[News] Excitement at new cancer treatment

Coxovi said:

I know this type of treatment as my old company was/is deeply involved. Hard to describe what it is like when a 20 something brilliant introvert wells up when explaining to you how they stopped a trial because they could not defend giving the control group a placebo when they are dying (such treatments are only trailed on terminal patients).

This being said this was a couple years back and still such treatments are not approved yet, so there must be something that still needs to be understood. As mentioned above if some patients are harmed or killed.

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Are you suggesting your company conducted a placebo controlled clinical trial on terminally ill cancer sufferers? The usual control in oncology trials is standard of care, not placebo. I doubt you'd ever get such a trial past an ethics committee. I stand to be corrected but I'd be surprised if this were the case.

There are several issues here

1. Until research is subjected to peer review and published it is always regarded in the science community as 'provisional' (i.e., not yet credible). Lots of great claims in the past have turned out to be false; especially cutting edge interventions such as stem cell therapy, and injecting dopamine-synthesizing cells into the brains of PD patients, etc.

2. A presentation at a credible meeting is a marginal step forward because the audience can ask awkward questions in a public forum, but the data are still not yet regarded as fully credible.

3. Given the above, the data appear to be suggesting this: in patients with accessible cancer (not solid tumours, but things like blood cancer - leukaemia), it may be possible to effect a cure with this type of therapy. The downside is there is a risk (not clear how great a risk yet - but real with 2 deaths) of cytokine storm. This is a 'class effect' of many types of 'biologics' which includes some forms of immunotherapy. This is why the trial here was done in people who were almost certain to die from their cancer (a 'last resort' clinical trial). My expectation is the risk will be much lower than the Northwick Park debacle because the cells being used are not only human, but actually derived from the individual patient, so the antigenicity (risk of immune response - cytokine storm) should be much lowered - but not zero).

Everything else is speculation, and will become clearer when the full study is published.

from https://www.fredhutch.org/en/news/c...erapy-remission-blood-cancer-AAAS-riddell.htm :

"Dramatic remissions seen in immunotherapy trial of blood cancer patients

Experimental, living T-cell therapy shows promise for treating advanced disease, making immunotherapy a ‘pillar’ of cancer care

Twenty-seven out of 29 patients with an advanced blood cancer who received an experimental, “living” immunotherapy as part of a clinical trial experienced sustained remissions, according to preliminary results of the ongoing study at Fred Hutchinson Cancer Research Center.

Some of the patients in the trial, which began in 2013, were originally not expected to survive for more than a few months because their disease had previously relapsed or was resistant to other treatments, said Dr. Stanley Riddell, an immunotherapy researcher and oncologist Fred Hutch. Today, there is no sign of disease.

He shared the results on Sunday as part of an update on new adoptive T-cell therapy strategies for cancer at the annual meeting of the American Association for the Advancement of Science in Washington, D.C.

Riddell, who has studied how to empower the immune system to effectively treat human disease for more than 25 years, said that progress now being made, underscored by these latest results, is finally making immunotherapy “a pillar of cancer therapy.”

But, he cautioned, “Much like chemotherapy and radiotherapy, it’s not going to be a save-all.” Some patients may require other treatments.

The trial is designed to test the safety of the latest iteration of an experimental immunotherapy in which a patient’s own T cells are reprogrammed to eliminate his or her cancer. The reprogramming involves genetically engineering the T cells with synthetic molecules called chimeric antigen receptors, or CARs, that enable them to target and destroy tumor cells bearing a particular target. Trial participants include patients with acute lymphoblastic leukemia, non-Hodgkin lymphoma and chronic lymphocytic leukemia.

Because T cells can continue to multiply once infused into patients, the therapy does not have to be administered repeatedly, as is the case with chemotherapies that are eventually broken down by and eliminated from the body. And by introducing the CARs into two specific subsets of T cells — an approach pioneered at Fred Hutch — the researchers have achieved more potent and longer-lasting immune responses against tumors.

In one arm of the study led by Riddell’s colleagues Drs. David Maloney and Cameron Turtle, 27 of 29 patients with acute lymphoblastic leukemia showed no trace of cancer in their bone marrow following their infusions. Nineteen of 30 non-Hodgkin lymphoma patients experienced partial or complete responses. In some patients, pounds of cancer were eliminated after a single dose of the engineered T cells — Riddell showed examples of patients whose tumors disappeared from imaging scans within weeks of the infusion.

The team has submitted a manuscript for journal publication describing their results with the first group of ALL patients."




The preliminary results seem fairly promising for ALL, but non-Hodgkins is not quite so good and the fact that they don't mention how the CLL subjects are doing suggests it's not as effective for them. It'll also be years before the full impact on overall survival times are known which is as important as complete remission rates.

The subject numbers are fairly small at the moment too so that's another reason to temper one's expectations.

If, as mentioned, cytokine release syndrome is a problem, then that would indicate it's safety profile may mean it's unlikely to ever be used as a first line treatment.

Nevertheless, the preliminary results are promising and do appear to indicate a step forwards.

cjd said:

Why you utter cretins from Crystal Palace are allowed to post on our Forums by our moderators, is completely beyond my comprehension.

For your information the poster who first mentioned Northwick Park on the thread has battled cancer for a long period of time. He is also a great source of information regarding cancer treatment.

To add to this, he is also a massive support to cancer sufferers on this forum.

Lastly, I suggest you read up on the disastrous clinical trials held at Northwick Parkin 2006 before you make crass remarks.

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1) I am sure that if I have done anything out of line, then my collar will be felt rapidly.

2) I have a great deal of respect for Alex-Alex-Dawson-oo!-oo! and what he has to say. I didn't reply to him.

3) I remember well what occurred at Northwick Park, as I pored over the reporting of the trial at the time. If anyone on NSC who was involved or had a relative or friend involved and is offended by my comment then I will readily apologise.

Please would you clarify one thing for me - are you in fact a sufferer of Creutzfeldt-Jakob Disease, or do you know someone who is afflicted by this dreadful condition?

Del Fenner said:

1)
Please would you clarify one thing for me - are you in fact a sufferer of Creutzfeldt-Jakob Disease, or do you know someone who is afflicted by this dreadful condition?

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Dude your crossing the line somewhat eh? Maybe unintentionally or just taking the piss I dunno

you're not your

maffew said:

Dude your crossing the line somewhat eh? Maybe unintentionally or just taking the piss I dunno

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How so? His user name is cjd, (which is an abbreviation of Creutzfeldt-Jakob Disease), and I am unaware why. To understand better where he is coming from and to treat him with respect, I have asked for clarification.