Who would like to hear some really good news? Thought so. One of the promises of the molecular biology and genomics revolutions was that gene therapy – replacing defective, disease-causing genes with functioning ones, or otherwise treating these diseases by genetic means – would become a reality. Even, optimistically, something commonplace. Like so many things, however, it has proved more complicated than hoped, and those longed-for treatments elusive. There has never been a therapy of any kind that alters the disease progress of a neurodegenerative disease – until now. Continue reading
Sometimes the science of the future seems very far away, and sometimes it seems to happen almost faster than you would think. Immunotherapy is taking off at a record pace in the search for better cancer treatments.
The National Institute for Clinical Excellence (Nice), the body in the United Kingdom that licences medicines for use, has just approved a combination of two immunotherapy drugs in record time. These two drugs are ipilumab and nivolumab, which I blogged about as a treatment showing promising clinical trial results only a short while ago.
Nivolumab blocks a molecule secreted by cancer cells that prevents the T-cells of the immune system from recognising and destroying them. Ipilumab, which was approved by Nice in 2012, stimulates the T-cells to multiply. This drug combination has been approved for the treatment of metastatic (i.e. spread from its original site) melanoma, a particularly intractable cancer to treat. The life expectancy for this type of cancer is only around two years: the combination treatment has extended this to as much as ten years (and counting, in some cases). Moreover, ipilumab alone is effective in about 20% of cases: the combination raises that to 60%. So these are massively improved odds. I expect to see more successes soon, and, as more experience is gained with these exciting new techniques, hopefully the side-effects will become more manageable as well.
It’s been a busy couple of weeks, with a teething baby eating my sleep and job applications eating my time, so a longer written piece is off the cards for now. It seems my piece on new cancer treatments, specifically immunotherapy, however, was a timely one, as it’s hitting the news again, with big successes reported in the use of modified T-cell therapy to treat blood cancers, reported in the Guardian here. These include some startling trial results:
In the most promising study, about 35 patients with ALL were treated with Cars-modified T-cells; 94% went into remission, though symptoms could reappear. More than 40 patients with lymphoma have also been treated, with remission rates of more than 50%. In a group with non-Hodgkin’s lymphoma, there was evidence of diminished cancer symptoms in more than 80% of cases.
These are really impressive figures. Is it just hype? These results were reported at a major scientific meeting, and the ALL (acute lymphoblastic leukaemia) trial results are described as being under review and pending publication. So it’s not just a press release from a laboratory that has been wildly spun out of all proportion by an over-enthusiastic press. I for one will definitely be wanting to read the original research paper when (if) it is published. We can expect to see a flood of trial results and papers published within the next couple of years, if it lives up to even half of its original promise.
How often do you hear a new medical treatment, or any scientific or technological innovation, as “It sounds like something out of science fiction but WonderDrug X will cure Deadly Disease Y….” ? Too often, in my humble opinion, and, in my suspicions, by people who don’t read that much science fiction (or fact). But there are some cancer treatments coming up that have been mooted (or at least something similar has) in science fiction. Let me throw some catchphrases at you: “Personalised medicine”, “Biological therapy”, and, best of all, “Nanobots!!!” Which obviously deserve three exclamations all of their own. Amidst the headline tags, there’s a welter of confusing terms: “Targeted therapy”, “Immunotherapy”, “Oncolytic therapy,” “proton beam therapy,” and, my personal favourite, “Cyberknife”. Now I’ll go through some of the newer cancer treatments that come with these labels attached: some in use, some in development, and see if they do the justice hype – and if science fiction really did say it all first.