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CRISPR cancer trial success paves the way for personalized treatments
- chasb 4y agoMy 27 year old sister got CAR-T for leukemia earlier this year after a failed stem cell transplant. She's in remission. It's incredible, literally curing cancer.
- znpy 4y agoI’m happy for you, best of luck to your sister.
- gleenn 4y agoIf you don't mind me asking, how was her pain for the 30-days after period? Another poster said they were extremely lucky to only have suffered a few fevers but some people were in a coma.
- teaearlgraycold 4y agoHad no idea we were at this point. But I’m so glad! Hope your sister lives to be 100.
- dis-sys 4y agoIncredible, hope your sister's remission to be a complete & permanent one. Literally curing cancer, just incredible.
- jmacd 4y agoMy friend's 68 year old mother also had it (after being quite sure she was facing a fairly rapid death after other treatments failed). She's pretty much back to normal. I might say better than before as she now takes her overall health much more seriously. Amazing.
- candiddevmike 4y agoHow does this compare to mRNA treatments for cancer?
- deleted 4y ago[deleted]
- _joel 4y agoThey're both in vary nascent stages in terms of having a comparable dataset in my layman's understanding. Both look extremely promising, some may be better suited to different classes so that's what larger studies will hopefully help detail.
- dsign 4y agoDespite what the article says, this can't be more complicated than producing 5 nm process chips. It's just less funded.
- dekhn 4y agoMaking safe and effective medicines is a lot harder than modern chip production because the subject is humans and we have to do medicine ethically. The pharmaceutical industry predates chiptech by quite some time, represents a fairly large market, the companies are quite technological, but the underlying problems are very different from making chips. And if trials like this succeed, that area of biotech will see billions in funding. It's not funded as much as chips but it's also a smaller overall market.
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- ethbr0 4y ago> this can't be more complicated than producing 5 nm process chips Chips don't randomly decide to unmake themselves: there's no active, living system you're interacting with. The other thing that makes biology so confounding is its diversity. E.g. something that works without side effect for 100,000 people will kill 1 of them, because they were in some way different than the others.
- bpodgursky 4y agoThe regulation and risk-aversion is far more impactful than the funding. It's not entirely unwarranted regulation, but fundamentally Intel can mess up 20 batches of 5nm chips before getting it right, and nobody cares. If a CRISPR trial kills someone, it's a BIG DEAL, and could potentially set the field back by years.
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- loeg 4y agoYou think the cancer / biotech industry is less funded than 5 nm nodes?
- bragr 4y agoIs the end state of this to eventually modify people's bone marrow to produce modified T cells, or do they envision treating people with infusions of modified T cells? On one hand, permanently modifying people's immune systems seams fraught with challenges. On the other, a steady supply of cancer killing T cells sounds like a strong protection against recurrence.
- pishpash 4y agoThe end state might be a little machine inside that does all of it without specific treatment, i.e. an enhanced immune system that knows what "cancer" is.
- airstrike 4y agoThe end end state is a bigger machine that replaces everything except the brain, i.e. an enhanced body that knows that "metabolism" is
- HPMOR 4y agoThe real end state is having an instance of our consciousness across a distributed system of servers that is provably impossible to error.
- UltraViolence 4y ago
- 127 4y agoMoney is just a form of accounting for value creation. Should people stop creating value to each other? I do not think so. People who only want to extract value of course do not want any credible accounting because then they would lose.
- TulliusCicero 4y agoUsername doesn't check out. But seriously, not only is that probably enormously harder, you realize companies would still make money off of that treatment, right?
- UltraViolence 4y agoNot exactly. You can't patent repairing something that's broken because it's a trivial invention. But hell, who knows. Maybe with today's fucked up patent system you can.
- yitr 4y ago
- OJFord 4y agoWhy is one approach more linked to '[making] money from it' than the other?
- timy2shoes 4y ago> We should stop treating cancer as foreign tissue that needs to be killed, destroyed or eliminated. ....but that's how t-cells work.
- RichEO 4y agoI don’t think I follow how your first sentence ties into the rest of your comment. Could you elaborate?
- ethbr0 4y agoThis pulls together so many advancements that it would make a 90s oncologist cry. 1) Being able to rapidly sequence the genomes of cancer cells to detect common mutations 2) Computationally simulating those mutations to look for viable T-cell targets 3) Custom building T-cell receptor proteins [0] capable of recognizing those targets 4) Inserting those custom receptor proteins into the patients' own T-cells with CRISPR Truly, we're living in the days of future medicine... [0] https://en.m.wikipedia.org/wiki/T-cell_receptor https://en.m.wikipedia.org/wiki/T-cell_receptor
- chasil 4y agoI might not understand it correctly, but the t4 helper cells don't directly work on antigens/pathogens. They do stimulate macrophages, and activate b-cells. This from some cartoons, and the associated book by Detmer, Immune.
