6 ms·

Immunology is one of the biggest fields that are stepping up to fight cancer. In a nutshell, we are programming the patients immune system to kill its own cance

Immunology is one of the biggest fields that are stepping up to fight cancer. In a nutshell, we are programming the patients immune system to kill its own cancer cells, a marked departure from the general toxic chemotherapy that weakened almost every dividing cell in the human body. I believe people in a few decades will look back and express disbelief at the barbaric way we tried to treat cancer.

dekhn 9y ago
or express disbelief that we didn't anticipate <fairly obvious outcome> as an unexpected side effect of immune system tailoring. <fairly obvious outcome> is likely to be "large increase in incididence of autoimmune disorders"
- rubatuga 9y ago
  Well if you use antibodies, they should be able to slowly be excreted and broken down after a while. I don’t believe antibodies undergo any memory effect. If you use a specific form of T cells, they should undergo the same degradation, although I guess there is a possibility that in some unknown cases it might revert to a memory cell, although to my knowledge this doesn’t happen. Lastly, since the virus used to express the receptor should only infect the cells extracted from his blood, any autoimmune response shouldn’t last (since cytotoxic T cells don’t last forever). The virus isn’t self replicating, and isn’t used to infect any other cells.
  - dekhn 9y ago
    thats a lot of "shoulds" for a complicated system.
    - rubatuga 9y ago
      I don’t believe you have a compelling argument, any biological organism has a degree of unpredictability, but with a series of molecular checks and controls, it becomes predictable, almost deterministic. Think of how the brain works, how you have billions of cells acting the way they “should”, and acting in a predictable way allowing you to perform daily tasks. I agree we have a lot to learn and that some mistakes might be made, but that’s what testing and clinical trials is for.
      - dekhn 9y ago
        Unfortunately, autoimmune diseases violate the assumption that biological organisms become also predictable. That's true for brains, too.
- reasonattlm 9y ago
  Which might be controlled by immune ablation; safer targeted forms of destroying all immune cells would be a very good way to stop all forms of autoimmunity, and would act as a good backstop to immunotherapies in general. Right now immune ablation is pretty rough chemotherapy, but has nonetheless been shown to put multiple sclerosis and type 1 diabetes into remission. There are new approaches to targeted cell killing under development now (such as Oisin Biotechnologies' system) that should be much better, with minimal side-effects. Couple that with a cell therapy to accelerate replacement of immune cells and it looks pretty promising.
zzalpha 9y ago
Well, the flipside is that if you stop chemo, the damage to your body stops. But if the immune system over reacts, it can run out of control and kill you. I have a relative with stage IV melanoma. She was included in a research trial that used a pair of immune stimulating drugs in an attempt to get her own body to fight the cancer. What they didn't realize is she had a latent, undiagnosed autoimmune condition called vasculitis. Unfortunately, while vasculitis is normally isolated to a particular part of the body, hers was systemic. What followed was an immediate halt of the drug regimen and massive doses of steroids to get it under control. If that hadn't have worked, it would have killed her. Full stop. The condition is now fortunately under control, but she has 30% kidney function, and the steroids pushed her over to full non-insulin-dependent diabetes. She's now on a targeted therapy that, for now, has pushed her into full remission, but it's only a matter of time before the melanoma becomes resistant to the drug. The reality is, doctors do not fully understand the immune system. Period. These treatments are in many ways astonishing, but they can turn frightening very very quickly. And they don't always work, either. Unfortunately, there are no miracles, here. Not yet.
- lr4444lr 9y ago
  That's true, but assuming this specific treatment doesn't reprogram the native immune system, it sounds like the side effects are much shorter and less devastating than the systemic damage of chemo, even if requiring repeated attempts.
  - zzalpha 9y ago
    Well, given the doctors in the article flat out stated that: There was a chance that his immune system would go into overdrive, and there was a chance that the edited T-cells wouldn’t be as potent as they expected. The medical team just really couldn’t be sure what would happen. That article goes on to note all manner of side effects with this style of therapy: fever, tremors, convulsions, encephalitis... and right at the end we have this quote: He had an atypical skin growth, a chronic cough, a sinus infection, a puddle of fluid at the bottom of his lungs, a virus in his right eye, and bad heartburn. Of course, as far as side effects go, this is pretty minor. But there's no understanding of why these types of things happen in the first place because our understanding of the immune system in vivo is just not very good.
Mz 9y ago
I would like to see a more elegant means to boost the immune function, without so much of the Dr. Frankenstein element. I think supporting the immune function is the way to go, but I think we need a lighter hand, not a heavier one.
- jfarlow 9y ago
  If you are directing the immune system against cells that the body perceives as 'self', then simply boosting the system to the point it attacks a cancer will likely be detrimental the patient. Cancers and other similar diseases are so difficult to address precisely because they are borne from a patient's own cells, own genome, and own systems. This therapy here is a very pointed mechanism to demonstrate to the immune system what is okay to attack, and what is not - a very particular and specific kind of guidance that a generalized 'boost' would not properly address. And in that way it actually is an elegant, precisely designed system in play here.
  - Mz 9y ago
    Cancers and other similar diseases are so difficult to address precisely because My general understanding is that they are so difficult to address because we don't really understand them. I have a condition that gets partly explained as "overactive immune response." I really hate the concept of autoimmune diseases and I hope that someday it will be mocked as "god, what those barbaric idiots believed back in the day."
    - jfarlow 9y ago
      'Cancer' is a huge umbrella term. Some cancers we know very well, many we do not. The one's being addressed by these therapies are well enough understood to target therapeutically. Some like cervical cancer, skin and lung cancer are well enough understood to in part be prevented. But under that umbrella the reason cancers are 'hard to treat' (from the perspective of a pharmaceutical education/industry/knowledgebase that had a century of success curing invading diseases) is because cancers do not present a 'differnece' that can be exploited biochemically. Cancers are by definition a mashup and amalgamation of the components that make up a human - again very much unlike a bacteria, viral or fungal infection. You are correct though that there is still a lot for us to learn. The technologies in this article are very much a glimpse of the next steps though.
PhasmaFelis 9y ago
I'm not sure "barbaric" is the right word. It's ugly and unpleasant, but it works and it's the best hope we have for many people. "Barbaric" to me would be bleeding a patient to balance their humors; chemotherapy is more along the lines of amputating a septic limb.

