6 ms·

Cancer Vaccine, tailor-made for each patient, advances to Stage 1 clinical trial

230 points by checoivan 15y ago

cperciva 15y ago
Remember, stage 1 clinical trials are just "does this treatment accidentally kill people" trials. They're a long way off from testing to see if the treatment actually works.
- scotty79 15y ago
  Nobel laureate Ralph Steinman had some of this kind of vaccines tested on himself when he got pancreatic tumor. He lived unusually long for this kind of tumor and died of pneumonia. There's piece about his fight in recent Scientific American. http://www.scientificamerican.com/article.cfm?id=the-patient-scientist http://www.scientificamerican.com/article.cfm?id=the-patient...
  - tibbon 15y ago
    Right, but that's the thing... some of these drugs might work for some and kill other people unexpectedly. The efficacy for one person doesn't mean that it wouldn't kill every other person that takes it, and looking at a sample size of 1 (nobel laureate or not) doesn't make for good science or good medicine.
    - beedogs 15y ago
      Some people who have exhausted all other treatment options might opt for it even then, though. At least they can.
    - Dn_Ab 15y ago
      This is exactly why personalized medicine, bioinformatics, computational pharmacokinetics, etc is key for the future of medicine. I am not a biologist but I imagine someday soon a scenario like this will be possible: You have a model of the sites and interactions the drug targets, and optimum biology - metabolism, target cells' proteomes etc. Measure these in the patient and you can predict ahead of time the efficacy of the drug and then optimize the drug's chemistry to be more effective for this individual. With a better understanding of protein modelling and such you could do a search for similar structures and compute the expected interactions and optimize for personalized effectiveness.
- betterth 15y ago
  While generally speaking, yes, you are totally correct, you have to remember one thing: the FDA has provisions for terminally ill patients to utilize unapproved medicines in highly restricted scenarios. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ClinicalTrials/compassionate-drug-use http://www.cancer.org/Treatment/TreatmentsandSideEffects/Cli...
scotty79 15y ago
My life partner has grade III brain tumor. Recently diagnosed and operated. She took surgery well. Apart from slightly higher chance of mispronunciation she feels as good as ever. It's interesting that you can live unchanged without the part of your brain. Her brain had time to adjust while her tumor was growing. She'll be starting irradiation and chemo next month. I really hope this vaccine will be available and effective when her tumor grows back.
DanielBMarkham 15y ago
Disclaimer: I am not an expert and basically just some random internet person. I've read several recently-published books on cancer, including "The Emperor of all Maladies," (http://amzn.to/xr2Mx1 http://amzn.to/xr2Mx1) which I highly recommend. We keep thinking we have a lock on curing cancer, but it continues to be very elusive. As I understand it, using automation to "debug" individual cancers is scalable. That is, reading a cancer, adapting to it, and creating a vaccine is something that can be done with increasing levels of detail as automation increases. So if they only show a 1% improvement, it's a strategy definitely worth continuing. This is very much like the hacker who keeps playing around with a broken method until it works -- only it's all automated. It very well may be that we "learn" how to contain/control many cancers without having a traditional understanding of them at all. Fascinating approach, and much different from previous forays. Watch this space. Given the history, my money says it's still going to be a long, hard slog -- perhaps decades, but still, a promising approach.
- loceng 15y ago
  I would hope we eventually start to put money towards prevention to reduce cancer to begin with. Prevention will always be less cost and less suffering.
  - darkmethod 15y ago
    Roswell Park employees also man the phones for the NYS Smokers Quitline. http://www.nysmokefree.com/ http://www.nysmokefree.com/ An ounce of prevention is worth a pound of cure.
  - freehunter 15y ago
    Trouble is, preventing cancer is hard when we don't even know what causes cancer. Obviously smoking is a big one and people have been working hard to great success to eliminate it. How about cooked vegetables? Raw vegetables? Processed sugar? Burnt pieces of meat? Cell phones/wifi? Sunlight? Artificial light? The reason it seems like everything causes cancer is because everyone is at risk for cancer. Living is a cancer risk. A lot of people don't die from cancer because they don't live long enough, but prevention will never happen. Cancer is inevitable.
abtinf 15y ago
Stage 1 clinical trials take healthy individuals, give them the drug, and wait to see if it kills them. To go from stage 1, through stage 2 (which determines effectiveness), through stage 3 (which determines safety for general distribution) takes 10-15 years. In other words, this is not news. There are probably hundreds of similar clinical trials every year.
