Friday December 15, 2017

Immunotherapy : Allison’s Trials

Among other honors, Jim Allison was a 2015 recipient of the prestigious Lasker Award for his achievements in medical science

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Doctors performing Operation Image Source: Wikimedia Commons
  • If the immune system was tweaked just right, it could do a better job of killing the cancer than the usual treatments.
  • Allison tried to persuade drug makers to create a human version of the treatment that had worked in mice.
  • Immunotherapy has transformed the way doctors think about cancer treatment.

Sharon Belvin’s nightmare with cancer began in 2004, when she was just 22.

Belvin was an avid runner but said she suddenly found she couldn’t climb the stairs without “a lot of difficulty breathing.”

Eventually, after months of fruitless treatments for lung ailments like bronchitis, she was diagnosed with melanoma — a very serious skin cancer. It had already spread to her lungs, and the prognosis was grim. She had about a 50-50 chance of surviving the next six months.

“Yeah, that was the turning point of life, right there,” she says.

What Belvin didn’t know at the time was that a revolutionary treatment for melanoma had begun testing in clinical trials. An immunologist named Jim Allison, now at the University of Texas MD Anderson Cancer Center, had figured out that if the immune system was tweaked just right, it could do a better job of killing the cancer than the usual treatments. (Joe Palca worked for Allison early in both men’s careers.)

Allison’s treatment was still experimental, but if it worked, it had the potential to save Belvin’s life.

“It’s a new modality for treating cancer,” Dr. Samuel Broder, a former director of the National Cancer Institute, says now of Allison’s pioneering research. “It used to be there were three basic treatment options for cancer — surgery, radiation and chemotherapy — or some combination of those three. It’s fair to say there’s now a fourth option.”

Allison’s long search for this new kind of treatment — one that has since become a lifesaver for some cancer patients — began around a decade before Belvin got sick, when Allison was running a lab at the University of California, Berkeley.

At the time, he was what you could call a research scientist’s research scientist. He was fascinated by certain powerful cells of the immune system — T cells. A subset of white blood cells, T cells travel around the body and can “protect us against just about anything,” Allison says.

T cells do recognize cancer cells, but not in a way that can eliminate the disease.Allison had been studying T cells for years, and thought that by tinkering with one key molecule on the outside of these cells, he could enhance their response to cancer, enough to eradicate the illness.

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He and one of his grad students ran an experiment to test the tweaked T cells on cancerous tumors in mice, and the initial results astounded them. The T cells seemed to be doing just what Allison had hoped they would do — shrink the tumors and kill the cancer.

Allison repeated the experiment with more mice over his winter break. After a few tense days, the tumors again disappeared.

“These mice were cured,” Allison says.

Cancer cured?

“I’ve been doing this sort of stuff for years, and I’d never seen anything like that,” Allison says. “And I thought, ‘If we could do that in people, this is going to be amazing.’ ”

Allison tried to persuade drugmakers to create a human version of the treatment that had worked in mice. He thought they would jump at the chance to try a new approach.

But the biotech companies he met with didn’t bite. In those days, most firms were focused on drugs that would target tumors directly, and Allison was asking them to try something very different.

“This was targeting the immune system, not the cancer,” he says. “We weren’t trying to kill the cancer cells. We were letting the T cells kill the cancer cells.”

Backbone Surgery Image Source: Wikimedia Commons
Backbone Surgery Image Source: Wikimedia Commons

Thanks, but no thanks, the companies told him.

“I got very depressed,” Allison says. He was sure this was the most important work of his career, but he had to get others on board.

Eventually, a scientist attending one of Allison’s research talks was intrigued enough to contact a pal at the biotech firm Medarex. The company had recently developed technology that could make a human version of Allison’s therapy, and was willing to give it a try.

It took a decade, but eventually Allison’s big idea was ready for testing in people. A clinical trial to study the drug — now called ipilimumab, or Ippy for short — was set up at Memorial Sloan Kettering Cancer Center in New York City.

Allison decided he wanted to be part of this next chapter in the testing of immunotherapy, so he packed up his California lab and moved it to Sloan Kettering.