dekhn 9y ago

or express disbelief that we didn't anticipate <fairly obvious outcome> as an unexpected side effect of immune system tailoring. <fairly obvious outcome> is likely to be "large increase in incididence of autoimmune disorders"

rubatuga 9y ago
Well if you use antibodies, they should be able to slowly be excreted and broken down after a while. I don’t believe antibodies undergo any memory effect. If you use a specific form of T cells, they should undergo the same degradation, although I guess there is a possibility that in some unknown cases it might revert to a memory cell, although to my knowledge this doesn’t happen. Lastly, since the virus used to express the receptor should only infect the cells extracted from his blood, any autoimmune response shouldn’t last (since cytotoxic T cells don’t last forever). The virus isn’t self replicating, and isn’t used to infect any other cells.
- dekhn 9y ago
  thats a lot of "shoulds" for a complicated system.
  - rubatuga 9y ago
    I don’t believe you have a compelling argument, any biological organism has a degree of unpredictability, but with a series of molecular checks and controls, it becomes predictable, almost deterministic. Think of how the brain works, how you have billions of cells acting the way they “should”, and acting in a predictable way allowing you to perform daily tasks. I agree we have a lot to learn and that some mistakes might be made, but that’s what testing and clinical trials is for.
    - dekhn 9y ago
      Unfortunately, autoimmune diseases violate the assumption that biological organisms become also predictable. That's true for brains, too.
reasonattlm 9y ago
Which might be controlled by immune ablation; safer targeted forms of destroying all immune cells would be a very good way to stop all forms of autoimmunity, and would act as a good backstop to immunotherapies in general. Right now immune ablation is pretty rough chemotherapy, but has nonetheless been shown to put multiple sclerosis and type 1 diabetes into remission. There are new approaches to targeted cell killing under development now (such as Oisin Biotechnologies' system) that should be much better, with minimal side-effects. Couple that with a cell therapy to accelerate replacement of immune cells and it looks pretty promising.

