Genetic Engineers Working to Reverse Cancer

An anonymous reader writes "Using a patient's own modified white blood cells, a team of researchers at the National Cancer Institute has reversed advanced melanoma in a study of 17 patients. The researchers tweaked the blood to recognize and attack cancer cells, and the head of the National Institutes of Health, Elias Zerhounibut, says there's big hope now that other common cancers, like breast and lung cancer, can be similarly treated. Though only 2 of the 17 patients responded successfully to the treatment, researchers are optimistic that future improvements on the technique will improve that rate of success." From the article: "In the study, Rosenberg and his colleagues took lymphocytes from the blood and inserted into them genes for a receptor capable of 'recognizing' a protein on melanoma cells called MART-1. This would allow the lymphocyte to attach to a tumor cell and kill it. The patients, all of whom had previously undergone surgery and immune-based treatments, got chemotherapy to temporarily wipe out their immune systems. The engineered cells were then reinjected, with the hope they would proliferate as the immune system recovered."

bbc has more info

[legoburner]

The BBC [bbc.co.uk] also has more info about the procedure.

For Mark Origer, 53, the treatment completely eliminated his skin cancer and another tumour on his liver shrunk enough that it could be removed surgically. Last week, doctors pronounced him completely clear of cancer cells.
Another man, aged 39, was able to clear the cancer that had spread to his liver, lymph nodes and lung.

Always nice to see the light of science burning brighter and any treatments that can get rid of cancer that has spread to the liver are pretty amazing.

Abstract

[xanthines-R-yummy]

Here's the absctract for the original article. Unfortunately, you have to be a subscriber to see the whole thing.

http://www.sciencemag.org/cgi/content/abstract/112 9003v1 [sciencemag.org]

I thought it was interesting how the lymphocytes stuck around for about a year. I thought they would have either died or kicked the gene out by then...

Re:This is an awesome way to treat cancer

[Wilson_6500]

It may not be invasive, but I bet it takes a hell of a toll on you. Part of the procedure used to implement this test protocol was chemotherapy to disable the immune system--and I'm not an M.D., but I don't think that's very much fun. Now, the payoff may be worth it (well, it IS worth it if the treatment takes), but I still imagine it's nearly as trying as standard modalities, especially for cancer patients who've already had surgery or radiotherapy or the like.

Re:Great news.

[RebelWebmaster]

RTFA. The immune system has to be completely wiped out at the beginning so that the modified cells have a chance to become prevalent in the body after being injected.

Re:Aids?

[paladinwannabe2]

It does not look like this technique will be useful against AIDS. Though the article is sparse on details, it says the treatment targets specific antigens that appear in about half of cancer types. The problem with AIDS is that it mutates rapidly, and this means that the antigens on its surface change with time. As a result, even if we could modify one patient's cells to kill Alice's AIDS, we would need a different set of modifications to kill Bob's AIDS.

Re:bbc has more info

[Xenna]

Usually in this type of trials the chances of survival are astronomically against you (practically noone is ever cured). The two that survived are extremely lucky...

X.

Take a look at Bone Marrow Transplants

[Anonymous Coward]

(sidenote: my wife had a BMT....she died October 2nd, 2005)

Bone Marrow Transplants knock out the immune system with a combo of chemo and radiation. It's not a fun process (although it is scarily simple).

Some people feel few ill effect. Most have vomiting, nausa and their hair falling out. My wife went into grade-4 Muciousitious (sp?) and had her mouth peeling. (Others have died from merely having their immune system knocked out)

The survival rates for BMT patents was something like 50-60% iirc (5 year survival rates).

Re:Statistical confidence

[exp(pi*sqrt(163))]

Suppose only 0.1% cancers of this type go into remission spontaneously. Then 2 out of 17 doing so is statistically significant because it's fairly unlikely. I've no idea what the spontaneous remission rates are, but neither do you.

With a simple confidence interval calculation...

You don't have the information required to make this computation. Without knowing spontaneous remission rates you don't have any kind of probability distribution to start working from. There is no "simple confidence interval computation". I think you're just blindly grabbing at any figures you can and fitting a completely meaningless normal distribution (or something) to then.

Please correct me if I am wrong.

My pleasure.

Re:This is an awesome way to treat cancer

[Anonymous Coward]

My father died of cancer a couple of years ago and I can assure you chemotheraphy is everything but not-invassive. It's incredible to see how a powerful body degrades to it's limits with it, but every hope is welcomed, even if you have to suffer with it :) I hope this research advances and we can treat it in the future, because cancer is getting worse everywhere with our 100% industrial food and environments, and that damn genetic thing says I'll probably follow my father. We need some Open Source replacement for DNA ASAP!!!

Cheers

This is just a technique, expect more later

[WillAffleckUW]

Seriously, I was at a few seminars here at the UW by one of the Cambridge scholars who had an actual real cure for 50 percent of all cancers, which involves a literal heating of the interior of cells, triggering an apotosis chain that causes cell death in 99.99 percent of all cancer cells (of that type) while only killing less than 1 percent of normal cells. It's in trials in the UK and elsewhere and won't be available before probably 2016.

