13 ms·

Immune discovery 'may treat all cancer'

625 points by sjcsjc 7y ago

davidchua 7y ago
This sounds very promising and also sounds like this case just a couple of days ago where a young boy was removed of cancer cells. I'm not sure if it's the same kind of treatment. https://www.channelnewsasia.com/news/singapore/oscar-saxelby-lee-cancer-leukaemia-experimental-treatment-12269276 https://www.channelnewsasia.com/news/singapore/oscar-saxelby...
gus_massa 7y ago
The title says may, but it's a very optimistic title anyway. From the article: > However, the research has been tested only in animals and on cells in the laboratory, and more safety checks would be needed before human trials could start. > Lucia Mori and Gennaro De Libero, from University of Basel in Switzerland, said the research had "great potential" but was at too early a stage to say it would work in all cancers.
- pilif 7y ago
  Relevant xkcd: https://xkcd.com/1217/ https://xkcd.com/1217/
- OJFord 7y ago
  The abstract closes: > These findings offer opportunities for HLA-independent, pan-cancer, pan-population immunotherapies. So it hasn't come (to the journalists) from nowhere.
jfk13 7y ago
One key quote: > "At the moment, this is very basic research and not close to actual medicines for patients."
- deleted 7y ago
  [deleted]
- toomuchtodo 7y ago
  At the same time, this could make chemo and radiation therapies obsolete long term. Leaches and amputations without anesthetic were once “state of the art”, and it feels like that’s where we’re currently at with cancer therapies. CRISPR is knocking on the door of amazing potential.
  - rzzzt 7y ago
    I'm wondering if there's a "Can I use"-kind of summary for proposed cancer treatments available somewhere; presenting the various methods attempted, which kind they target, do they work in vitro, in animal models, are they currently in clinical trial, effectiveness results, link to papers, etc.
    - crystaldev 7y ago
      Can we just get an npm package already?
      - ThalesX 7y ago
        Ugh... have you stopped following the Javascript ecosystem for the last three hours? We use YARN or NPX now. /s
    - deleted 7y ago
      [deleted]
- Ajedi32 7y ago
  That seems to contradict what the paper's authors have to say on the matter: > Prof Sewell said the ‘right people’ are now interested in developing the potential new therapy and said progress could now move ‘quite fast’. The team says human trials on terminally ill patients could begin as early as November if the new treatment passes further laboratory safety testing. Source: https://www.telegraph.co.uk/science/2020/01/20/immune-cell-kills-cancers-discovered-accident-british-scientists/ https://www.telegraph.co.uk/science/2020/01/20/immune-cell-k... Some level of skepticism is certainly warranted, but it's not impossible that this is way closer to "actual medicines for patients" than you might think.
ramraj07 7y ago
Original article - https://www.nature.com/articles/s41590-019-0578-8 https://www.nature.com/articles/s41590-019-0578-8 Very interesting finding indeed, these T cells seem to (not fully confirmed) target cells with abnormal mrtabolism, which is one of the hallmarks of cancer in general (most cancers at least). This solves one of the biggest problems with immunotherapy, which is that if a cancer is not different from regular tissue in any fundamental way that the immune system cannot recognize, then it can't fight it. This is why melanoma is the poster child of immunotherapies (skin cells get mutated a ton due to UV so skin cancer has a lot of mutations to differentiate it by). If this cell stands further scrutiny, it could potentially be a very general therapy option indeed. Potential caveat is that cancers typically find a way to generate resistance, and markers of abnormal metabolism (at least as detected by this MR1 receptor) night be easy to suppress, in which case this might just become one in a line of multiple treatments. That might still be good enough though.
- himinlomax 7y ago
  > which is one of the hallmarks of cancer in general (most cancers at least) It may well be the definition factor, at least some people think so: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/ If I remember their argument correctly, cells that "only" reproduce anarchically present little danger (benign tumor) if they don't also do so at an abnormally fast rate / metabolism.
  - tialaramex 7y ago
    Most cells stay in the same place, die when told to and don't make more copies. Necessarily some of your cells don't obey one or more of these rules (you wouldn't last long if your blood cells weren't endlessly copied for example or if they stayed in one place). But if all three rules get broken you've got cancer. The cancer I had when I was young, Hodgkin Lymphoma, is one extra rule broken because the lymphatic cells already don't stay in one place and makes extra copies of themselves - which is why it relatively often occurs in young people. One copying error and the "Die when told to" feature breaks in the new copies and now you've got cancer.
rosybox 7y ago
I'm happy for all the progress being made with cancer. I wish we would also make progress on diseases that attack the nervous system for which we seemed to have made next to none. Alzheimer's, ALS, MS, Parkinson's, Hunnington's Disease, Kennedy Disease, Muscular Dystrophy, small fiber neuropathy, even benign issues such as essential tremors have no cure, and some of these are painful death sentences. We seem to know so little about how our bodies work. There are no bio markers for some of these or early detection and little idea what are the causes or the important details of what's happening as the disease progresses.
- aaomidi 7y ago
  The progress of these are independent from each other.
  - pmiller2 7y ago
    Not totally. Those conditions have money and people working on them that could be put to work on cancer and heart disease.
  - slimed 7y ago
    Unless society is willing to allocate a larger percentage of GDP towards medical research it really is zero-sum which diseases get funding and which do not.
    - afarrell 7y ago
      Yea, but if Cambridge and Somerville Massachusetts allowed more housing construction, it would be easier for medial research labs to get staff.
- pmiller2 7y ago
  As a matter of public health, we should really be focusing the vast majority of our efforts on cancer and cardiovascular disease. Odds are that most people will end up dying of one or the other.
alan-crowe 7y ago
Perhaps this discovery could end up going the other way, with those newly discovered T-cells being the culprit in auto-immune diseases. Boosting their action would be too dangerous to use as treatment for cancer, but knowing that they are there may lead to new treatments for auto-immune diseases. And where does this fit into transplant rejection? Perhaps MR-1 differs enough between people to cause problems. This reads like the early days of a discovery that could lead anywhere.
