A Look at the Current State of Cancer Immunotherapy

The next generation of cancer treatments are all about targeting, finding ways to distinguish and destroy only cancer cells, to as to produce therapies that are much more effective, even against late stage metastatic cancer, and have few side effects. The present staples of chemotherapy and radiation therapy are arduous and only partially effective precisely because they are not very selective. It is easy to destroy cells, but hard to destroy only particular cells. One of the more promising lines of research and development for targeted cell destruction is immunotherapy: making use of the existing capabilities of immune cells and directing them to attack cancer cells:

When immunologist Michel Sadelain launched his first trial of genetically engineered, cancer-fighting T cells in 2007, he struggled to find patients willing to participate. Studies in mice suggested that the approach - isolating and engineering some of a patient's T cells to recognize cancer and then injecting them back - could work. But Sadelain did not blame colleagues for refusing to refer patients. "It does sound like science fiction," he says. "I've been thinking about this for 25 years, and I still say to myself, 'What a crazy idea'."

Since then, early results from Sadelain's and other groups have shown that his 'crazy idea' can wipe out all signs of leukaemia in some patients for whom conventional treatment has failed. And today, his group at the Memorial Sloan Kettering Cancer Center in New York City struggles to accommodate the many people who ask to be included in trials of the therapy, known as adoptive T-cell transfer.

[This is] the promise of engineered T cells - commonly called CAR (chimaeric antigen receptor) T cells - for treating leukaemias and lymphomas. The field has been marred by concerns over safety, the difficulties of manufacturing personalized T-cell therapies on a large scale, and how regulators will view the unusual and complicated treatment. But those fears have been quelled for some former sceptics by data showing years of survival in patients who once had just months to live. "The numbers are pretty stunning. Companies have clearly decided that it's worth the pitfalls of how much this therapy is going to cost to develop."

Link: http://www.nature.com/news/immune-cells-boost-cancer-survival-from-months-to-years-1.16519

Comments

An offshoot of any successful technique could I imagine also be potentially adapted to target senescent cells too and allow us to clean our system up. It could be a real help to the SENS stratergy.

Posted by: Steve H at December 12th, 2014 9:17 AM

"And today, his group at the Memorial Sloan Kettering Cancer Center in New York City struggles to accommodate the many people who ask to be included in trials of the therapy, known as adoptive T-cell transfer."

"The field has been marred by concerns over safety, the difficulties of manufacturing personalized T-cell therapies on a large scale, and how regulators will view the unusual and complicated treatment."

"Companies have clearly decided that it's worth the pitfalls of how much this therapy is going to cost to develop."

A great example of over regulation and its negative impact. Regulators have no business telling sick people what they can and cannot expirement with. They are only hurting the people they are trying to help.

Posted by: johnathan at December 12th, 2014 9:47 AM

@johnathan: Puh-lease. Cut the bad faith and quote the part mentioning patient deaths linked to the experimental therapy. Who's hurting who, now?

Regulations are here for a reason. Reforms are surely needed, but sick people will always need a gatekeeper.

Posted by: Nico at December 12th, 2014 9:35 PM

@Nico

"Since then, early results from Sadelain’s and other groups have shown that his ‘crazy idea’ can wipe out all signs of leukaemia in some patients for whom conventional treatment has failed."

The people who participate in risky trials like these are doing so because they have no other choice. So, yes, via the article, five people died in one of the trials. Were they going to die anyway without the trial? Probably. However, mathmatetically, from an "expected value" perspective they made the right choice.

Additionally, because of their sacrifice the treatments will only get better which will ultimately save more lives. Without iron clad regulations and ridiculous expenses maybe lives could have been saved sooner and the medicine advanced faster.

Consenting adults with severe life threatening illnesses and low survival rates should be able to do whatever they want. Unfortunately they cannot and that is a sad thing, for everyone.

Posted by: johnathan at December 13th, 2014 10:36 AM

@johnathan: I'm all for letting people, who'd have nothing to lose otherwise, volunteer for highly experimental programmes. They should have an easier time applying being enrolled as experimental subjects.

But even untried therapies need guidelines and some form of overseeing.
As a patient of an experimental treatment, would you rather die from an unpredictable outcome or from an obvious mistake due to negligence?

This is the point I'm making. Zealous regulations are stupid, but getting rid of regulations altogether would be equally stupid.

Posted by: Nico at December 13th, 2014 1:27 PM

@Nico

Well, unpredictable outcomes and negligence get blurrier as the degree of experimentation goes up because their isn't enough time or resources for thorough due diligence.

FWIW I never said anything about getting rid of regulations altogether (although we agree they are over zealous). Just that...

IMO if a person willingly and intelligently accepts the risk of acting outside of regulation and guidance then that is their prerogative to do so (assuming they are not being lied to or mislead about risks and results). With that said, I say this with late stage ALS or aggressive cancer type things mostly in mind...

Posted by: johnathan at December 13th, 2014 3:37 PM

@johnathan: well then I was mistaken by your sentence stating that "Regulators have no business telling sick people what they can and cannot expirement with."

Agreed on the fact that the line blurs between unpredictability and negligence, the more experimental a treatment gets.
As you pointed out, it is crucial in any case that the prospective patient gets a clear explanation of what the treatment entails - risks, rewards, pains.

Posted by: Nico at December 15th, 2014 10:02 AM

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