FDA Approves First Cell-Based Therapy For Cancer (npr.org)
An anonymous reader quotes a report from NPR: The Food and Drug Administration on Wednesday announced what the agency calls a "historic action" -- the first approval of a cell-based gene therapy in the United States. The FDA approved Kymriah, which scientists refer to as a "living drug" because it involves using genetically modified immune cells from patients to attack their cancer. The drug was approved to treat children and young adults suffering from acute lymphoblastic leukemia, a cancer of blood and bone marrow that is the most common childhood cancer in the United States. About 3,100 patients who are 20 and younger are diagnosed with ALL each year. The treatment involves removing immune system cells known as T cells from each patient and genetically modifying the cells in the laboratory to attack and kill leukemia cells. The genetically modified cells are then infused back into patients. It's also known as CAR-T cell therapy.
The treatment, which is also called CTL109, produced remission within three months in 83 percent of 63 pediatric and young adult patients. The patients had failed to respond to standard treatments or had suffered relapses. Based on those results, an FDA advisory panel recommended the approval in July. The treatment does carry risks, however, including a dangerous overreaction by the immune system known as cytokine-release syndrome. As a result, the FDA is requiring strong warnings.
The treatment, which is also called CTL109, produced remission within three months in 83 percent of 63 pediatric and young adult patients. The patients had failed to respond to standard treatments or had suffered relapses. Based on those results, an FDA advisory panel recommended the approval in July. The treatment does carry risks, however, including a dangerous overreaction by the immune system known as cytokine-release syndrome. As a result, the FDA is requiring strong warnings.
Let's put this in perspective. ALL already had treatments that put 98% of affected children into remission within a couple of months, with 8% of those eventually relapsing. So 90% are completely cured with existing therapies. There are other cancers where the numbers are an order of magnitude worse. I'm puzzled why the focus seems to be on diseases that medical science has already very nearly cured, rather than the ones that kill most of the people who get them.
Also, is this actually measurably better than existing treatments? If existing treatments fail to produce remission in 2% and allow a relapse in another 8%, you'd expect only about 20% of the patients to be in that 2% group that weren't helped by chemo. So a remission rate of only 83% is probably not statistically significantly different from what they would have gotten if they had used the current generation of chemo, and doesn't necessarily indicate any benefit for people who did not respond to chemo. So this could very well be a no-op, all at a tremendous cost that insurance won't cover (because it is experimental).
I'm not saying that the research isn't valuable, because it is, but in the zero-sum game of medical research, seeing the first approved cell-based cancer treatment be for a disease that is already all but cured just seems bafflingly backwards. I would have expected the first treatments to be for things like pancreatic cancer or mesothelioma or, if you want a childhood cancer with a high case fatality rate, perhaps neuroblastoma. Brain cancers kill significantly more kids than leukemia, despite being much less common.
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My mother is still alive today thanks to this treatment, and no thanks to you.
Il n'y a pas de Planet B.
i'd flip that coin
Well Trump runs the US and the US runs the FDA, right?
It's amazing to think that one day cancer could be a thing of the past, like smallpox.
lucm, indeed.
Once it becomes FDA approved and a patent is awarded, one of the big pharma companies will come in with a blank check to the patent owner and will immediately proceed to bury this knowledge and it'll never be used again, all in favor of high-priced chemotherapy.
TFA says that the bill for this one-time treatment weighs in at $475,000. That's probably even more high-priced than almost any chemotherapy.
Gleevec, a drug used to treat CML, GIST and HES runs about $7,350.00 for a 30 day supply of 100mg tablets. I've been on Gleevec for roughly 8 years now.
Now, I know that the insurance companies don't pay full price, but if they did, then that 8 years of "treatment" with Gleevec has cost them $705,600.00, and that cost continues until the day I die.
That makes a single payment of 475,000 cheap compared to 30 years of medication at a whopping $2,646,000.00... (if the price remained unchanged)
Hypereosinophilic Syndrome, or HES as it's commonly referred to is a cancer that affects roughly 1 in 18 million people. A bone/blood cancer that causes the marrow to create too many eosinophils. These eosinophils are toxic to the body in that when they die, they go 1 of 3 possible ways, each way killing cells surrounding them. Having been diagnosed with HES almost 8 years ago, after over 4 years of feeling like I'd slept in a bed of poison-ivy while having chicken-pox and a 3rd degree sunburn. At the time of diagnosis, my kidneys were failing, I had heart palpitations, my gall bladder was 4 times normal size from it trying to pull in as many eosinophils as it could, but with counts ranging from 23,000 to 54,000 per unit of blood (normal ranges are from 0 to 400, where 400 is a moderate to severe allergic reaction) there was no chance of it taking in enough to make a difference without destroying itself, and my optic nerves were being hampered with, showing up as ocular migraines, some occurring while operating a motor vehicle. To put it bluntly, I was months from death.