zzalpha 9y ago

Well, the flipside is that if you stop chemo, the damage to your body stops. But if the immune system over reacts, it can run out of control and kill you. I have a relative with stage IV melanoma. She was included in a research trial that used a pair of immune stimulating drugs in an attempt to get her own body to fight the cancer. What they didn't realize is she had a latent, undiagnosed autoimmune condition called vasculitis. Unfortunately, while vasculitis is normally isolated to a particular part of the body, hers was systemic. What followed was an immediate halt of the drug regimen and massive doses of steroids to get it under control. If that hadn't have worked, it would have killed her. Full stop. The condition is now fortunately under control, but she has 30% kidney function, and the steroids pushed her over to full non-insulin-dependent diabetes. She's now on a targeted therapy that, for now, has pushed her into full remission, but it's only a matter of time before the melanoma becomes resistant to the drug. The reality is, doctors do not fully understand the immune system. Period. These treatments are in many ways astonishing, but they can turn frightening very very quickly. And they don't always work, either. Unfortunately, there are no miracles, here. Not yet.

lr4444lr 9y ago
That's true, but assuming this specific treatment doesn't reprogram the native immune system, it sounds like the side effects are much shorter and less devastating than the systemic damage of chemo, even if requiring repeated attempts.
- zzalpha 9y ago
  Well, given the doctors in the article flat out stated that: There was a chance that his immune system would go into overdrive, and there was a chance that the edited T-cells wouldn’t be as potent as they expected. The medical team just really couldn’t be sure what would happen. That article goes on to note all manner of side effects with this style of therapy: fever, tremors, convulsions, encephalitis... and right at the end we have this quote: He had an atypical skin growth, a chronic cough, a sinus infection, a puddle of fluid at the bottom of his lungs, a virus in his right eye, and bad heartburn. Of course, as far as side effects go, this is pretty minor. But there's no understanding of why these types of things happen in the first place because our understanding of the immune system in vivo is just not very good.

Mz 9y ago

I would like to see a more elegant means to boost the immune function, without so much of the Dr. Frankenstein element. I think supporting the immune function is the way to go, but I think we need a lighter hand, not a heavier one.

jfarlow 9y ago
If you are directing the immune system against cells that the body perceives as 'self', then simply boosting the system to the point it attacks a cancer will likely be detrimental the patient. Cancers and other similar diseases are so difficult to address precisely because they are borne from a patient's own cells, own genome, and own systems. This therapy here is a very pointed mechanism to demonstrate to the immune system what is okay to attack, and what is not - a very particular and specific kind of guidance that a generalized 'boost' would not properly address. And in that way it actually is an elegant, precisely designed system in play here.
- Mz 9y ago
  Cancers and other similar diseases are so difficult to address precisely because My general understanding is that they are so difficult to address because we don't really understand them. I have a condition that gets partly explained as "overactive immune response." I really hate the concept of autoimmune diseases and I hope that someday it will be mocked as "god, what those barbaric idiots believed back in the day."
  - jfarlow 9y ago
    'Cancer' is a huge umbrella term. Some cancers we know very well, many we do not. The one's being addressed by these therapies are well enough understood to target therapeutically. Some like cervical cancer, skin and lung cancer are well enough understood to in part be prevented. But under that umbrella the reason cancers are 'hard to treat' (from the perspective of a pharmaceutical education/industry/knowledgebase that had a century of success curing invading diseases) is because cancers do not present a 'differnece' that can be exploited biochemically. Cancers are by definition a mashup and amalgamation of the components that make up a human - again very much unlike a bacteria, viral or fungal infection. You are correct though that there is still a lot for us to learn. The technologies in this article are very much a glimpse of the next steps though.

PhasmaFelis 9y ago

I'm not sure "barbaric" is the right word. It's ugly and unpleasant, but it works and it's the best hope we have for many people. "Barbaric" to me would be bleeding a patient to balance their humors; chemotherapy is more along the lines of amputating a septic limb.