- ethbr0 4y agoOnly tangentially my field, but both cytotoxic and helper T-cells bind on antigens, and indeed this work CRISPR edited anything with a TCR to their (3) preferred, cancer-targeting receptors (for each patient). The press release has a few more details (in addition to the Nature paper): https://pactpharma.com/news/pact-pharma-reports-data-from-first-clinical-study-using-crispr-to-substitute-a-gene-in-patients-immune-cells-to-treat-cancer/ https://pactpharma.com/news/pact-pharma-reports-data-from-fi...
- dm319 4y agoYour CD4 T cells are basically the directors of your immune system. They license CD8 T cells (T killer cells), B cells and recruit NK and immune cells to sites. The type thought to be most anti-cancer are the Th1, which recruit CD8 T cells and NKs, and are optimised for intracellular pathogens. Cancer can be thought of as an intracellular pathogen because it harbors mutations.
- ramraj07 4y agoIt’s good progress but I want to say it’s still not a magical cure - the fundamental idea is flawed - the tumor can and likely will in many patients just mutate the immunogenic epitope.
- borissk 4y agoThis is very good news for the wealthy, not so much for the average Joe - it will take a lot of time for this treatment to become cheap enough to be used at scale.
- culopatin 4y agoIt’s still good news for average joe because at least there is something to look forward to.
- danuker 4y agoReminds me of this story: https://spellbinders.org/the-smell-of-baking-bread/ https://spellbinders.org/the-smell-of-baking-bread/ The smell of bread in this story is the knowledge that treatment exists.
- vtail 4y agoOn the contrary, it’s a very, very good news for an average Joe. Every sufficiently advanced technology starts very expensive. Then capitalism and progress do their job, and it becomes available for masses. The path to “make it cheaper” is generally easier than the path to “make it possible”.
- marricks 4y ago
- dumbmrblah 4y agoMD and I work in the field. The technology is called CAR-T, as the article mentioned. It’s been used pretty widely for “liquid” tumors for a while (eg leukemia, lymphoma, and multiple myeloma),but solid tumors are particularly difficult to target using current CAR-T therapy. If this CRISPR tech can be applied widespread to solid tumors that opens up a huge swath of patients that can be treated. However cost and logistics are a huge factor. CAR-T therapy currently cost about $300,000-$500,000 to treat a patient. Beyond the cost of the immunotherapy you require a huge institutional investment because there are characteristic side effects that occur within the first 30 days of treatment which necessitates patients to be either admitted to the hospital for 30 days or stay in close proximity with daily check-ins (yes the cancer is getting treated BUT now your immune system is hyperactive which can be very dangerous in the short term). Very few academic hospitals, let alone community hospitals, have this bandwidth which will lead to cancer care being concentrated in a handful of a few very large cancer specific institutions.
- jojobas 4y agoDoes that $300,000-$500,000 go mainly to super-highly qualified labour, expensive materials or rare machine time? Still more or less on par with a few rounds of chemo.
- dumbmrblah 4y agoGood question and I should have been more clear. The drug itself is $300,000-$500,000. It’s crazy expensive, but it’s not like a hedge fund patenting 100 year old insulin or something, it’s a bespoke medication. I still think they are price gouging however. The medical care would likely add another $500,000. https://ashpublications.org/ashclinicalnews/news/3469/CAR-T-Cell-Therapies-Predicted-to-Cost-More-Than-1 https://ashpublications.org/ashclinicalnews/news/3469/CAR-T-... All in about $1,000,000 per patient. There were some drama in England about NICE not willing to put the medication on NHS formulary because of the sheer expense. Is it better to treat 1000 diabetics or one cancer patient? https://www.biopharma-reporter.com/Article/2018/09/21/Novartis-disappointed-and-surprised-by-NICE-CAR-T-call https://www.biopharma-reporter.com/Article/2018/09/21/Novart... They ultimately approved it.
- sniperjoe360 4y ago"Five patients had stable disease, and the other 11 had disease progression as best response on therapy" great science, but disappointing clinical results
- awillen 4y ago> Although the efficacy of the treatment was low, the researchers used relatively small doses of T cells to establish the safety of the approach, says Ribas. “We just need to hit it stronger the next time,” he says.
- _joel 4y agoThey did a low dose as this is new technology, the next round will have a higher count, so hopefully we'll see greater efficacy.
- joshxyz 4y agoshit man i pray to fucking god for better resutls
- TaupeRanger 4y agoThey weren't trying to get results, only giving a low dose to verify acceptable side effects. Wait for the larger doses to render judgement on clinical results of the treatment modality itself.
- sniperjoe360 4y agoI completely agree with you. If there was even one response I would be much more optimistic. Since there is no clinical signal this is at best a proof of concept and safety.