What saved me? A drug, designed for CML patients, and certain GISTs (gastro-intestinal sarcomas), called Gleevec or Imatinib. Within 2 weeks of starting the chemo, it had my numbers under control.
Now, if this treatment works for Leukemia, I'd imagine it could be used to similar effect with the poorly encoded genetic sequence inside my own bone-marrow.
I look forward to my next appointment with my oncologist.
Just think, if this treatment works there won't be any slashdot posts left.
This treatment is coming from Novartis.... (A big pharma from Switzerland)
and a patent is awarded,
Most of the individual steps that are involved rely on knowledge that has been published in scientific articles and spoken about in conference (I was there !) and thus constitutes "prior art".
The most expensive part (due to regulation, certification, approval, guarantee, etc.) is putting all the steps together into a process.
And that about the only thing that they can patent (because that one specifically might not have been published) the exact specific steps this process relies on.
Meaning that if such patent-trolling happens, it doesn't prevent any other company to putting together the necessary key steps (which again, are already available published knowledged, not patented) into a slightly different process (and do it enough slightly differently so that it's not covered by the above process) that can be used.
Lastly, TFS make it seem rather simple ("Hey just fix a gene in the white cell, inject it back and problem solved !") whereas in practice, it's extremely complicated and tedious steps.
e.g.: it takes a lot of cultures and trial-and-error until you get the "perfect antibody" that will work, that you can then CISPR-splice back into the patients' white sells.
It's not something that is quickly cobbled by a technician in a clinic's lab, it something that require a crew of biology/immunology university scientists and a whole bio-informatics division (= computers are used to detect potential best targets to accelerate the work of the lab team).
Meaning it's an expensive process.
Meaning that the company that decides to implement this on a large scale commercially has still lots of money to earn (they'll be basically selling the "service" of doing all this tedious steps per patient).
It's *definitely not* going to insta-kill the big pharma's golden-eggs-laying goose. Just replace one goose (chemotherapies manufacturing and selling) by another (service of adapting gene/cell therapies).
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
The thing is :
- these classes of methods are generic. With very few problems (it's not relying on killing the patient slower than killing the cancer. It's about specifically targetting the cancer) Eventually this method could be adapted to other cancers as well.
so the fact that they used it against leukemia isn't a major drawback for brain cancer.
(Unlike chemotherapies which rely a lot on the general charecteristics of the cancer, to find a way to poison it with a drug faster than the drug posions the rest of the patient. Different type of cancer = different type of characteristics. Poisons will therefore work differently)
- because leukemia is well studied and has already lots of studies done with other treatment, that gives a lot data point to compare against, and to combine with.
- leukemia happens to be a slightly lower hanging fruit here. (everything happens in the blood stream, which is where you'd be injecting the modified cells).
(but again, all fruits *on the same tree*. Not an entirely different tree like chemotherapies).
These are reasons to take it as a first target, before expanding to other cancers.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
I doubt that will happen any time soon. I mean, like most things, the human body can go wrong in many more ways than it can go right, and "cancer" happens to be an umbrella term for like a quarter of those things that can kill you. I've noticed that many such treatments as outlined above are focused on leukemia in particular. Perhaps that's because leukemia seems to be on the opposite side of "curability by modified T-cells" than, say, astrocytoma. It might take a very long time to find out what to do with all cancers that you could possibly get.
Ezekiel 23:20
For the love of Pete, why do this with ALL at first? ALL might be the most common childhood leukemia but it is the least common of all leukemia.
They should have gone after AML first, as that is the most common form of leukemia in the world, and it also the most agonizing and painful way to die of all of them.
'FDA approves new treatment for ALL cancer'
XML is like violence. If it doesn't solve the problem, use more.
studied. You have to remember - just 50 years ago, ALL was pretty much a death sentence and it tends to hit kids more than adults. 2nd - this treatment is used AFTER patients had failed to respond or relapsed. So this treatment this roughly an 85% success rate takes it from 90% to what, an almost 98% success rate (overall)? But the real question (and I haven't seen it answered by anyone yet) is whether or not it'll be effective for Philadelphia chromosome (9/22) patients. (I haven't had a chance to research that yet.) While ALL treatmentment are very good, for ALL Philadelphia patients the prognosis was still poor last I checked.
Philadelphia positive patients (9/22)
https://clinicaltrials.gov/ct2...
> genetically modified immune cells
I can hear the anti-GMO people's heads explode with this one.
TFA says that the bill for this one-time treatment weighs in at $475,000 in America.
Fixed that for you.
For those of you who, for some reason don't see it or refuse to see it, your system is complete and totally shit.