As it happens, Belvin was also in New York — a patient of Dr. Jedd Wolchok at Sloan Kettering. By the fall of 2004, Belvin had run through all the treatment options available to her. Nothing had worked to control the melanoma; it continued to spread dangerously throughout her body.

Belvin remembers feeling sick and depressed, and says she wasn’t even paying much attention when Wolchok walked into the exam room and suggested one last treatment.

“Sharon, we have an opportunity to participate in a clinical trial here. It’s something you should consider,” Wolchok told her.

Belvin says she signed up without hesitation. After just four injections of Ippy across three months, her cancer was nearly gone. And at Belvin’s follow-up appointment a year later, Wolchok delivered news that was hard for her to take in: “Sharon, you no longer have cancer.”

And in the next breath, Belvin recalls, “he goes, ‘Oh, the guy who invented this is upstairs. Do you want to meet him?’ ”

“Yes, of course I want to meet him!” she told her doctor.

Wolchok called Allison, who was working nearby, and told him to drop everything and come to the clinic — a part of the hospital Allison had rarely seen. Though the research scientist couldn’t imagine why Wolchok was in such a rush, he quickly figured it out as he opened the door and was greeted by Belvin with a huge hug.

Belvin says she tried not to tackle him. “It was hard to control myself,” she says. “I owe this man my life.”

Adoptive T-cell therapy Image Source- Wikimedia Commons
Adoptive T-cell therapy Image Source- Wikimedia Commons

Belvin was the first recipient of the immunotherapy that Allison had ever met. “It really meant a lot,” he says. “It reminded me what it’s all about at the end of the day.”

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That was in 2005; today, Sharon Belvin is still cancer-free.

Ippy is now sold under the brand name Yervoy by Bristol-Myers Squibb, which bought Medarex in 2009.

Meanwhile, Jim Allison has become a bit of a celebrity in the cancer research world. Among other honors, he was a 2015 recipient of the prestigious Lasker Award for his achievements in medical science.

He’s become well-known among patients, too. Now and again, Allison fields calls from patients yearning to learn from the master himself what it will take to cure their disease.

Allison can’t really answer them. Each case is different, and using a patient’s own cells to destroy tumors won’t work in every patient or in every type of cancer. Still, the approach offers promise to some people that other therapies can’t, and has transformed the way doctors think about cancer treatment.

It might be too early to say we’re going to cure cancer, Allison says, “but we’re going to cure certain types of cancers. We’ve got a shot at it now.”

-by Ajay Krishna (with inputs from NPR)

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Immunotherapy Drug Pembrolizumab May Treat Rare Pregnancy Cancer, Says Research

An immunotherapy drug - Pembrolizumab- has the potential to treat a rare pregnancy cancer belonging to a group of diseases called gestational trophoblastic disease (GTD), results of a clinical trial show

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Immunotherapy Drug May Treat Rare Pregnancy Cancer. Pixabay.

London, Nov 27: An immunotherapy drug has the potential to treat a rare pregnancy cancer belonging to a group of diseases called gestational trophoblastic disease (GTD), results of a clinical trial show.

Three out of four patients with the cancerous forms of GTD went into remission after receiving the immunotherapy drug pembrolizumab in a clinical trial carried out by researchers at London’s Imperial College.

The findings, published in the journal Lancet, suggest that immunotherapy could be used as a a safer alternative to conventional treatment for the disease.

Pembrolizumab is the trial drug/ immunotherapeutic agent:

The trial, which took place at Charing Cross Hospital, is the first to show that Pembrolizumab can be used to successfully treat women with GTD, according to the study

The researchers hope that this small early stage study could provide another treatment option for women who have drug-resistant GTD and lead to a 100 per cent cure rate.

“We have been able to show for the first time that immunotherapy may be used to cure patients of cancerous GTD,” said Professor Michael Seckl, lead author of the study.

The current treatments to tackle GTD cure most cases of the disease. However, there are a small number of women whose cancers are resistant to conventional therapies and as a result have a fatal outcome,” Seckl added.

“Immunotherapy may be a life-saving treatment and can be used as an alternative to the much more toxic high dose chemotherapy that is currently used,” Seckl said.