- geerlingguy 7y ago
  As someone with Crohn's and who knows people with all sorts of similar (maybe?) autoimmune diseases, any nugget of hope for something besides immunosuppressant treatment (meaning our bodies are always welcoming of other infections/sickness) is welcome.
- jonlucc 7y ago
  Fortunately, the paper shows that this particular treatment doesn't attack normal cells, but it may cause trouble longer term (which is one reason additional safety studies are required before human trials). Also, I'm pretty sure there is already an increase in autoimmune disorders after current immuno-oncology (IO) treatment. Patients should certainly have that information before treatment.
kasperni 7y ago
Some more details at https://www.telegraph.co.uk/science/2020/01/20/immune-cell-kills-cancers-discovered-accident-british-scientists/ https://www.telegraph.co.uk/science/2020/01/20/immune-cell-k... > The team says human trials on terminally ill patients could begin as early as November if the new treatment passes further laboratory safety testing.
- cchance 7y ago
  This is what I like to hear! People die daily from cancer, treatments like this with promise should be an option even if it's a long shot, the people are about to die anyway, it can only do good, for them or for science.
  - 1shooner 7y ago
    I definitely agree making it available is a good thing. However, I'd take exception to 'it can only do good'. I've had a loved one opt for experimental treatment that was ineffective, and made the last months of his life more painful and separated from his family (treatment was in another city). I'm not saying we would choose differently if we were faced with it again, but in some respects I wonder if it was more a service to our peace of mind at having done all we could than it was for his comfort or happiness.
    - derefr 7y ago
      If that treatment didn't exist, your loved one would have opted for some other experimental treatment, no? So the existence of said treatment didn't make their life worse relative to that particular treatment not existing. (Rather, the existence of a class of experimental treatments for a particular cancer that maybe don't work, makes life worse for people, but once there's one, there's no harm in adding more, only potential benefit in at least one of them maybe working.)
    - zeta0134 7y ago
      Mind here that it can also be for the patient's peace of mind. My grandfather was faced with a similar dilemna, terminally ill from pancreatic cancer, with a long-shot to try to cure it. The doctors were wonderfully frank about the potential for failure and "time lost"; even still, he opted to go down fighting. Alas, his liver wasn't strong enough to sustain the treatment, and it just ended up killing him faster. He was a spiritual man and didn't seem regret the decision, but his family had a harder time with it. They were arguing for something closer to hospice, and wanted to take him traveling to enjoy the last months of his life in relative peace. In the end, that didn't get to happen. There will always be a twinge of regret, I think. One can always look back and ask, "what if we had done it this way?" But it was the way he wanted to go, and I think the knowledge that he had tried everything that he could helped him to find peace.
Ericson2314 7y ago
So who has the mutation in their T cells already?
aazaa 7y ago
> The findings, published in Nature Immunology, have not been tested in patients, but the researchers say they have "enormous potential". then later: > However, the research has been tested only in animals and on cells in the laboratory, and more safety checks would be needed before human trials could start. The abstract for the original article notes: > ... An MR1-restricted T cell clone mediated in vivo regression of leukemia and conferred enhanced survival of NSG mice. TCR transfer to T cells of patients enabled killing of autologous and nonautologous melanoma. ... https://www.nature.com/articles/s41590-019-0578-8 https://www.nature.com/articles/s41590-019-0578-8 What does that second sentence mean?
- acqq 7y ago
  “ Melanoma, also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.[1]” (from Wikipedia) “autologous - adjective - (of cells or tissues) obtained from the same individual.”
- acqq 7y ago
  Also: TCR == T cell receptor Here are some the descriptions of the related methods currently researched: https://www.cancerresearch.org/immunotherapy/treatment-types/adoptive-cell-therapy#tcr https://www.cancerresearch.org/immunotherapy/treatment-types...
aaavl2821 7y ago
this describes a t cell receptor that recognized and killed cells from several cancers while sparing healthy cells theoretically this could may made into a therapy by taking t cells from patients, modifying their DNA to express this receptor, and then readministering the modified t cells to patients there are two FDA approved drugs that use this basic approach. however, this only works currently in "liquid tumors", not "solid tumors" like breast cancer, lung cancer, prostate, etc This article gives a nice, simple explanation as to why solid tumors are more difficult (scroll down to the chart): https://www.the-scientist.com/features/the-next-frontier-of-car-t-cell-therapy--solid-tumors-65612 https://www.the-scientist.com/features/the-next-frontier-of-... if this works, then the first challenge listed in the chart would be mitigated. however the challenges of a suppressive tumor environment and sufficient delivery to tumor cells is still a major unsolved challenge
- aduitsis 7y ago
  One more good article: https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies https://www.newyorker.com/magazine/2019/07/22/the-promise-an... and: https://www.novartis.com/news/media-library/car-t-cell-therapy-infographic https://www.novartis.com/news/media-library/car-t-cell-thera...
SubiculumCode 7y ago
I wonder if this could have anti-aging uses to identify and remove cells dealing with metabolic dysregulation.
- xiphias2 7y ago
  One anti-aging speedup would be that long term safety of HGH therapy would be much less important if cancer would be easy to cure. Peter Thiel started HGH therapy in 2014 because ,,cancer would be cured in 10 years anyways''. It seems to me like his prediction is coming true (maybe we'll need 5 extra years though).
jjgreen 7y ago
Er, wasn't that the plot of I Am Legend, "... three years later ..."
Vysero 7y ago
Why does more testing need to take place? I would be willing to bet the majority of people currently dying of cancer within the next month or so would have zero problems testing it for them. So much bureaucracy. People need help now.
