Immune discovery 'may treat all cancer'

Immune discovery 'may treat all cancer'

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Riley Blue

Original Poster:

20,907 posts

225 months

Tuesday 21st January 2020
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gruffalo

7,509 posts

225 months

Tuesday 21st January 2020
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Wow if this works what a huge leap forward in medical science!


marksx

5,052 posts

189 months

Tuesday 21st January 2020
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Cue the conspiracy theorists saying 'they' won't let it happen.

anonymous-user

53 months

Tuesday 21st January 2020
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Really encouraging, we can only hope that this is the beginning of the end for cancer.

Biker 1

7,690 posts

118 months

Tuesday 21st January 2020
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Having watched a family member die from brain cancer which took a couple of years, I can only hope this new technique will come to something. Chemotherapy does horrible things to the body & brain surgery really sucks......

don'tbesilly

13,900 posts

162 months

Tuesday 21st January 2020
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Riley Blue said:
A fascinating and totally absorbing programme that follows two patients through treatment using similar/same technology outlined in the link above.

A must see programme if cancer is of interest or impacts on your life in any way:

https://www.bbc.co.uk/iplayer/episode/m0006nzt/war...

An intimate, feature-length documentary following two patients through groundbreaking ‘first in-human’ trials for CAR T-cell therapy, a treatment described as the beginning of the end of cancer.

Not allowed to meet and separated by two floors of a hospital, 53-year-old Graham and 18-year old-Mahmoud are nevertheless bound together by their commitment to the treatment and their faith in the science. Terminally ill, the trial represents their only option. How do their ages and life experiences affect their physical and emotional response?

For Martin Pule, the scientist who has developed the treatment, the responsibility of curing patients is both exciting and daunting. He knows he stands on the cusp of a breakthrough that could radically change the way we treat cancer.

At the heart of this film is the complex relationship between the patients and the clinical team. How much hope can the patients be given when they are effectively going into these trials as human guinea pigs? The patients and clinical team must weigh up hope with realism and their response is a profound and revealing reflection of the human condition



pavarotti1980

4,836 posts

83 months

Tuesday 21st January 2020
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New therapies such as this and CAR-T will work and patient will improve. However it will require a bold NICE/NHS/Government to use them earlier in patients with cancer. Having to be bold is due to the enormous cost involved and the success they will achieve. c.£250k (drug cost) per patient + associated costs around the treatment cycle will be put a huge burden on the NHS.

Maybe private healthcare providers could treat their insured patients earlier than current NICE guidance and see what the results are like?

TTwiggy

11,499 posts

203 months

Tuesday 21st January 2020
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I would imagine that costs will come down once it's more mass-market. And I suppose you have to offset that against the cost of current treatment regimes and the ongoing/palliative care associated with the disease.

pavarotti1980

4,836 posts

83 months

Tuesday 21st January 2020
quotequote all
TTwiggy said:
I would imagine that costs will come down once it's more mass-market. And I suppose you have to offset that against the cost of current treatment regimes and the ongoing/palliative care associated with the disease.
CAR-T is last line so the current treatments have all been attempted so as it stands the cost is additional to current costs.

There may be a price drop however the drug companies are spend 4 or 6 weeks "working on cells" and that isnt a cheap business

anonymous-user

53 months

Tuesday 21st January 2020
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Please let this happen.

BevR

675 posts

142 months

Tuesday 21st January 2020
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TTwiggy said:
I would imagine that costs will come down once it's more mass-market. And I suppose you have to offset that against the cost of current treatment regimes and the ongoing/palliative care associated with the disease.
Cost may come down but this kind of medicine wont be cheap unless we can generate heterologous T cells. Until we do we will have to put up with the high costs and infrastructure, if it becomes commonplace you will have specialist centres with rooms of CliniMACs Prodigy machines. unfortunately for each patient you would be monopolizing a machine for two weeks or so. It is very specialized work, not just the cell collection but the virus production, validation, release tests, transduction selection etc....

At the moment there are only a few centers in Europe licensed to do this kind of work but hopefully with the market approval of Kymriah more will be established.

This is an area I used to work in so find it very exciting but realistically we are 5-10 years from meaningful clinical work. I

I have skimmed the paper and it seems very solid but they must have had a bit of a wobble when the genome wide screen gave so few hits. Followed by a feeling of being on cloud nine when all of the validation experiments worked! I think the first author was a PhD student, hell of a paper to get out of your PhD.


Edit: The lab website has some good videos if you want more information : http://www.tcells.org/

dieselgrunt

684 posts

163 months

Tuesday 21st January 2020
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Can you imagine a definite 100% cure for cancer but only the super rich could access it.

anonymous-user

53 months

Tuesday 21st January 2020
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the issues i see, are using viruses as the method of application. Considering viruses can alter your DNA, it may solve one problem and cause another..