GTD is the term used to describe abnormal cells or tumors that start in the womb from cells that normally give rise to the placenta. They are extremely rare but can happen during or after pregnancy.

Globally, 18,000 women are diagnosed annually with cancerous forms of GTD, most of whom are cured with chemotherapy or surgery.

However, up to five per cent of these women’s outcomes are fatal due to factors such as chemotherapy resistance and rare forms of the cancer such as placental site trophoblastic tumours (PSTT) that develop four or more years after the causative pregnancy has ended. (IANS)

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How Strength-based Exercise can keep you fit in a Long Run?

Some health benefits of doing strength-based exercise.

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Push ups is srength-based exercise.Pixabay
  • Do you want to stay fit and longer? Daily push-ups and sit-ups may add a few extra years to your lifespan, reveals new research.

Benefits of doing Strength-based Exercise

The research found that the people who did strength-based exercise had a 23 percent reduction in risk of premature death and a 31 percent reduction in cancer-related death.

“The study shows that strength-based exercise may be just as important for health as aerobic activities like jogging or cycling,” said Emmanuel Stamatakis, Associate Professor at the University of Sydney in Australia.

“And assuming our findings reflect cause and effect relationships, it may be even more vital when it comes to reducing the risk of death from cancer,” Stamatakis added.

The researchers observed 80,306 adults for two years and made some adjustments in order to reduce the influence of certain factors such as age, sex, health status, lifestyle behavior and educational level.

All participants with established cardiovascular disease or cancer at the baseline and those who passed away in the meanwhile were excluded from the study.

The research, published in the American Journal of Epidemiology, showed that exercises performed using one’s own body weight without specific equipment were just as effective as gym-based training.

“When people think of strength-based exercise, they instantly think of doing weights in a gym, but that doesn’t have to be the case,” noted Stamatakis.

“Many people are intimidated by gyms, the costs or the culture they promote, so it’s great to know that anyone can do classic exercises like triceps dips, sit-ups, push-ups or lunges in their own home or local park and potentially reap the same health benefits,” the researcher said. (IANS)

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Butterfly IQ : The iPhone-based Portable Ultrasound Machine to Detect Cancer

Developed by Connecticut-based start-up Butterfly Network, the pocket sized device works by shooting sound into the body and capturing the echoes.

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Butterfly IQ
There is a new portable device that might be able to detect cancer. Pixabay

New York, October 29, 2017 : A novel iPhone-based portable ultrasound machine that can help detect cancer easily at home has been developed by US researchers.

The device called Butterfly IQ is a scanner of the size of an electric razor that can display black-and-white imagery of the body, when paired with an iPhone.
Developed by Connecticut-based start-up Butterfly Network, the pocket sized device works by shooting sound into the body and capturing the echoes.
Usually, the sound waves are generated by a vibrating crystal. But Butterfly’s machine instead uses 9,000 tiny drums etched onto a semiconductor chip, reported the MIT Technology Review on Friday.
Earlier this year, John Martin, a US-based vascular surgeon and chief medical officer at Butterfly Network, discovered a cancerous mass in his own throat while testing the device.
Martin felt an uncomfortable feeling of thickness on his throat, thus he oozed out some gel and ran the probe along his neck.
On his smartphone, to which the device is connected, black-and gray images quickly appeared.
He found a 3 cm mass that was diagnosed as squamous-cell cancer — a form of skin cancer that develops in the cells of the outer layer of the skin.
Instead of vibrating crystals, Butterfly IQ uses “capacitive micro-machined ultrasound transducers”, or CMUTs, tiny ultrasonic emitters layered on a semiconductor chip a little larger than a postage stamp.
“The device gives you the ability to do everything at the bedside: you can pull it out of your pocket and scan the whole body,” Martin said.
The company now plans to combine the instrument with artificial-intelligence software that could help a novice position the probe, collect the right images, and interpret them.
By 2018, its software will let users automatically calculate how much blood a heart is pumping, or detect problems like aortic aneurisms, the report said.
The Butterfly IQ is the first solid-state ultrasound machine to reach the market in the US. The company plans to go on sale this year for $1,999-far less than any other model on the market. (IANS)