). The first use of a clinical linear accelerator for high-energy radiotherapy wasn't until 1956, at Stanford.

      The first clinical x-ray CT scanner was used in 1971; it took five minutes to collect a slice of data, and more than two hours to process that data into a rather low-resolution image. PET scanning using FDG started around 1976. The first commercial MR imagers appeared around 1980, after a decade or so of futzing about with technical challenges.

      The drug cisplatin wasn't approved by the FDA until 1978; it was the first discovered of a line of platinum-containing antineoplastic drugs. The drug taxol received FDA approval in late 1992. It was the first clinically-used taxane, a family of compounds which inhibit microtubule formation and thereby disrupt cell division. Rituximab was approved in 1997. It was the first anti-cancer monoclonal antibody therapy; there are now more than a dozen. Imatinib was the first small-molecule kinase inhibitor for cancer therapy, approved in 2001.

      All of the above techniques and therapies are available to *you* and in routine use today - when they haven't been superseded by even newer developments. I hate to break it to you, but this ain't your grandma's oncology.

      --
      ~Idarubicin
    14. Re:Cancer cured! by transporter_ii · · Score: 4, Interesting

      there is no one single disease, "cancer."

      Scientists are in "complete surprise" that cancers closely resemble each other across widely varying organs, according to Dr. Douglas Levine of Memorial Sloan Kettering Cancer Center and the principal investigator on a new endometrial cancer study published Wednesday in the journal, Nature.

      "The problem," leading to existing drug treatments performing at an unsatisfactory 10% death rate, was in "the traditional methods for categorizing the leukemia," said Dr. Timothy Ley of Washington University in St. Louis, who co-led a study simultaneously published in The New England Journal of Medicine.

      "Cancer of the uterine lining closely resembles the worst ovarian and breast cancers... telling evidence that cancer will increasingly be seen as a disease defined primarily by its genetic fingerprint rather than just by the organ where it originated," says The New York Times' interpretation of these results.

      --
      Doctors destroy health, lawyers destroy justice, universities destroy knowledge, religion destroys spirituality
    15. Re:Cancer cured! by transporter_ii · · Score: 3, Interesting

      I get tired of the false meme that "oh, we would have cured disease X already if the results weren't being suppressed in a big conspiracy"

      This guy was on to something good. When he was farting around in the lab, he got funding. When he started to get results, the funding vanished. I love his statement in bold below:

      http://www.popularmechanics.com/blogs/science_news/4273366.html

      So how did you get it funded up to this point?

      There is some private funding and the university put some funding into it. And also, at early stages when we studied the mechanisms of these mice, we had one Mitchell Cancer Institute grant, several small grants from Cancer Research Institute. But they all stopped funding me. It was kind of a strange situation. I thought it was our common goal to come up with a new weapon to fight cancer, but the moment I announced I had a new weapon to test in real human cancer situations, everybody shied away.

      --
      Doctors destroy health, lawyers destroy justice, universities destroy knowledge, religion destroys spirituality
    16. Re:Cancer cured! by Courageous · · Score: 3, Insightful

      You're letting your imagination get away from you. If you are an insurance company, and a patient presents to you with a potential in $500K+ in medical expenses, you'd want to unbook that risk as quickly and as affordably as possible.

  3. Stem Cell "Training Project" for Skin Cancer by BoRegardless · · Score: 4, Interesting

    California Stem Cell, Inc. has been doing a similar project since about 2005 in training white blood cells of a patient to recognize malignant melanoma cells out side the body, growing large numbers of those white blood cells and then reinjecting them back into the patient. To date they have achieved some very high remission/cure rates. They have FDA clearance pending but not yet issued. The process was originally developed by doctors at Hoag Hospital in Newport Beach, CA as I recall from a speach.

    www.californiastemcell.com

    1. Re:Stem Cell "Training Project" for Skin Cancer by Anonymous Coward · · Score: 4, Informative

      I had a similar treatment (tumor infiltrating lymphocyte (TIL) w/o genetic engineering) for my stage 4 malignant melanoma 16 months ago at NIH. My tumors are almost gone: one left, barely large enough to be visible in the resolution of the CT scanner. The fifteen years of statistics at NIH of this trial show five-year survival rates of 20% to 40% (depending on whether or not total body radiation was included), which is incredible for melanoma. Some patients are getting genetic engineering on their WBC to see whether or not that improves the procedure. Modern medicine is incredible. Personalized therapy for cancers via immunology is a very promising direction.