- Gatsky 15y ago
  Not quite. Phase I trials often happen in patients with the disease, because otherwise the data you get on toxicity aren't that relevant. Definitive efficacy is established in a phase III trial, along with safety. en.wikipedia.org/wiki/Phases_of_clinical_research This trial is news-worthy for a few reasons. One is that the only documented cases of cure of a disseminated cancer are proabably all due to an immune-mediated attack (exceptions are lymphomas and testicular cancers which can be cured with chemotherapy even if widespread). Vaccines are trying to exploit this mechanism. Another reason is that most of the treatments we use in phase I trials are poorly understood. The treatment employed in this study however utilises a pretty simple and elegant approach - find something that only cancer cells have, then try and bait the immune system with it.
- uptown 15y ago
  "The purpose of this study is to test the safety of a treatment called DC205 NY ESO 1 vaccine, given with and without sirolimus, and to see what effects (good or bad) it has on you and your type of cancer." http://www.roswellpark.org/clinical-trials/list/191511 http://www.roswellpark.org/clinical-trials/list/191511
bedris 15y ago
There is already an FDA-approved therapeutic cancer vaccine that is sold by Dendreon for the treatment of prostate cancer (Provenge). Like this Roswell Park therapy linked to, Provenge also harnesses dendritic cells. More info on Provenge: http://en.wikipedia.org/wiki/Sipuleucel-T http://en.wikipedia.org/wiki/Sipuleucel-T
darkmethod 15y ago
I'm proud to say that I work at Roswell Park. I'm one of five web developers in the IT dept. I write internal applications focused on supporting the many clinical trials happening here. There is definitely a huge buzz going through Roswell's campus regarding this. Here is the publicly available information regarding this particular Phase I study. http://www.roswellpark.org/clinical-trials/list/191511 http://www.roswellpark.org/clinical-trials/list/191511
- tomkin 15y ago
  As a near-border neighbour in Hamilton, it's great to see Roswell Park and Buffalo get some much deserved attention on the biomed front.
  - darkmethod 15y ago
    Agreed. Some great things are happening in Buffalo/Roswell, this is just one of the more vocal discoveries worthy of attention. I truly hope this trial continues on successfully as the PIs (principal investigators) envision. On a personal note, I find it mildly entertaining to say that "I code to cure cancer". It is an honor to support incredibly smart people working to eradicate such a horrible array of diseases.
- daviddaviddavid 15y ago
  I'm curious, how do you like working there? I'm a programmer in Buffalo, NY. I always check Roswell's "Available Careers" and they always have to same two Programmer Analyst postings. Do you have a chance to use cool technologies there? The postings mention JSP/VB/blah. I'd love to send in a resume to support meaningful work.
  - darkmethod 15y ago
    I've been at Roswell nine years. I intend to retire from here. I'm also a Buffalo native and I can't think of anywhere else in the city I'd rather work. Roswell is run similarly to a college campus (I've had previous experience supporting NY State colleges), meaning there are many departments, each run fairly independently of each other and each with different technical needs. The departments usually fall in one of three categories: there is an educational group that works with UB's medical campus, a clinical component that treats patients, and obviously a heavy research component. During my time here, there have been at least four startups/companies that have formed as a result of research I've helped support. Roswell currently has about 3,300+ employees. The Programmer/Analyst positions you have seen are an attempt to fill needed positions in various departments. Everyone's version of "cool technologies" is different. I'm of the opinion, for the most part, whatever gets the job done thoroughly and accurately works. In the past nine years I've written and maintain about 20+ applications in VBscript, C#, Actionscript, PHP, Ruby, etc with the various associated frameworks. Since every department requires something slightly different I've had to adapt as needed. However, recently we've been running with an inhouse PHP framework called Surebert which was/is written by a co-worker. http://www.surebert.com http://www.surebert.com https://github.com/surebert https://github.com/surebert Interestingly enough for me, I've never written anything professionally in Java, but a lot of my co-workers have. Out of the five of us on the web team, I'm the Apple fanboy. So I'm on a MacBook, iPhone, etc. Another one is on Fedora, another is using a Dell (ugh). To each their own. And Roswell lets me moonlight on the side. I've had fairly steady freelancing gigs for a couple years now. Interesting place to work. Good people. Very little complaints (nothing's perfect).
thetrendycyborg 15y ago
Soon, everyone can smoke without worry.
splicer 15y ago
Two words: zombie apocalypse