The method mentioned is a technique - it increases the rate, and is a great discovery, but is not a "cure" for "cancers". It's just better than what we have now.

Great news

[Washizu]

The current treatments for advanced melanoma (Dartmouth protocol or Interleukin 2) are extremely difficult to take and they only have a 5-10% chance of a full recovery. Granted, this new treatment only worked for 11% of the patients but typically the people in these studies are in them as a last resort. We tried to get my Dad into one after his chemo stopped responding.

It was too late for him, but hopefully not for the thousands who die from melanoma every year.

Re:Using the body's immune system

[shawb]

Actually what you are describing happens, except that neurons don't appear in "random" locations but certain locations of the brain (see neurogenesis [wikipedia.org].) Neurons also naturally migrate naturally in the brain. An individual neuron in the brain really doesn't have much control over thought processes, it's the network of connections that are important, and there is a lot of redundancy built in to deal with damage and cell death. The brain is also pretty decent at routing around some types of damage, sometimes with people missing the majority of the cortex of an entire hemisphere functioning fairly normally.) Sure, some patterns can be lost (I.E. you forget facts and lose skills after time if they are not reinforced) but I sincerely believe that it is possible for Medicine to come up with treatments that A)delay or moderate brain cell death, B)increase adult neurogenesis and C)increase uptake of these new neurons into the thought pathways within the brain. I believe it's also been shown that a good proportion of senility can be prevented or at least moderated by keeping the person mentally active and stimulated. Any other part of the body will atrophy if not used in order to conserve energy. It would make sense that the brain (one of the highest energy demand organs in the body) will atrophy to some extent if not exercised.

Physical ability seems to decline far earlier than mental ability, so I wouldn't be surprised to find out that physical aging leaves people in such a situation where they simply don't have the ability to do the things that allow for mental stimulation, such as diminished strength precludes sports, diminished eyesight begins to preclude reading, diminished hearing precludes conversational skills, etc etc. I don't doubt that there is a physical neurological component to senility, but I believe keeping the body healthy would allow a person to keep their brain healthier and "younger." This makes the job of finding a pill or other treatment to keep the brain healthy much less troublesome, although it would make effecacy testing far more difficult as various stages of physical sensecence and condition should also be compared in order to fully understand the effect of novel treatments.

So yes, as we get better at 1)fighting cancer and 2)replacing/repairing failing organs (including the brain) through medical advances and lifestyle changes/improvements we will be able to put off death further and further. Medical treatments to stave off senility shouldn't be viewed as strictly unnatural: the brain (along with the rest of the body) is constantly replacing dead, dying and malfunctioning cells. Even the cells that do survive for a long period of time will have their various structures repaired and replaced. I heard somewhere that in five years an average person will have none of the same atoms making up their body (Although I can't find a source for that five years "fact" so take it for what it's worth. And with a grain of salt while you're at it.)

Re:Statistical confidence

[denoir]

Good work. Now I can start computing

No you can't. You need the variance to compute significance levels, which we don't have. Either way we don't need it as we can't reject the null hypothesis anyway due to the too small number of samples.

It most certainly is not. If the probability of spontaneous remission were zero then it'd be impossible to get 2 out of 17 spontaneous remissions so we'd be 100% sure that the two remissions were not spontaneous.

No, I didn't say that the probability of spontaneous remission would be zero, but that the probability for the medicine could be it, given the margin of error. That the positive hits had some completely different cause and were only included because of a too small sample size - which in turn resulted that by chance a far more improbable cause dominated the results of the sample.

You're saying something completely bizarre. After you've collected 1000 sample posts you'll either catch my posts or not. If you do, then you'll be able to reject the hypothesis as clearly false.

With mathematical logic, yes, with statistics, no. With 1 out of 1000 samples being true we would with 99% certainty not be able to reject the hypothesis (that no such signatures exist). c = +-sqrt(2.58^2 * (1/1000)*(1-1/1000)/1000) = 2.6/1000. With one positive sample the confidence interval would be 1+-2.6 of 1000. This encompasses zero probability (e.g the null hypothesis) hence we can't reject it at a 99% confidence level.

Had we found 2 posts of 1000, then we would still confirm the hypothesis at a 95% level (z=1.96), but we would reject it at a 80% level (z=1.28) You have to understand that confirming or rejecting a hypothesis at a confidence level (statistics) has very little to do with confirming or rejecting a hypothesis using deductive logic.

Statistics deals with probabilities and is never absolute. You don't say that a hypothesis is true or false, but that it is true or false at a certain confidence level. And that's what's great about it as real-world science deals with real-world measurements which are always associated with various forms of errors and weird correlations that you don't want influencing your results. Sampling to obtain a probability estimate is a very convenient tool, but if you take too few samples, the margin of error will be to great, and if it encompasses zero, then it is worthless. An estimate that doesn't reject the null hypothesis means that the estimate is no better than a random guess.