- jessriedel 7y ago
  Vast majority of new cancer treatments do not end up improving survival times and generally come with significant, unpleasant side effects. Of the small minority that are found to be a net benefit, most are just barely worth it: very modest extension of life expectancy with sufficient toxicity that many well-informed patients will nevertheless decline them. This is not just chemo either; immunotherapies can be brutal.
- randcraw 7y ago
  Like most new cancer therapies, this will surely get “expedited” status from the US FDA, which will enable as fast a development as imaginable, like FIM (first in man) within the year. If it delivers on its promise, it will receive initial approval for those with advanced metastases of the initially targeted forms of cancer within a year after that. A major question is the cost of the therapy. If it equals CAR-T, which it closely resembles, it will NOT see rapid adoption until the price per treatment falls below CAR-T's current bill of $500,000 US.
  - NotSammyHagar 7y ago
    Beating 500k/patient seems like an approachable target. When my mom had lung cancer, when it recurred it came so fast there was never any time to think about speculative treatments. Of course you'd pay anything to save your loved one.
- jonstewart 7y ago
  I went from 0-60 on prostate cancer in a few days last year when my dad was diagnosed at stage 4 (he’s much better now). I was surprised to find that getting into clinical trials is not so difficult and they’re well catalogued; as an example, check out https://www.cancer.gov/about-cancer/treatment/clinical-trials https://www.cancer.gov/about-cancer/treatment/clinical-trial.... Generally, it seems that promising therapies advance pretty quickly, and oncologists seem to stay current. So, I don’t think there’s quite the level of bureaucracy as you may suspect. That said, with trials there’s a good chance a patient will wind up in the control group (sad trombone), and a lot of new treatments don’t work all that well, or merely extend survival for a few months in exchange for several side effects. A LOT of trials are also simply studying the efficacy of the combination of known treatments; these trials are safer bets, but they’re also unlikely to provide one with a miracle. With immunotherapies, keep in mind that side effects during treatment can be severe and potentially fatal. Basically, if you have late stage cancer and treatment works, you almost die from the toxic effects of your immune system kicking into overdrive and blowing up all the tumor cells in a few days. There’s a ton of supportive therapy. If a new immunotherapy like the one in TFA showed promise, all the necessary supportive therapy acts as a limiter on rapid scale-up, even with perfect knowledge sharing and patient access.
chefkoch 7y ago
Couldn't one develop BiTEs (Bi-specific T-cell engagers) for this receptor? That would be cheaper and off the shelf for every patient.
ajarmst 7y ago
I thought we learned our lesson about "paradigm-changing" scientific results released to the media simultaneous with initial publication a while back. The paper was published today, and only available behind a pay wall. Yes, this is exciting, but what they appear to have is a better way of tagging cancer cells so the immune system will attack them. This is one round of rodent studies in immunosuppressed mice, for which the abstract only claims "enhanced survival". There is no reflection or information from anyone who isn't actively on the team. This is a press release before a funding cycle, not science. "May treat all cancers?" Please.
- headmelted 7y ago
  This. How many times in the last 10 years have we gone bananas on HN for an immunotherapy wonder drug just to find it’s another casualty of the current unable-to-reproduce crisis in current science? Remember when CD47 monoclonal antibodies from the Stanford trials were going to save millions of lives? What a time to be not yet dead that was. The poster above is correct. Wanting this to be something wonderful doesn’t make it so, and anyone familiar with the subject matter knows this deserves skepticism. This is getting upvoted because it sounds good, not because there’s solid evidence it has legs. I’d love for this to become a high efficacy treatment for millions of people, but we’ve had the same thing play out so many times now that it’s impossible to be excited. This is what usually happens: They’ll try it in the lab, and it’ll kill cancer. They’ll inject it in mice, and it’ll kill cancer. They’ll try it on people, and it’ll reduce the size of their tumors for six-to-eight weeks before they start growing again. I’ll remember to check back in a year to to see if this is even still a thing. * temporarily
  - ammon 7y ago
    Reducing the size of a tumor for six to eight weeks (especially via a new method) could actually be an important result. Many cancer drugs only result in temporary remission when used in isolation, before the cancer out-evolves the drug and comes back. However, using multiple drugs simultaneously (combination chemotherapy) and using the drugs after surgery to kill remnant cells can have a far larger impact. Many of the drugs that can now 'cure' certain cancers in combination only provide brief remission by themselves. (Disclaimer: my only knowledge of this comes from the book The Emperor of All Maladies)
DoreenMichele 7y ago
The upgraded cells would be grown in vast quantities in the laboratory and then put back into the patient. What I would like to see is a world in which doctors and researchers ask "Why isn't your body already making enough of these and what can we do to help it crank them out in sufficient quantities?"
- Nitramp 7y ago
  My understanding is that cancer kills you late enough in your life to has little impact on your ability to reproduce, and thus fitness in the evolutionary sense. https://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/age#heading-Zero https://www.cancerresearchuk.org/health-professional/cancer-... These are deaths / 100'000 people. It's a bit difficult to judge precisely in that resolution, but death by cancer is <1%/year before the age of 40. That was roughly the life expectancy (assuming you made it past childhood, big if), for humans during most of their evolution. So the likely answer is that it never mattered to our body (or survival) to combat cancer effectively.
  - DoreenMichele 7y ago
    Or, alternately, we produce plenty of them normally in our youth so as to keep cancer from getting a good hold and we develop deficiencies that reduce their production as we age and this allows cancer to go from whatever stuff causes it floating around the body randomly to full-blown tumors and the like. Either way, your framing has zero bearing on my point. If they can produce them in quantity in vats for purposes of combatting cancer, why not produce them in quantity in the body? That's my point.