230 points by checoivan 15y ago

Remember, stage 1 clinical trials are just "does this treatment accidentally kill people" trials. They're a long way off from testing to see if the treatment actually works.

scotty79 15y ago
Nobel laureate Ralph Steinman had some of this kind of vaccines tested on himself when he got pancreatic tumor. He lived unusually long for this kind of tumor and died of pneumonia. There's piece about his fight in recent Scientific American. http://www.scientificamerican.com/article.cfm?id=the-patient-scientist http://www.scientificamerican.com/article.cfm?id=the-patient...
- tibbon 15y ago
  Right, but that's the thing... some of these drugs might work for some and kill other people unexpectedly. The efficacy for one person doesn't mean that it wouldn't kill every other person that takes it, and looking at a sample size of 1 (nobel laureate or not) doesn't make for good science or good medicine.
  - beedogs 15y ago
    Some people who have exhausted all other treatment options might opt for it even then, though. At least they can.
  - Dn_Ab 15y ago
    This is exactly why personalized medicine, bioinformatics, computational pharmacokinetics, etc is key for the future of medicine. I am not a biologist but I imagine someday soon a scenario like this will be possible: You have a model of the sites and interactions the drug targets, and optimum biology - metabolism, target cells' proteomes etc. Measure these in the patient and you can predict ahead of time the efficacy of the drug and then optimize the drug's chemistry to be more effective for this individual. With a better understanding of protein modelling and such you could do a search for similar structures and compute the expected interactions and optimize for personalized effectiveness.
betterth 15y ago
While generally speaking, yes, you are totally correct, you have to remember one thing: the FDA has provisions for terminally ill patients to utilize unapproved medicines in highly restricted scenarios. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ClinicalTrials/compassionate-drug-use http://www.cancer.org/Treatment/TreatmentsandSideEffects/Cli...

scotty79 15y ago

My life partner has grade III brain tumor. Recently diagnosed and operated. She took surgery well. Apart from slightly higher chance of mispronunciation she feels as good as ever. It's interesting that you can live unchanged without the part of your brain. Her brain had time to adjust while her tumor was growing. She'll be starting irradiation and chemo next month. I really hope this vaccine will be available and effective when her tumor grows back.

DanielBMarkham 15y ago

Disclaimer: I am not an expert and basically just some random internet person. I've read several recently-published books on cancer, including "The Emperor of all Maladies," (http://amzn.to/xr2Mx1 http://amzn.to/xr2Mx1) which I highly recommend. We keep thinking we have a lock on curing cancer, but it continues to be very elusive. As I understand it, using automation to "debug" individual cancers is scalable. That is, reading a cancer, adapting to it, and creating a vaccine is something that can be done with increasing levels of detail as automation increases. So if they only show a 1% improvement, it's a strategy definitely worth continuing. This is very much like the hacker who keeps playing around with a broken method until it works -- only it's all automated. It very well may be that we "learn" how to contain/control many cancers without having a traditional understanding of them at all. Fascinating approach, and much different from previous forays. Watch this space. Given the history, my money says it's still going to be a long, hard slog -- perhaps decades, but still, a promising approach.

loceng 15y ago
I would hope we eventually start to put money towards prevention to reduce cancer to begin with. Prevention will always be less cost and less suffering.
- darkmethod 15y ago
  Roswell Park employees also man the phones for the NYS Smokers Quitline. http://www.nysmokefree.com/ http://www.nysmokefree.com/ An ounce of prevention is worth a pound of cure.
- freehunter 15y ago
  Trouble is, preventing cancer is hard when we don't even know what causes cancer. Obviously smoking is a big one and people have been working hard to great success to eliminate it. How about cooked vegetables? Raw vegetables? Processed sugar? Burnt pieces of meat? Cell phones/wifi? Sunlight? Artificial light? The reason it seems like everything causes cancer is because everyone is at risk for cancer. Living is a cancer risk. A lot of people don't die from cancer because they don't live long enough, but prevention will never happen. Cancer is inevitable.

abtinf 15y ago

Stage 1 clinical trials take healthy individuals, give them the drug, and wait to see if it kills them. To go from stage 1, through stage 2 (which determines effectiveness), through stage 3 (which determines safety for general distribution) takes 10-15 years. In other words, this is not news. There are probably hundreds of similar clinical trials every year.

