3 ms·

Behind the Scenes of a Radical New Cancer Therapy

95 points by LinuxBender 7y ago

heymijo 7y ago
Thought this might be another hype article, but instead I found an informative article from the perspective of a physician on the front lines treating patients with CAR-T therapy.
- jessriedel 7y ago
  I also found it pretty illuminating to hear from a practicing physician how CAR-T is actually deployed, and what it's like to deal with all the complications of a brand new treatment like that. (I found the human-interest component to be useless and distracting, as usual, but these vignettes are so ubiquitous it's hard to fault the author for following the script.)
  - vo2maxer 7y ago
    For physicians, it is understanding the biology together with the patient’s unique humanity which makes it much more rewarding or heartbreaking depending on outcome. As William Osler said: “The good physician treats the disease; the great physician treats the patient who has the disease.”
heisenbit 7y ago
I was impressed how many gene therapy approaches were combined. To target the cancer: - T cell cancer targeting via virus - T cell activation via virus - T cell outside body multiplication To deal with symptoms: - Interleukin-6 surpression (I suspect grown in Chinese Hamster Ovary cells which are the gene tech workhorses)
- vo2maxer 7y ago
  A good review of Chimeric Antigen Receptor Therapy [1] and its potential modification for solid tumors [2]. Unfortunately both are behind paywall. [1] https://www.nejm.org/doi/full/10.1056/NEJMra1706169 https://www.nejm.org/doi/full/10.1056/NEJMra1706169 [2] https://www.cell.com/cancer-cell/fulltext/S1535-6108(19)30426-X https://www.cell.com/cancer-cell/fulltext/S1535-6108(19)3042...
- AllegedAlec 7y ago
  > - T cell outside body multiplication This is scary though. They tried this before with children with SCID and accidentally gave them cancer [0]. 0: https://scidstuff.wordpress.com/2007/12/18/gene-therapy-cancer-case/ https://scidstuff.wordpress.com/2007/12/18/gene-therapy-canc...
joshmn 7y ago
I've followed this and related studies closely and I'm glad people are finally receiving this breakthrough cancer care. But let this comment serve as a reminder that medical professionals aren't necessarily "good" because they're in practice. They fail patients all the time. They're not up-to-date on the latest and greatest care; they've simply memorized the cliff notes assigned to them by their overseers.
- AllegedAlec 7y ago
  > But let this comment serve as a reminder that medical professionals aren't necessarily "good" because they're in practice. They fail patients all the time. They're not up-to-date on the latest and greatest care; they've simply memorized the cliff notes assigned to them by their overseers. You're a fucking moron. The reason for them not using these therapies is because they are unproven, and could very easily do much more harm than good.
  - joshmn 7y ago
    Ask my mom how poorly her doctors informed her of all available treatment options at three hospitals. When I contacted Mayo Clinic asking for other options (when she was declared out of them) they had a long, long list. Ask my mom why she was given Lorazepam, Oxy, and Seroquel in an effort to manage her nicotine fits, even against FDA warnings (classified as most severe) which said it's very dangerous to administer all three together. They did it anyway, to my frail, sick, 60LB mother. The result? She almost went into respiratory arrest and was in a coma-like state for 48 hours. When I brought this to their attention they said they didn't know it was an issue. I could write a book about how frequently the system failed my mother. The medical system in the US isn't designed for care. Ask any medical professional what they think and they'll overwhelmingly agree. Unfortunately, you can't ask my mom because she died two weeks ago after suffering from PCNSL for 5 years. I spent the last 5 years of my life fighting her disease alongside her. I spent 69 of her last 75 days with her for at least 8 hours each day. I would hardly consider myself ill-informed. Instead, I would call you an ill-informed moron, and my mom would call you an duplicitous asshole.
    - 7y ago

95 points by LinuxBender 7y ago

Thought this might be another hype article, but instead I found an informative article from the perspective of a physician on the front lines treating patients with CAR-T therapy.

jessriedel 7y ago
I also found it pretty illuminating to hear from a practicing physician how CAR-T is actually deployed, and what it's like to deal with all the complications of a brand new treatment like that. (I found the human-interest component to be useless and distracting, as usual, but these vignettes are so ubiquitous it's hard to fault the author for following the script.)
- vo2maxer 7y ago
  For physicians, it is understanding the biology together with the patient’s unique humanity which makes it much more rewarding or heartbreaking depending on outcome. As William Osler said: “The good physician treats the disease; the great physician treats the patient who has the disease.”

heisenbit 7y ago

I was impressed how many gene therapy approaches were combined. To target the cancer: - T cell cancer targeting via virus - T cell activation via virus - T cell outside body multiplication To deal with symptoms: - Interleukin-6 surpression (I suspect grown in Chinese Hamster Ovary cells which are the gene tech workhorses)

vo2maxer 7y ago
A good review of Chimeric Antigen Receptor Therapy [1] and its potential modification for solid tumors [2]. Unfortunately both are behind paywall. [1] https://www.nejm.org/doi/full/10.1056/NEJMra1706169 https://www.nejm.org/doi/full/10.1056/NEJMra1706169 [2] https://www.cell.com/cancer-cell/fulltext/S1535-6108(19)30426-X https://www.cell.com/cancer-cell/fulltext/S1535-6108(19)3042...
AllegedAlec 7y ago
> - T cell outside body multiplication This is scary though. They tried this before with children with SCID and accidentally gave them cancer [0]. 0: https://scidstuff.wordpress.com/2007/12/18/gene-therapy-cancer-case/ https://scidstuff.wordpress.com/2007/12/18/gene-therapy-canc...

joshmn 7y ago

I've followed this and related studies closely and I'm glad people are finally receiving this breakthrough cancer care. But let this comment serve as a reminder that medical professionals aren't necessarily "good" because they're in practice. They fail patients all the time. They're not up-to-date on the latest and greatest care; they've simply memorized the cliff notes assigned to them by their overseers.

AllegedAlec 7y ago
> But let this comment serve as a reminder that medical professionals aren't necessarily "good" because they're in practice. They fail patients all the time. They're not up-to-date on the latest and greatest care; they've simply memorized the cliff notes assigned to them by their overseers. You're a fucking moron. The reason for them not using these therapies is because they are unproven, and could very easily do much more harm than good.
- joshmn 7y ago
  Ask my mom how poorly her doctors informed her of all available treatment options at three hospitals. When I contacted Mayo Clinic asking for other options (when she was declared out of them) they had a long, long list. Ask my mom why she was given Lorazepam, Oxy, and Seroquel in an effort to manage her nicotine fits, even against FDA warnings (classified as most severe) which said it's very dangerous to administer all three together. They did it anyway, to my frail, sick, 60LB mother. The result? She almost went into respiratory arrest and was in a coma-like state for 48 hours. When I brought this to their attention they said they didn't know it was an issue. I could write a book about how frequently the system failed my mother. The medical system in the US isn't designed for care. Ask any medical professional what they think and they'll overwhelmingly agree. Unfortunately, you can't ask my mom because she died two weeks ago after suffering from PCNSL for 5 years. I spent the last 5 years of my life fighting her disease alongside her. I spent 69 of her last 75 days with her for at least 8 hours each day. I would hardly consider myself ill-informed. Instead, I would call you an ill-informed moron, and my mom would call you an duplicitous asshole.
  - 7y ago