GMO Cowpox vs liver cancer

This is ridiculous. After all of the papers I have read, written about, the new stuff we can do with GMO viruses...I can still be amazed. This is insane:

Randomized dose-finding clinical trial of oncolytic immunotherapeutic vaccinia JX-594 in liver cancer

The patients in this study had liver cancer.  Specifically, malignant hepatocellular carcinoma (HCC).  In general, someone diagnosed with HCC can expect to live 3-6 months.

These patients had already failed conventional therapies, so they were looking at 2-4 months.

So they tried the best kind of alternative therapy-- Not witch doctors or snake-oil salesmens potions, but real scientific alternative therapies.  New ideas that need to be tested before they get thrown away, or turned into tomorrows standard therapy.

This alternative therapy was a genetically modified cowpox virus.  Specifically, the Wyeth strain that has proven itself safe as a vaccine for over 100 years.

The first thing they did was remove a viral gene-- not to make it 'safer', but to get the virus addicted to cancer.  The new virus NEEDS cancer to replicate.  The scientists did this by removing the viral gene for a thymidine kinase... an enzyme the virus requires... that is also upregulated in cancers. In other words, they took away something the virus needs, something tumors have in abundance.

They also gave the virus some additional anti-tumor tools-- instructions to stimulate the immune system.  Again, not in the sense that which doctor/snake-oil-salesmen sell garbage to 'stimulate the immune system', I mean they gave the virus the gene that encodes human granulocyte-macrophage colony-stimulating factor.  A molecule that tells your immune system "HELLOOOOO?? MAKE MOAR IMMUNE CELLS PLZ, THX!"

The patients had liver cancer for different reasons-- Some from Hepatitis C, some from Hepatitis B, some from alcohol, some for other reasons.  A heterogeneous group.  But they split them up into two groups, giving some of the patients a lower dose of virus, some of the patients more virus.  The only side-effect was that one of the patients got really nauseous for a few days (compare that to surgery/radiation/chemo side-effect profiles, I think I could handle really freaking nauseous for a while).

... Okay, now, remember, these patients were only supposed to live, statistically, 2-4 months.

The low dose patients lived, on average, 6.7 months.

The high dose patients lived, on average, 14.1 months.  Some were (are?) still alive at the 2 year (24 month) time-point.

...

2-4 months.

Into 24 months.

Thanks to a GMO virus (formally a vaccine virus).

Quite literally, awesome.

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Neat, but does it work in people that got vaccinated against small pox?

Excellent question!

They checked for pre-existing anti-smallpox antibodies (neutralizing), and the titers did not correlate with therapy outcome, either better or worse.

If I were to guess why, I think the dose of the therapy overwhelmed the anti-smallpox Abs. When you are exposed to a pathogen, it starts out as just a few virions, not 10^9.

Looking at cancer prognoses is so depressing sometimes, but when you go from a 2-4 month estimate and end up living two years, it must feel like getting another chance. I'm grateful to be living in a time where so much progress is being made. It's getting awfully hard to hear that one more person I know is fighting cancer or losing the battle.

By Katie Graham (not verified) on 18 Feb 2013 #permalink

I wonder what the quality of life was during those additional months? some cancer therapies can extend survival but not "living" as the patient would envision it prior to receiving the therapy.

Qwellian

I wonder what the quality of life was during those additional months?

Not great

some cancer therapies can extend survival but not “living” as the patient would envision it prior to receiving the therapy.

We all know that going in, and can quit anytime we want. Treating us 'terminal' folk is not mandatory. Weighing the quality of life in the last days vs extending or the long shot of cure is all we think about. We don't suddenly get stupid nor desperate when our time is running out.

Great article! Nice combination of facts, citations, and comments :). This is the first article of yours I've read and will definitely take a look at others!