Jinx

11,343 posts

259 months

Tuesday 21st January 2020
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Thesprucegoose said:
the issues i see, are using viruses as the method of application. Considering viruses can alter your DNA, it may solve one problem and cause another..
Virus introduced into T-Cells = T-Virus = Resident Evil... You heard it here first - right I'm off to the Winchester Tavern until it all blows over.....

BevR

675 posts

142 months

Tuesday 21st January 2020
quotequote all
Thesprucegoose said:
the issues i see, are using viruses as the method of application. Considering viruses can alter your DNA, it may solve one problem and cause another..
It depends on the virus, the retroviruses used in the mid 200's for the ADA-SCID trials were a little disastrous but there have not yet been any similar cases using lentivirus. While they both insert the DNA thereby permanently changing the DNA the preference for where it goes is key. This paper is one I often refer back to regarding the difference: https://www.nature.com/articles/nbt1216

If you look at what can be achieved with gene therapy it is absolutely extraordinary. in 2017 they literally regrew a boys skin, he had a genetic condition that prevented his skin from anchoring to his body, they removed stem cells, introduced the required gene, expanded the cells and then transplanted them back to him:

https://www.nature.com/articles/nature24487

I have presented this paper a number of times and it still blows my mind. Importantly they do the integration profile analysis and don't find anything untoward.

pavarotti1980

4,836 posts

83 months

Tuesday 21st January 2020
quotequote all
BevR said:
Cost may come down but this kind of medicine wont be cheap unless we can generate heterologous T cells. Until we do we will have to put up with the high costs and infrastructure, if it becomes commonplace you will have specialist centres with rooms of CliniMACs Prodigy machines. unfortunately for each patient you would be monopolizing a machine for two weeks or so. It is very specialized work, not just the cell collection but the virus production, validation, release tests, transduction selection etc....

At the moment there are only a few centers in Europe licensed to do this kind of work but hopefully with the market approval of Kymriah more will be established.

This is an area I used to work in so find it very exciting but realistically we are 5-10 years from meaningful clinical work. I

I have skimmed the paper and it seems very solid but they must have had a bit of a wobble when the genome wide screen gave so few hits. Followed by a feeling of being on cloud nine when all of the validation experiments worked! I think the first author was a PhD student, hell of a paper to get out of your PhD.


Edit: The lab website has some good videos if you want more information : http://www.tcells.org/
Approval for Kymriah and Yescarta was simultaneous and the likelihood of more centres taking on the cell work is slim (at least according to the respective reps) Currently 2 sites used. One in Germany and one in USA depending on which therapy a patient is approved for.

Following apheresis 4 week turn around for Gilead and 6 weeks for Novartis

BevR

675 posts

142 months

Tuesday 21st January 2020
quotequote all
pavarotti1980 said:
Approval for Kymriah and Yescarta was simultaneous and the likelihood of more centres taking on the cell work is slim (at least according to the respective reps) Currently 2 sites used. One in Germany and one in USA depending on which therapy a patient is approved for.

Following apheresis 4 week turn around for Gilead and 6 weeks for Novartis
I thought UCL was still doing quite a few CAR-T trials? I would imagine that as new CAR-T treatments come out there would be a need to more centers to become accredited, assuming they are affordable.

Have any patients been treated with Kymriah in the UK yet? I seem to remember that the number of patients in the US was not as high as Novartis expected.

don'tbesilly

13,900 posts

162 months

Tuesday 21st January 2020
quotequote all
BevR said:
I thought UCL was still doing quite a few CAR-T trials? I would imagine that as new CAR-T treatments come out there would be a need to more centers to become accredited, assuming they are affordable.

Have any patients been treated with Kymriah in the UK yet? I seem to remember that the number of patients in the US was not as high as Novartis expected.
They certainly were last year, the programme shown last night on the Beeb covered two patients undergoing the trials.
Sadly neither Mahmoud or Graham survived however many who underwent the same trials have been in remission, and some for quite some time.
Well worth a watch:

https://www.bbc.co.uk/iplayer/episode/m0006nzt/war...


Thales

619 posts

56 months

Tuesday 21st January 2020
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marksx said:
Cue the conspiracy theorists saying 'they' won't let it happen.
It's not a conspiracy. Big pharma is BIG business.

Jasandjules

69,825 posts

228 months

Tuesday 21st January 2020
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Fingers crossed this gets improved and results. Hell even if it were only for a few types of cancer, the lives saved would be incredible.