    - Nitramp 7y ago
      > Either way, your framing has zero bearing on my point. If they can produce them in quantity in vats for purposes of combatting cancer, why not produce them in quantity in the body? That's my point. I tried to answer "why are these not naturally produced in quantity by your body". Are you asking why the scientists didn't alter human bodies to artificially produce these cells in quantity inside the body? No idea, but that does sound a lot more difficult/dangerous than producing them in a vat?
msie 7y ago
Neil Peart, David Bowie, Gordon Downie. I’ll know we’ve made significant advances if a celebrity can use his/her status to get cured.
- jonstewart 7y ago
  How’s a former President? https://abcnews.go.com/Health/remarkable-cancer-treatment-helped-jimmy-carter-combat-brain/story?id=37467459 https://abcnews.go.com/Health/remarkable-cancer-treatment-he... (Although there’s no indication his status led to his cure, of course. With immunotherapy, the requisite status seems to be “can become patient of a decent clinic,” not “former leader of the free world” and/or legendary rock god.)
pg_is_a_butt 7y ago
Humanity itself is cancer.
jl2718 7y ago
What is the theory here with MR1? They say it’s a metabolic indicator, but it’s a MHC. Looks to be involved with B3/NAD. Does a cancer cell just run out of NAD so MR1 doesn’t get presented?
- jl2718 7y ago
  Side note: I’ve been self-experimenting with high doses of niacinamide, and experiencing some weird side effects, possibly immune-related, like angular chelitis. Probably unrelated.
  - 1996 7y ago
    Please tell us more. High dose of NMN are supposed to be helping develop some cancers. angular chelitis is totally new to me. Are you on retinoids by any chance?
    - jl2718 7y ago
      I took a lot of cod liver oil once it started, maybe a little bit before too, so I suppose it could be that. I did a lot of research into what would increase NAD levels, and it’s all pretty inconclusive, so I figured niacinamide was as good as any other B3 in the pathway. I later found that it chelates with some minerals, so I may be giving myself a deficiency.
      - 1996 7y ago
        Yes a deficiency is far more likely than an autoimmune disorder
  - dpatrick86 7y ago
    Might be inhibiting sirtuin activity... http://www.jbc.org/content/277/47/45099.short http://www.jbc.org/content/277/47/45099.short
jonplackett 7y ago
It’s not quite a ‘one size fits all’ if you have to take cells and genetically modify them for every patient. Sounds like it would be very expensive. Amazing nevertheless if it really works.
- jonstewart 7y ago
  There’s a similar treatment already, CAR-T. The “one size fits all” aspect here is that this receptor mechanism may possibly work with many common solid tumor types (*in mice), whereas CAR-T’s efficacy is limited with solid tumors, but can be dramatic with leukemias and lymphomas. There’s a related therapy for prostate cancer, Provenge (https://en.m.wikipedia.org/wiki/Sipuleucel-T https://en.m.wikipedia.org/wiki/Sipuleucel-T), but it’s merely a life-extending treatment and not the cure that CAR-T can be.
OrgNet 7y ago
If I need this right now no matter the outcome, what do I need to do?
_wldu 7y ago
A vlogger I follow on Youtube (Mark Carriker) was diagnosed just over a year ago. He's recorded everything. From first diagnosis, surgery, radiation, chemo, immunotherapy, trial drugs and now Hospice. It's heart breaking to see someone go through this. Hopefully, a cure will be found soon. https://www.youtube.com/watch?v=CZ5Sk7x7VwY https://www.youtube.com/watch?v=CZ5Sk7x7VwY
oliverfriedmann 7y ago
I am by no means an expert in this area, but whenever I read a new discovery in medicine that essentially boils down to "by doing this simple adjustment to an already existing complex machinery, this major problem is solved" I can't help but ask myself the question why - if the adjustment is so easy - hasn't this adjustment already successfully appeared in evolution? Why isn't this already in the feature set out of the box? Or the corollary to this: there is probably a major downside to this simple adjustment...
codekansas 7y ago
My girlfriend (who is in medical school) actually brought this up to me when I was talking to her about how it seemed that not only the rate of R&D was increasing, but the time to market was also falling dramatically. It's cool to see these kinds of developments being utilized so much faster
symplee 7y ago
Anyone know how we HN readers can help this effort? Is there some open source scientific community/repository like GitHub? (Where people can pull down the latest data and ideas, and add to them, then push our changes back to the main scientists.)
- jeswin 7y ago
  > Where people can pull down the latest data and ideas, and add to them, then push our changes back to the main scientists. A repository of ideas from non-experts will probably slow down things rather than help them. I'm not dismissing the idea outright; perhaps there's a way structured inputs from patients and caregivers can be helpful (again with some review mechanism so that real researchers don't have to wade through irrelevant data.)
  - symplee 7y ago
    Thanks for the feedback. So maybe the main scientists would host the repository, with their ideas and data. Then we could review and perhaps add to the main scientist's ideas, or find problems with the data. Or add more data with our own experiments. In other words, a collaborative approach. Maybe the main scientists could limit contributions to people who met a certain threshold of earlier verified contributions. Or let other people corroborate and verify before the main scientists even saw the layperson's contributions. Just an idea, open to improvements!
    - GGfpc 7y ago
      The fact is that research at this level results in such specialized knowledge that not a lot of people would be able to contribute. Additionally, the pressure of academia would probably prevent scientists from disclosing publishable results.
    - pc86 7y ago
      How do you feel about opening up your company's git repositories to non-experts? I think an adequate example of the difference in expertise between an average software developer and a cancer researcher means we should probably open up your git repos to a 9 year old. Most of the people in this thread have about as much reason to "share ideas" with cancer researchers as a 9 year old has to share ideas about your line-of-business form-over-data web application.
classified 7y ago
Did they find a cure for Dunning-Kruger syndrome yet?