- deleted 4y ago[deleted]
- 29_29 4y agoMy mom has a very serious type of Breast Cancer, Triple Negative, so this news is very encouraging. She's undergoing immunotherapy - but this looks even more promising. Thanks for posting.
- daniloalmeida 4y agoyay. I read the headline in order to be elated. Now I'll read the article to get carefully optimistic and then I'll visit the HN comment section to come crashing down.
- lost_tourist 4y agoNah just a reality check. This will only work for very rich people. However as they learn more and costs come down it can trickle down to us plebes :)
- thret 4y agoI read an article (or watched an interview) a few years ago, where they were saying that because cancer is unique to the individual, to truly cure cancer you would have to target each cancer individually. Hence CRISPR. But they also warned that this kind of control could also be used to target individuals or groups of individuals. The example they gave of what could theoretically be possible was 'making women of a certain racial group hyper sensitive to sunlight'. Was this hyperbole? I can't find any references to it today.
- piyushpr134 4y agoAs per the article, calling this a "success" is a little over the top. Out of 16 patients, it stopped progression of tumour in 5 had stopped but it doesn't say it decreased. Moreover for 2, it had adverse reactions when admittedly the dosage was low. I won't call that a success. IT is a good start and promising result. "Success" would mean at least 50% patients REDUCED the tumour. So let us not hold our breath yet
- timbit42 4y agoWhile removing the cancer cells would be preferable, killing them all so they no longer replicate means the patient will not die from that cancer.
- dm319 4y agoI'm a haematologist who is involved with patients who have CAR-T (I don't do it myself, but do other types of transplant and I look after the patients before and after) and my research area is in the way T cells target cancer. This study isn't CAR-T. It is more similar to adoptive TIL therapy because it is using the T cell receptor (TCR) to target the cancer's mutations. This has a huge advantage over CAR-T. At the moment we use CAR-T to target, mostly, B cell cancers. These cancers have CD19 and CD20 on their cell surface, as do most B cells. We can safely target these cells because it turns out your B cells aren't critical for life. Think of it like an amputation. Your B cells went rogue, you wipe them out. The problem is this doesn't translate to other cancers, which don't have an obvious cell protein you can target specific to a group of cells you can do without. All cancer cells have mutations, and all cells in the human body have to display a sample of its proteins on its cell surface. This way our immune system regularly identifies cancer and removes it. Cancers that get established have somehow leveraged local immunosuppression to hold off the immune system, and so the immune system and cancer become a stalemate, or worse the cancer takes off and kills the person. If we can target the mutations of the cancer, then we can get at the heart of the cancer itself. You might ask why the cancer just doesn't display it's antigens on the surface. If a cell does this it gets removed by NK cells (natural killers) - our body's fail safe. What I find interesting is that I didn't think we were close to predicting what TCRs can bind to to a peptide on MHC on the cell surface. I'm going to need to look at the article to findout how they did this. I suspect they used a library of known TCR-antigen interactions.
- readittwice 4y agoSince there are people here that seem to know a bit about this stuff, I will take the chance to ask some naive questions ;) Do I have this right that CAR T-cells have this engineered B-cell/antibody like receptor that recognizes antigens only on the cell membrane. While the regular T-cell receptor can look into cells as well? And that's why the T-cell receptor is potentially better at recognizing solid cancers? So cancers usually create this immunosuppresive environment, wouldn't this stop this engineered T-cells as well?
- dm319 4y ago
- roschdal 4y agoCure for cancer, nice.
- ck2 4y agoRandom but CRISPR babies are going to sweep the Olympics in 2040 China and Russia have to be fiddling with it at this point and it will either be completely undetectable or un-bannable in competition by then.
- timbit42 4y agoIt won't be undetectable. If the changes are something no one else on earth has, it will show up. If the changes are something other people have, it will still show up when comparing with their parent's DNA.
- midoridensha 4y agoWhat if the "changes" are simply optimizing someone's genetics? i.e., eliminating /fixing any genes that are bad mutations, so you get the best possible combination of genes from the parents? Or, suppose someone really does have a beneficial mutation that naturally occurred, and isn't the product of genetic engineering. Are you going to disqualify them because neither of their parents had the mutation?
- deleted 4y ago[deleted]
- yieldcrv 4y agoI love that this form of reproducible science converges with the goals and beliefs of holistic practitioners which relies on non-reproducible methods Maybe the latter will go away once we have holistic/personalized solutions via CRISPR
- 6stringmerc 4y agoToo bad the Baby Boomers spent all their money and won’t have enough to enjoy these new innovations. Blood letting in the poor house for you buster!
- khnov 4y agoMy father has cancer on stage 4, he probably will die soon, can anyone help me try this on his case ?