I have close family members who still live the US. One who recently was diagnosed with Cancer. Turns out that the cancer was a result of another illness which went undetected for nearly 20 years.
The medicine for the illness is in excess of 40k per treatment in America. The family member was able to come to the EU country in which I live and paid 1000€ for the non-insurance price to have the doctor give the injections.
The people who support this price gouging system, to mind, are fucking disgusting human beings. If in fact they should even be considered Humans.
What kind of sick fuck literally holds lives hostage in an effort to increase their profits 100 fold?
Worse than ISIS, Hitler, Stalin and Satan combined.
You're the sick person if you think that price gouging (even at it's worse) is more evil than ISIS, Hitler and Stalin.
Let's see now - actively killing people whose views you don't like - or the worst case of corporate greed. You realize that even the greediest corporation needs customers. They cannot make it so expensive that no one will buy their product.
In fact the economic history shows that volume of sales almost always trumps profit made per sale.
Make a one hundred million sales a day with a profit of one dollar each OR
make one thousand sales a day with a profit of one thousand dollars each?
Which is the more successful company?
If you're scared of your govt then you need to further restrict its powers
Vote 3rd Party in 2016 and beyond
From Google: Novartis, Switzerland. Swiss multinational pharmaceutical company Novartis had a market value of $227.44bn and $126.3bn worth assets as of May 2014.Oct 9, 2014
Novartis prices CAR-T Kymriah at $475K
You are mistaken. Big Pharma already has this technology and is milking it for all they can get.
Is Novartis, the company who licensed it and is producing it, not considered a big pharma company?
Examine even your most deeply held beliefs. Nobody is always right.
What ever you say, Hitler.
Or measles. Oh, wait, thanks to idiots failing to do the responsible thing and get their children vaccinated it's making a comeback and killing children once again.
it'll never go away just because of how cancer works, but the sorts that "aren't a big deal'" will get more broad.
Once it becomes FDA approved and a patent is awarded, one of the big pharma companies will come in with a blank check to the patent owner and will immediately proceed to bury this knowledge and it'll never be used again, all in favor of high-priced chemotherapy.
TFA says that the bill for this one-time treatment weighs in at $475,000. That's probably even more high-priced than almost any chemotherapy.
I know that this is moving the goalposts a bit, but a very common treatment for leukemia is a stem cell transplant after intensive chemo. That can go well over $1,000,000 all told, more like $2,000,000. Again, that is the listed price, the insurance companies will pay less.
(Don't ask me how I know this... :-( )
Ironic that one party at fault for price gouging is... YOU. The reason your drugs cost so much less than those in the U.S. is because WE subsidize YOU. U.S. government could fix this with a simple tiny piece of legislation, our drugs would drop in price by easily 2/3. Yours would double in price. You deserve it.
Kite's $12b acquisition by Gilead on Monday may be a harbinger of anticipated success of these kinds of biotherapeutics.
Given the modularity of these CAR systems, I'd expect to see a cascade of more approvals as the therapeutic scaffold is perfected. It's not just giant pharma working on these systems either. Younger companies like Cell Design Labs, Chimera bio, Nkarta are taking very novel approaches to further refining the specificity and precision of these kinds of treatments.
The cool thing about the CAR system is that it's amenable to rational engineering from modular, biological components. The CAR approved here was the product of low-throughput painstaking labor, but many companies are trying to boost the rate of R&D.
You can dig into the structure of the approved CAR therapy here: https://serotiny.bio/notes/proteins/car19/
Ha. I'm a Hitler because I think that price gouging is not as horrible as exterminating people as did Hitler, Stalin and Mao.
Add to that that it's clear that I think that price gouging is immoral, and you still equate me to Hitler.
You've jumped the shark. Thank you for so clearly exposing your views.
If you're scared of your govt then you need to further restrict its powers
Vote 3rd Party in 2016 and beyond
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They're not idiots, they're a symptom that the credibility of the scientific community is not what it used to be. I don't think this is a matter of intelligence as much as it is a matter of social fragmentation.
lucm, indeed.
Depends on your definition of "soon". I believe we are about 25 years away from being able to cure 95% of stage IV cancers, as long it is not in the very end stage.
There are some very good approaches in the super early stage of development. I mean, this therapy that was just approved -- the concept originated in the mid 1980s. Today is what 2017? That's how long it takes. They had to test it and tweak it for years to make it work. And then they had to get past the FDA's senseless paranoia just because it uses a heavily modified HIV virus as the lentiviral vector.
Although this looks like a very stinging thing to say, in the mentality of /. you are giving this fellow compliment.
They just think there are too many humans on the earth and prolonging life just takes resources from the young, fun people and the government elite.
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