Monday October 22, 2018

Immunotherapy Becomes World’s First Therapy which Cured Breast Cancer

A "highly personalized" anti-cancer therapy

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Research technician Ashwini Balakrishnan works in the immunotherapy research lab of Dr. Stanley Riddell at the Fred Hutchinson Cancer Research Center in Seattle, March 28, 2017.
Research technician Ashwini Balakrishnan works in the immunotherapy research lab of Dr. Stanley Riddell at the Fred Hutchinson Cancer Research Center in Seattle, March 28, 2017. VOA
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A woman with an aggressive form of breast cancer which defied chemotherapy and spread to other organs, was cured with an experimental treatment that triggered her immune system, researchers said Monday.

The woman has been cancer-free for two years, reported the U.S.-based team, presenting their results as “a new immunotherapy approach” for the treatment of patients with a late-stage form of the disease.

Other experts not involved in the work hailed it as “exciting”.

So-called “immunotherapy” has already been shown to work in some people with cancer of the lung, cervix, blood cells (leukaemia), skin (melanoma) and bladder.

But an immune breakthrough for bowel, breast and ovary cancer has remained elusive.

In the latest study, a team extracted immune cells called lymphocytes from the patient, tweaked them in the lab, then reinjected them.

Cancer patient
Cancer patient, flickr

The woman was 49 when she signed up for the clinical trial after several attempts at a cure through conventional treatments had failed, said the study published in the scientific journal Nature Medicine.

The cancer had spread to various parts of her body, including the liver.

A person’s immune system is designed to kill invaders, including rogue, cancerous cells. But it can fail, often because it cannot recognize cancer cells containing the patient’s own DNA.

Immunotherapy trains a patient’s own immune cells to recognize and fight cancer.

For the new study, researchers took lymphocytes from a tumor in the woman’s body and scanned them for specific types which reacted to mutant, cancerous cells.

Complete regression

These were reactivated or “switched on” in the lab and injected back, along with a so-called “immune checkpoint inhibitor” — another type of immunotherapy that has shown success in other types of cancer.

Cancer survivor
Cancer survivor, flickr

This resulted in a “highly personalized” anti-cancer therapy that yielded “complete tumor regression,” the researchers wrote.

In a comment also published by Nature Medicine, expert Laszlo Radvanyi from Canada’s Ontario Institute for Cancer Research said the woman’s response to the treatment was “unprecedented” for such advanced breast cancer.

This work showed “we are now at the cusp of a major revolution in finally realizing the elusive goal of being able to target the plethora of mutations in cancer through immunotherapy,” he wrote.

In a reaction via the Science Media Centre in London, immunotherapy professor Alan Melcher of The Institute of Cancer Research said the trial was “fascinating and exciting.”

The work “provides a major ‘proof-of-principle’ step forward, in showing how the power of the immune system can be harnessed to attack even the most difficult-to-treat cancers,” he said.

Peter Johnson, an oncology professor at the Cancer Research UK Centre, said the study confirmed the immune system can recognize some cancers, and “if this can be stimulated in the right way, even cancers that have spread to different parts of the body may be treatable.”

The technique is “highly specialized and complex”, he cautioned, and may not be suitable for many patients. (VOA)

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Immunotherapy Drugs Show Significant Improvement Against Breast Cancer: Study

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts.

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Breast Cancer
This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. VOA

For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine.

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

Breast Cancer
Weight loss may lower breast cancer risk for post-menopausal women. Pixabay

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

breast cancer
FILE – A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice, July 26, 2012. VOA

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Breast Cancer
Breast cancer cell, Wikimedia Commons

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Also Read: New DNA Tool To Predict People’s Height And Risk For Cancer

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it. (VOA)