Gatsky 15y ago
Not quite. Phase I trials often happen in patients with the disease, because otherwise the data you get on toxicity aren't that relevant. Definitive efficacy is established in a phase III trial, along with safety. en.wikipedia.org/wiki/Phases_of_clinical_research This trial is news-worthy for a few reasons. One is that the only documented cases of cure of a disseminated cancer are proabably all due to an immune-mediated attack (exceptions are lymphomas and testicular cancers which can be cured with chemotherapy even if widespread). Vaccines are trying to exploit this mechanism. Another reason is that most of the treatments we use in phase I trials are poorly understood. The treatment employed in this study however utilises a pretty simple and elegant approach - find something that only cancer cells have, then try and bait the immune system with it.
uptown 15y ago
"The purpose of this study is to test the safety of a treatment called DC205 NY ESO 1 vaccine, given with and without sirolimus, and to see what effects (good or bad) it has on you and your type of cancer." http://www.roswellpark.org/clinical-trials/list/191511 http://www.roswellpark.org/clinical-trials/list/191511

bedris 15y ago

There is already an FDA-approved therapeutic cancer vaccine that is sold by Dendreon for the treatment of prostate cancer (Provenge). Like this Roswell Park therapy linked to, Provenge also harnesses dendritic cells. More info on Provenge: http://en.wikipedia.org/wiki/Sipuleucel-T http://en.wikipedia.org/wiki/Sipuleucel-T

darkmethod 15y ago

I'm proud to say that I work at Roswell Park. I'm one of five web developers in the IT dept. I write internal applications focused on supporting the many clinical trials happening here. There is definitely a huge buzz going through Roswell's campus regarding this. Here is the publicly available information regarding this particular Phase I study. http://www.roswellpark.org/clinical-trials/list/191511 http://www.roswellpark.org/clinical-trials/list/191511

tomkin 15y ago
As a near-border neighbour in Hamilton, it's great to see Roswell Park and Buffalo get some much deserved attention on the biomed front.
- darkmethod 15y ago
  Agreed. Some great things are happening in Buffalo/Roswell, this is just one of the more vocal discoveries worthy of attention. I truly hope this trial continues on successfully as the PIs (principal investigators) envision. On a personal note, I find it mildly entertaining to say that "I code to cure cancer". It is an honor to support incredibly smart people working to eradicate such a horrible array of diseases.
daviddaviddavid 15y ago
I'm curious, how do you like working there? I'm a programmer in Buffalo, NY. I always check Roswell's "Available Careers" and they always have to same two Programmer Analyst postings. Do you have a chance to use cool technologies there? The postings mention JSP/VB/blah. I'd love to send in a resume to support meaningful work.
- darkmethod 15y ago
  I've been at Roswell nine years. I intend to retire from here. I'm also a Buffalo native and I can't think of anywhere else in the city I'd rather work. Roswell is run similarly to a college campus (I've had previous experience supporting NY State colleges), meaning there are many departments, each run fairly independently of each other and each with different technical needs. The departments usually fall in one of three categories: there is an educational group that works with UB's medical campus, a clinical component that treats patients, and obviously a heavy research component. During my time here, there have been at least four startups/companies that have formed as a result of research I've helped support. Roswell currently has about 3,300+ employees. The Programmer/Analyst positions you have seen are an attempt to fill needed positions in various departments. Everyone's version of "cool technologies" is different. I'm of the opinion, for the most part, whatever gets the job done thoroughly and accurately works. In the past nine years I've written and maintain about 20+ applications in VBscript, C#, Actionscript, PHP, Ruby, etc with the various associated frameworks. Since every department requires something slightly different I've had to adapt as needed. However, recently we've been running with an inhouse PHP framework called Surebert which was/is written by a co-worker. http://www.surebert.com http://www.surebert.com https://github.com/surebert https://github.com/surebert Interestingly enough for me, I've never written anything professionally in Java, but a lot of my co-workers have. Out of the five of us on the web team, I'm the Apple fanboy. So I'm on a MacBook, iPhone, etc. Another one is on Fedora, another is using a Dell (ugh). To each their own. And Roswell lets me moonlight on the side. I've had fairly steady freelancing gigs for a couple years now. Interesting place to work. Good people. Very little complaints (nothing's perfect).

thetrendycyborg 15y ago

Soon, everyone can smoke without worry.

splicer 15y ago

Two words: zombie apocalypse