Using a genetically modified HIV-1 to genetically modify leukemia patients T-cells to teach them how to kill the cancer?
Thats childs play, at this point.
Lets give those GMO viruses a real challenge.
Lets get them to fight a real bastard form of leukemia-- B-cell Acute Lymphoblastic Leukemia (B-ALL) in adults.
In kids, B-ALL has high cure rates (>80% cured).
In adults, things are more difficult (38% are alive 5 years post-diagnosis). Things get much more difficult if the adult has relapsed (7% alive 5 years post-diagnosis).
Can a GMO HIV-1 do better than 7% in relapsed adult B-ALL patients?
There are five patients in this study. Four were >50 years old. One was only 23.
One had bone marrow that was 70% tumor. Yeah...
Four of the five patients went into remission and were eligible for bone marrow transplants. One died of unrelated issues, but the other three are doing just fine.
The fifth patient just couldnt get the bone marrow transplant because of other heath problems, and the cancer came back.
But four out of five went from "My bone marrow is basically just tumor and Ive got a 7% chance of surviving" to "Thanks to GMO HIV, I could get a bone marrow transplant and now Im fine."
All that dead tumor really pissed off their homeostasis and they had high fevers/high cytokine levels for a while, but it was easily treated with some steroids (but unfortunately would impair the tumor slaughterfest). They gotta improve that. But as far as 'cancer treatment side-effect' profiles go, Ill take it.
So Im happy about this, right?
Well, Im sick of writing about the papers. Im sick of writing about four patients, five patients, six patients. I *know* this is a process, but this kind of protocol *WORKS*. We need this therapy to be fast-tracked into the clinics. We need this to be normal.
This is good news indeed. If anyone has had experience of any kind of leukenia in the family they will know that it pretty much does not get worse than 'blood cancer'.
I have been following this from the get go, and its amazing to think that soon this will be just standard protocol for these diseases soon - it is possibly the most exciting and significant new medical paradigm at the minute - and this sophisticatted - but elegant solutoin - getting the' enemies' in medical seince to work for it - well its enough to make you cry! Yeah science is moving - OK!?
One things for sure - current chemotherapy regimes will soon be seen as a once mediaval 'solution' to these diseases - a desparate attempt to defy the odds for the want of anything better.
Early stage human trials are all well and good, but all to often we find things in the next few steps that were not anticipated. 5 people is a phase zero trial.
I'll agree that this needs to be bumped up to a phase 2 or 3 clinical trial though.
Abbie, how difficult are these protocols to implement? Do you have to custom grow virii for every patient, are can this become a routine treatment?
Mu, even if they have to custom grow the virii, it's not a major issue. The patients are already having some cells removed, treated with the virus, and re-introduced, which while not super common is already in practice for some commerical treatments. (Autologus immunotherapy). It is challanging to scale this sort of treatment up to major production, but I think the first order of business is like Bryan said, larger trials.
And all of these patients got bone-marow transplants, which might be muddying the waters a bit. I really hope to see some larger trials soon.
If bone marrow transplants are necessary after this treatment, then the treatment is no better than any other that is being used now. If this were a "cure" bone marrow transplants would be unnecessary.
I suffer from MDS. There are chemo treatments that bring this form of Leukemia under control. But most all require Stem cell or Bone marrow transplants.
The problem with autologous bone marrow transplants in leukemia is that it's hard to get rid of residual leukemic cells in the bone marrow. A friend of mine lost his 8 yr old daughter years ago because the affinity purification they used on her marrow cells didn't completely work, and she relapsed after a while. I've seen papers recently where they are working on virus treatments on the stored bone marrow that purge it of leukemic cells using myxoma virus, which apparently has a natural selectivity for leukemic cells.