625 points by sjcsjc 7y ago

This sounds very promising and also sounds like this case just a couple of days ago where a young boy was removed of cancer cells. I'm not sure if it's the same kind of treatment. https://www.channelnewsasia.com/news/singapore/oscar-saxelby-lee-cancer-leukaemia-experimental-treatment-12269276 https://www.channelnewsasia.com/news/singapore/oscar-saxelby...

gus_massa 7y ago

The title says may, but it's a very optimistic title anyway. From the article: > However, the research has been tested only in animals and on cells in the laboratory, and more safety checks would be needed before human trials could start. > Lucia Mori and Gennaro De Libero, from University of Basel in Switzerland, said the research had "great potential" but was at too early a stage to say it would work in all cancers.

pilif 7y ago
Relevant xkcd: https://xkcd.com/1217/ https://xkcd.com/1217/
OJFord 7y ago
The abstract closes: > These findings offer opportunities for HLA-independent, pan-cancer, pan-population immunotherapies. So it hasn't come (to the journalists) from nowhere.

jfk13 7y ago

One key quote: > "At the moment, this is very basic research and not close to actual medicines for patients."

deleted 7y ago
[deleted]
toomuchtodo 7y ago
At the same time, this could make chemo and radiation therapies obsolete long term. Leaches and amputations without anesthetic were once “state of the art”, and it feels like that’s where we’re currently at with cancer therapies. CRISPR is knocking on the door of amazing potential.
- rzzzt 7y ago
  I'm wondering if there's a "Can I use"-kind of summary for proposed cancer treatments available somewhere; presenting the various methods attempted, which kind they target, do they work in vitro, in animal models, are they currently in clinical trial, effectiveness results, link to papers, etc.
  - crystaldev 7y ago
    Can we just get an npm package already?
    - ThalesX 7y ago
      Ugh... have you stopped following the Javascript ecosystem for the last three hours? We use YARN or NPX now. /s
  - deleted 7y ago
    [deleted]
Ajedi32 7y ago
That seems to contradict what the paper's authors have to say on the matter: > Prof Sewell said the ‘right people’ are now interested in developing the potential new therapy and said progress could now move ‘quite fast’. The team says human trials on terminally ill patients could begin as early as November if the new treatment passes further laboratory safety testing. Source: https://www.telegraph.co.uk/science/2020/01/20/immune-cell-kills-cancers-discovered-accident-british-scientists/ https://www.telegraph.co.uk/science/2020/01/20/immune-cell-k... Some level of skepticism is certainly warranted, but it's not impossible that this is way closer to "actual medicines for patients" than you might think.

ramraj07 7y ago

Original article - https://www.nature.com/articles/s41590-019-0578-8 https://www.nature.com/articles/s41590-019-0578-8 Very interesting finding indeed, these T cells seem to (not fully confirmed) target cells with abnormal mrtabolism, which is one of the hallmarks of cancer in general (most cancers at least). This solves one of the biggest problems with immunotherapy, which is that if a cancer is not different from regular tissue in any fundamental way that the immune system cannot recognize, then it can't fight it. This is why melanoma is the poster child of immunotherapies (skin cells get mutated a ton due to UV so skin cancer has a lot of mutations to differentiate it by). If this cell stands further scrutiny, it could potentially be a very general therapy option indeed. Potential caveat is that cancers typically find a way to generate resistance, and markers of abnormal metabolism (at least as detected by this MR1 receptor) night be easy to suppress, in which case this might just become one in a line of multiple treatments. That might still be good enough though.

himinlomax 7y ago
> which is one of the hallmarks of cancer in general (most cancers at least) It may well be the definition factor, at least some people think so: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/ If I remember their argument correctly, cells that "only" reproduce anarchically present little danger (benign tumor) if they don't also do so at an abnormally fast rate / metabolism.
- tialaramex 7y ago
  Most cells stay in the same place, die when told to and don't make more copies. Necessarily some of your cells don't obey one or more of these rules (you wouldn't last long if your blood cells weren't endlessly copied for example or if they stayed in one place). But if all three rules get broken you've got cancer. The cancer I had when I was young, Hodgkin Lymphoma, is one extra rule broken because the lymphatic cells already don't stay in one place and makes extra copies of themselves - which is why it relatively often occurs in young people. One copying error and the "Die when told to" feature breaks in the new copies and now you've got cancer.

rosybox 7y ago

I'm happy for all the progress being made with cancer. I wish we would also make progress on diseases that attack the nervous system for which we seemed to have made next to none. Alzheimer's, ALS, MS, Parkinson's, Hunnington's Disease, Kennedy Disease, Muscular Dystrophy, small fiber neuropathy, even benign issues such as essential tremors have no cure, and some of these are painful death sentences. We seem to know so little about how our bodies work. There are no bio markers for some of these or early detection and little idea what are the causes or the important details of what's happening as the disease progresses.

aaomidi 7y ago
The progress of these are independent from each other.
- pmiller2 7y ago
  Not totally. Those conditions have money and people working on them that could be put to work on cancer and heart disease.
- slimed 7y ago
  Unless society is willing to allocate a larger percentage of GDP towards medical research it really is zero-sum which diseases get funding and which do not.
  - afarrell 7y ago
    Yea, but if Cambridge and Somerville Massachusetts allowed more housing construction, it would be easier for medial research labs to get staff.
pmiller2 7y ago
As a matter of public health, we should really be focusing the vast majority of our efforts on cancer and cardiovascular disease. Odds are that most people will end up dying of one or the other.