  4. Re:How long were his previous remissions? by K.+S.+Kyosuke · · Score: 5, Informative

    You're correct about the fact that the term "cancer-free" essentially means "we can't detect very small numbers of cells" in common-sense English, but the fact remains that this therapy (which isn't exactly news, BTW) leaves a large persistent population or cancer-killing modified leukocytes in a patient's body even after a period of over a year, and reappearance of large numbers of cancer cells simply doesn't seem likely under these circumstances.

    --
    Ezekiel 23:20
  5. Important but over-hyped by John_Yossarian · · Score: 3, Interesting

    My wife was part of a stage 3 melanoma study for the drug Ipilimumab (brand name Yervoy), an immunotherapy drug that inhibits the signal mechanism used by the immune system to turn off an attack. So any metastatic cells floating around her body would not be able to masquerade as normal cells by flying the right protein flag. Unfortunately, halfway through the trial she had a major reaction that caused brain swelling, requiring her to be hospitalized twice. Fortunately, she survived the side effects and the oncologist believes she had enough of the juice to get most of the benefit. Without the drug, we were looking at 50% survival rate for 5 years. The study is still in progress, so no idea how Ipilimumab will improve the odds.

    There is research out there claiming green tea, spices like tumeric, and just eating better can have dramatic results. I would like to see some serious research by respected oncologists into the efficacy of simple life changes like that, instead of study after study pushing big pharma's insanely expensive drugs (thankfully covered by the trial in our case) that cause side effects potentially more dangerous than the disease they are intended to treat.

    I don't know if reprogramming T-Cells like in TFA is more or less dangerous than conventional immunotherapy. Cancer makes people desperate enough to take some pretty big treatment risks. I certainly appreciate the fact that oncologists are aggressive in their mission to save lives, but I wish we had more non-fringe research into potentially good treatments that were also cheap and safe.

  6. Re:How long were his previous remissions? by rmdingler · · Score: 4, Interesting

    Some people have an evolutionary resistance to cancer in the way their killer t-cells target it more aggressively. Others contract the HIV virus and never get AIDS, and there has been interesting speculation folks with these immunities may be descended from plague survivors from centuries ago. If this immunity can be taught to a cancer-ridden patient's own immune system, essentially someone with no other options, its side effects can then be carefully studied. I would look carefully at autoimmune disorders first.

    --
    Happiness in intelligent people is the rarest thing I know.

    Ernest Hemingway

  7. Re:How long were his previous remissions? by fuzzyfuzzyfungus · · Score: 4, Interesting

    It's also worth noting (not that it means that kiddo is necessary not doomed; but just as a general thing) that culling abnormal cells is something that the immune system does quite regularly. It doesn't always do it well enough; which is when you get to have a chat with the oncologist, but this isn't some fundamentally artificial capability that fades as soon as treatment stops.

    If he has a cancer cell population that punched through the various safeguards and reached clinically relevant levels once, his odds are probably worse; but holding the line against some modest population of dangerously aberrant cells isn't a terribly abnormal condition.

  8. Isn't this rather old news? by rnturn · · Score: 4, Interesting

    A very close friend was supposed to go through this treatment almost two years ago. Unfortunately for him, you need to be is pretty good shape before this is begun and his cancer was spreading to various places in his body and he was never quite to the point where the doctors felt he could tolerate a new form of treatment. All I could think of was that the oncologists were stuck in a deadly game of whackamole; hit that place where the cancer was discovered and it popped up somewhere else. When the cancer spread to his brain, it was all over. By then his estimated of survival was, maybe, six weeks and he lasted less than a week after the discovery of it having gotten into the brain. Maybe if the original "We got it in time, there's nothing in the lymph nodes"[*] had been followed up with this treatment he'd still be around. When it was discovered to have returned it was probably already too late.

    [*] -- The cancer that was discovered a couple of years ago was found to be the same one that he'd had surgery/chemo for years earlier. My feeling is that `clean' lymph nodes are probably a false hope. What evidence is there that cancer always leaves a trace in the lymph nodes anyway?

    --
    CUR ALLOC 20195.....5804M
  9. Re:How long were his previous remissions? by tibit · · Score: 4, Insightful

    I would say this: as long as this therapy, even if it were to have serious side effects, simply lowers the mortality rate by, say, a factor of 2, it's a win. There is nothing else out there that, at the moment of introduction, would lower cancer mortality by such a factor, AFAIK. So far, presumably, most of the patients who received the therapy in this limited trial would have been dead by now. That's way, way over a 2x decrease in mortality. As far as I'm concerned, this is an unqualified success. Even if those patients turned into zombies 1 year from now, it'd still be a success, for crying out loud. There is nothing at this point in cancer therapy history that's this good, nor has there been anything that was that good on human subjects so quickly after the initial trials, IIRC. Feel free to correct me, of course.

    --
    A successful API design takes a mixture of software design and pedagogy.