alan-crowe 7y ago

Perhaps this discovery could end up going the other way, with those newly discovered T-cells being the culprit in auto-immune diseases. Boosting their action would be too dangerous to use as treatment for cancer, but knowing that they are there may lead to new treatments for auto-immune diseases. And where does this fit into transplant rejection? Perhaps MR-1 differs enough between people to cause problems. This reads like the early days of a discovery that could lead anywhere.

geerlingguy 7y ago
As someone with Crohn's and who knows people with all sorts of similar (maybe?) autoimmune diseases, any nugget of hope for something besides immunosuppressant treatment (meaning our bodies are always welcoming of other infections/sickness) is welcome.
jonlucc 7y ago
Fortunately, the paper shows that this particular treatment doesn't attack normal cells, but it may cause trouble longer term (which is one reason additional safety studies are required before human trials). Also, I'm pretty sure there is already an increase in autoimmune disorders after current immuno-oncology (IO) treatment. Patients should certainly have that information before treatment.

kasperni 7y ago

Some more details at https://www.telegraph.co.uk/science/2020/01/20/immune-cell-kills-cancers-discovered-accident-british-scientists/ https://www.telegraph.co.uk/science/2020/01/20/immune-cell-k... > The team says human trials on terminally ill patients could begin as early as November if the new treatment passes further laboratory safety testing.

cchance 7y ago
This is what I like to hear! People die daily from cancer, treatments like this with promise should be an option even if it's a long shot, the people are about to die anyway, it can only do good, for them or for science.
- 1shooner 7y ago
  I definitely agree making it available is a good thing. However, I'd take exception to 'it can only do good'. I've had a loved one opt for experimental treatment that was ineffective, and made the last months of his life more painful and separated from his family (treatment was in another city). I'm not saying we would choose differently if we were faced with it again, but in some respects I wonder if it was more a service to our peace of mind at having done all we could than it was for his comfort or happiness.
  - derefr 7y ago
    If that treatment didn't exist, your loved one would have opted for some other experimental treatment, no? So the existence of said treatment didn't make their life worse relative to that particular treatment not existing. (Rather, the existence of a class of experimental treatments for a particular cancer that maybe don't work, makes life worse for people, but once there's one, there's no harm in adding more, only potential benefit in at least one of them maybe working.)
  - zeta0134 7y ago
    Mind here that it can also be for the patient's peace of mind. My grandfather was faced with a similar dilemna, terminally ill from pancreatic cancer, with a long-shot to try to cure it. The doctors were wonderfully frank about the potential for failure and "time lost"; even still, he opted to go down fighting. Alas, his liver wasn't strong enough to sustain the treatment, and it just ended up killing him faster. He was a spiritual man and didn't seem regret the decision, but his family had a harder time with it. They were arguing for something closer to hospice, and wanted to take him traveling to enjoy the last months of his life in relative peace. In the end, that didn't get to happen. There will always be a twinge of regret, I think. One can always look back and ask, "what if we had done it this way?" But it was the way he wanted to go, and I think the knowledge that he had tried everything that he could helped him to find peace.

Ericson2314 7y ago

So who has the mutation in their T cells already?

aazaa 7y ago

> The findings, published in Nature Immunology, have not been tested in patients, but the researchers say they have "enormous potential". then later: > However, the research has been tested only in animals and on cells in the laboratory, and more safety checks would be needed before human trials could start. The abstract for the original article notes: > ... An MR1-restricted T cell clone mediated in vivo regression of leukemia and conferred enhanced survival of NSG mice. TCR transfer to T cells of patients enabled killing of autologous and nonautologous melanoma. ... https://www.nature.com/articles/s41590-019-0578-8 https://www.nature.com/articles/s41590-019-0578-8 What does that second sentence mean?

acqq 7y ago
“ Melanoma, also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.[1]” (from Wikipedia) “autologous - adjective - (of cells or tissues) obtained from the same individual.”
acqq 7y ago
Also: TCR == T cell receptor Here are some the descriptions of the related methods currently researched: https://www.cancerresearch.org/immunotherapy/treatment-types/adoptive-cell-therapy#tcr https://www.cancerresearch.org/immunotherapy/treatment-types...

aaavl2821 7y ago

this describes a t cell receptor that recognized and killed cells from several cancers while sparing healthy cells theoretically this could may made into a therapy by taking t cells from patients, modifying their DNA to express this receptor, and then readministering the modified t cells to patients there are two FDA approved drugs that use this basic approach. however, this only works currently in "liquid tumors", not "solid tumors" like breast cancer, lung cancer, prostate, etc This article gives a nice, simple explanation as to why solid tumors are more difficult (scroll down to the chart): https://www.the-scientist.com/features/the-next-frontier-of-car-t-cell-therapy--solid-tumors-65612 https://www.the-scientist.com/features/the-next-frontier-of-... if this works, then the first challenge listed in the chart would be mitigated. however the challenges of a suppressive tumor environment and sufficient delivery to tumor cells is still a major unsolved challenge

aduitsis 7y ago
One more good article: https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies https://www.newyorker.com/magazine/2019/07/22/the-promise-an... and: https://www.novartis.com/news/media-library/car-t-cell-therapy-infographic https://www.novartis.com/news/media-library/car-t-cell-thera...

SubiculumCode 7y ago

I wonder if this could have anti-aging uses to identify and remove cells dealing with metabolic dysregulation.

xiphias2 7y ago
One anti-aging speedup would be that long term safety of HGH therapy would be much less important if cancer would be easy to cure. Peter Thiel started HGH therapy in 2014 because ,,cancer would be cured in 10 years anyways''. It seems to me like his prediction is coming true (maybe we'll need 5 extra years though).

jjgreen 7y ago

Er, wasn't that the plot of I Am Legend, "... three years later ..."

Vysero 7y ago

Why does more testing need to take place? I would be willing to bet the majority of people currently dying of cancer within the next month or so would have zero problems testing it for them. So much bureaucracy. People need help now.

jessriedel 7y ago
Vast majority of new cancer treatments do not end up improving survival times and generally come with significant, unpleasant side effects. Of the small minority that are found to be a net benefit, most are just barely worth it: very modest extension of life expectancy with sufficient toxicity that many well-informed patients will nevertheless decline them. This is not just chemo either; immunotherapies can be brutal.
randcraw 7y ago
Like most new cancer therapies, this will surely get “expedited” status from the US FDA, which will enable as fast a development as imaginable, like FIM (first in man) within the year. If it delivers on its promise, it will receive initial approval for those with advanced metastases of the initially targeted forms of cancer within a year after that. A major question is the cost of the therapy. If it equals CAR-T, which it closely resembles, it will NOT see rapid adoption until the price per treatment falls below CAR-T's current bill of $500,000 US.
- NotSammyHagar 7y ago
  Beating 500k/patient seems like an approachable target. When my mom had lung cancer, when it recurred it came so fast there was never any time to think about speculative treatments. Of course you'd pay anything to save your loved one.
jonstewart 7y ago
I went from 0-60 on prostate cancer in a few days last year when my dad was diagnosed at stage 4 (he’s much better now). I was surprised to find that getting into clinical trials is not so difficult and they’re well catalogued; as an example, check out https://www.cancer.gov/about-cancer/treatment/clinical-trials https://www.cancer.gov/about-cancer/treatment/clinical-trial.... Generally, it seems that promising therapies advance pretty quickly, and oncologists seem to stay current. So, I don’t think there’s quite the level of bureaucracy as you may suspect. That said, with trials there’s a good chance a patient will wind up in the control group (sad trombone), and a lot of new treatments don’t work all that well, or merely extend survival for a few months in exchange for several side effects. A LOT of trials are also simply studying the efficacy of the combination of known treatments; these trials are safer bets, but they’re also unlikely to provide one with a miracle. With immunotherapies, keep in mind that side effects during treatment can be severe and potentially fatal. Basically, if you have late stage cancer and treatment works, you almost die from the toxic effects of your immune system kicking into overdrive and blowing up all the tumor cells in a few days. There’s a ton of supportive therapy. If a new immunotherapy like the one in TFA showed promise, all the necessary supportive therapy acts as a limiter on rapid scale-up, even with perfect knowledge sharing and patient access.

chefkoch 7y ago

Couldn't one develop BiTEs (Bi-specific T-cell engagers) for this receptor? That would be cheaper and off the shelf for every patient.

ajarmst 7y ago

I thought we learned our lesson about "paradigm-changing" scientific results released to the media simultaneous with initial publication a while back. The paper was published today, and only available behind a pay wall. Yes, this is exciting, but what they appear to have is a better way of tagging cancer cells so the immune system will attack them. This is one round of rodent studies in immunosuppressed mice, for which the abstract only claims "enhanced survival". There is no reflection or information from anyone who isn't actively on the team. This is a press release before a funding cycle, not science. "May treat all cancers?" Please.

headmelted 7y ago
This. How many times in the last 10 years have we gone bananas on HN for an immunotherapy wonder drug just to find it’s another casualty of the current unable-to-reproduce crisis in current science? Remember when CD47 monoclonal antibodies from the Stanford trials were going to save millions of lives? What a time to be not yet dead that was. The poster above is correct. Wanting this to be something wonderful doesn’t make it so, and anyone familiar with the subject matter knows this deserves skepticism. This is getting upvoted because it sounds good, not because there’s solid evidence it has legs. I’d love for this to become a high efficacy treatment for millions of people, but we’ve had the same thing play out so many times now that it’s impossible to be excited. This is what usually happens: They’ll try it in the lab, and it’ll kill cancer. They’ll inject it in mice, and it’ll kill cancer. They’ll try it on people, and it’ll reduce the size of their tumors for six-to-eight weeks before they start growing again. I’ll remember to check back in a year to to see if this is even still a thing. * temporarily
- ammon 7y ago
  Reducing the size of a tumor for six to eight weeks (especially via a new method) could actually be an important result. Many cancer drugs only result in temporary remission when used in isolation, before the cancer out-evolves the drug and comes back. However, using multiple drugs simultaneously (combination chemotherapy) and using the drugs after surgery to kill remnant cells can have a far larger impact. Many of the drugs that can now 'cure' certain cancers in combination only provide brief remission by themselves. (Disclaimer: my only knowledge of this comes from the book The Emperor of All Maladies)

DoreenMichele 7y ago

The upgraded cells would be grown in vast quantities in the laboratory and then put back into the patient. What I would like to see is a world in which doctors and researchers ask "Why isn't your body already making enough of these and what can we do to help it crank them out in sufficient quantities?"

Nitramp 7y ago
My understanding is that cancer kills you late enough in your life to has little impact on your ability to reproduce, and thus fitness in the evolutionary sense. https://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/age#heading-Zero https://www.cancerresearchuk.org/health-professional/cancer-... These are deaths / 100'000 people. It's a bit difficult to judge precisely in that resolution, but death by cancer is <1%/year before the age of 40. That was roughly the life expectancy (assuming you made it past childhood, big if), for humans during most of their evolution. So the likely answer is that it never mattered to our body (or survival) to combat cancer effectively.
- DoreenMichele 7y ago
  Or, alternately, we produce plenty of them normally in our youth so as to keep cancer from getting a good hold and we develop deficiencies that reduce their production as we age and this allows cancer to go from whatever stuff causes it floating around the body randomly to full-blown tumors and the like. Either way, your framing has zero bearing on my point. If they can produce them in quantity in vats for purposes of combatting cancer, why not produce them in quantity in the body? That's my point.
  - Nitramp 7y ago
    > Either way, your framing has zero bearing on my point. If they can produce them in quantity in vats for purposes of combatting cancer, why not produce them in quantity in the body? That's my point. I tried to answer "why are these not naturally produced in quantity by your body". Are you asking why the scientists didn't alter human bodies to artificially produce these cells in quantity inside the body? No idea, but that does sound a lot more difficult/dangerous than producing them in a vat?

msie 7y ago

Neil Peart, David Bowie, Gordon Downie. I’ll know we’ve made significant advances if a celebrity can use his/her status to get cured.

jonstewart 7y ago
How’s a former President? https://abcnews.go.com/Health/remarkable-cancer-treatment-helped-jimmy-carter-combat-brain/story?id=37467459 https://abcnews.go.com/Health/remarkable-cancer-treatment-he... (Although there’s no indication his status led to his cure, of course. With immunotherapy, the requisite status seems to be “can become patient of a decent clinic,” not “former leader of the free world” and/or legendary rock god.)

pg_is_a_butt 7y ago

Humanity itself is cancer.

jl2718 7y ago

What is the theory here with MR1? They say it’s a metabolic indicator, but it’s a MHC. Looks to be involved with B3/NAD. Does a cancer cell just run out of NAD so MR1 doesn’t get presented?

jl2718 7y ago
Side note: I’ve been self-experimenting with high doses of niacinamide, and experiencing some weird side effects, possibly immune-related, like angular chelitis. Probably unrelated.
- 1996 7y ago
  Please tell us more. High dose of NMN are supposed to be helping develop some cancers. angular chelitis is totally new to me. Are you on retinoids by any chance?
  - jl2718 7y ago
    I took a lot of cod liver oil once it started, maybe a little bit before too, so I suppose it could be that. I did a lot of research into what would increase NAD levels, and it’s all pretty inconclusive, so I figured niacinamide was as good as any other B3 in the pathway. I later found that it chelates with some minerals, so I may be giving myself a deficiency.
    - 1996 7y ago
      Yes a deficiency is far more likely than an autoimmune disorder
- dpatrick86 7y ago
  Might be inhibiting sirtuin activity... http://www.jbc.org/content/277/47/45099.short http://www.jbc.org/content/277/47/45099.short

jonplackett 7y ago

It’s not quite a ‘one size fits all’ if you have to take cells and genetically modify them for every patient. Sounds like it would be very expensive. Amazing nevertheless if it really works.

jonstewart 7y ago
There’s a similar treatment already, CAR-T. The “one size fits all” aspect here is that this receptor mechanism may possibly work with many common solid tumor types (*in mice), whereas CAR-T’s efficacy is limited with solid tumors, but can be dramatic with leukemias and lymphomas. There’s a related therapy for prostate cancer, Provenge (https://en.m.wikipedia.org/wiki/Sipuleucel-T https://en.m.wikipedia.org/wiki/Sipuleucel-T), but it’s merely a life-extending treatment and not the cure that CAR-T can be.

OrgNet 7y ago

If I need this right now no matter the outcome, what do I need to do?

_wldu 7y ago

A vlogger I follow on Youtube (Mark Carriker) was diagnosed just over a year ago. He's recorded everything. From first diagnosis, surgery, radiation, chemo, immunotherapy, trial drugs and now Hospice. It's heart breaking to see someone go through this. Hopefully, a cure will be found soon. https://www.youtube.com/watch?v=CZ5Sk7x7VwY https://www.youtube.com/watch?v=CZ5Sk7x7VwY

oliverfriedmann 7y ago

I am by no means an expert in this area, but whenever I read a new discovery in medicine that essentially boils down to "by doing this simple adjustment to an already existing complex machinery, this major problem is solved" I can't help but ask myself the question why - if the adjustment is so easy - hasn't this adjustment already successfully appeared in evolution? Why isn't this already in the feature set out of the box? Or the corollary to this: there is probably a major downside to this simple adjustment...

codekansas 7y ago

My girlfriend (who is in medical school) actually brought this up to me when I was talking to her about how it seemed that not only the rate of R&D was increasing, but the time to market was also falling dramatically. It's cool to see these kinds of developments being utilized so much faster

symplee 7y ago

Anyone know how we HN readers can help this effort? Is there some open source scientific community/repository like GitHub? (Where people can pull down the latest data and ideas, and add to them, then push our changes back to the main scientists.)

jeswin 7y ago
> Where people can pull down the latest data and ideas, and add to them, then push our changes back to the main scientists. A repository of ideas from non-experts will probably slow down things rather than help them. I'm not dismissing the idea outright; perhaps there's a way structured inputs from patients and caregivers can be helpful (again with some review mechanism so that real researchers don't have to wade through irrelevant data.)
- symplee 7y ago
  Thanks for the feedback. So maybe the main scientists would host the repository, with their ideas and data. Then we could review and perhaps add to the main scientist's ideas, or find problems with the data. Or add more data with our own experiments. In other words, a collaborative approach. Maybe the main scientists could limit contributions to people who met a certain threshold of earlier verified contributions. Or let other people corroborate and verify before the main scientists even saw the layperson's contributions. Just an idea, open to improvements!
  - GGfpc 7y ago
    The fact is that research at this level results in such specialized knowledge that not a lot of people would be able to contribute. Additionally, the pressure of academia would probably prevent scientists from disclosing publishable results.
  - pc86 7y ago
    How do you feel about opening up your company's git repositories to non-experts? I think an adequate example of the difference in expertise between an average software developer and a cancer researcher means we should probably open up your git repos to a 9 year old. Most of the people in this thread have about as much reason to "share ideas" with cancer researchers as a 9 year old has to share ideas about your line-of-business form-over-data web application.

classified 7y ago

Did they find a cure for Dunning-Kruger syndrome yet?