Immune-boosting compound can effectively fight deadly pancreatic cancer: study

WASHINGTON, July 3 (Xinhua) -- Scientists in the United States have identified an immune-boosting compound that could significantly shrink the pancreatic tumors in animals when combined with immunotherapy.

Source: Xinhua| 2019-07-04 04:01:35|Editor: Shi Yinglun

The study published on Wednesday in Science Translational Medicine showed that in mice experiments, the compound worked to reduce tumor growth and metastases of the pancreatic cancer, a disease so deadly that only eight percent of patients are still alive five years after diagnosis.

In theory, immunotherapies release the brake on immune T cells to prod them into killing cancer cells. In practice, those therapies worked only for fewer than five percent of pancreatic cancer patients.

The researchers then realized that myeloid cells in and around tumors can either tamp down or ramp up the immune response by releasing molecules that affect how many T cells are recruited to the tumor. In pancreatic tumors, however, myeloid cells typically suppress other immune cells, according to the study.

The researchers from Rush University in Chicago found a compound called ADH-503 that could interfere with the migration of myeloid cells. Administering the compound to mice with pancreatic cancer decreased the myeloid cells and increased cancer-killing T cells in the tumor, according to the study.

Then, the researchers including those from Washington University School of Medicine treated those mice with a standard immunotherapy in conjunction with ADH-503, and they found that the tumors shrank and the mice survived significantly longer.

In some experiments, all the tumors disappeared within a month of treatment and all the mice survived for four months, while all the untreated mice died within six weeks, according to the study.

Also, mice treated with chemotherapy or radiation therapy both fared significantly better when ADH-503 was included into the regimen.

"In animal studies, this small molecule led to very marked improvements and was even curative in some cases. We are hopeful that this approach could help pancreatic cancer patients," said the paper's co-senior author David DeNardo, associate professor of medicine at Washington University School of Medicine.

http://www.xinhuanet.com/english/2019-07/04/c_138196546.htm

Boosting our immune system to treat tumours

The immune system is our body’s armed forces, designed to defend our body against all intruders that seek to harm us.

SEPTEMBER 5, 2018

A doctor examines a chest x-ray. One of the cancers immunotherapy has been successful in treating is non-small cell lung cancer. — Photos: AFP

So, why doesn’t it seem to work when it comes to cancer?

Well, the answer is that cancer cells can be really crafty, employing a number of strategies to avoid being sought out and destroyed by our body’s soldiers.

That is why we humans had to get even craftier.

Immunotherapy is a form of cancer treatment that helps our immune system in its fight against cancer.

According to consultant clinical oncologist Dr Tho Lye Mun: “Immunotherapy is probably the biggest, most exciting breakthrough we’ve had in cancer for a long, long time.”

He adds: “The success story of immunotherapy is in melanoma, but we don’t get a lot of that in Malaysia.

“But we get a lot of lung cancer. It is the number one cancer killer of men in Malaysia, and the third for women after breast and cervical cancer.

“And that’s where immunotherapy has had the greatest impact (in Malaysia).”

He explains that immunotherapy was initially used as second-line treatment after non-small cell lung cancer (NSCLC) patients had failed to improve after chemotherapy or targeted therapy.

However, immunotherapy has proved to work so well that it is now a first-line treatment.

According to Dr Tho, the majority of patients who are suitable for immunotherapy now receive it as their first treatment.

“And it’s been shown to be more effective than chemotherapy,” he says, adding that Malaysia actually took part in the international Keynote-042 clinical trial, which established that a particular immunotherapy drug, pembrolizumab, was more effective than chemotherapy for advanced NSCLC – the most common type of lung cancer.

Blocking proteins

Pembrolizumab, also known by the brand name Keytruda, is a type of immunotherapy known as a checkpoint inhibitor.

A checkpoint inhibitor is basically a monoclonal antibody that blocks proteins that stop the immune system from attacking the cancer cells.

A monoclonal antibody is a type of protein made in the laboratory that is produced by a single cell line and only binds to one substance, i.e. one particular antigen.

Dr Tho explains: “When tumour cells exist and when they die, they release antigens into the bloodstream, and these are picked up by antigen-presenting cells.

“These cells then travel to the lymph node where they ‘educate’ or prime T-cells (a type of immune cell) to recognise the antigens.

“These T-cells then exit the lymph nodes into the bloodstream and travel to the tumour, where they recognise it and kill it.”

However, some tumour cells have cleverly managed to incorporate a protein called programmed death-ligand 1 (PD-L1) into themselves.

According to Dr Tho, PD-L1 exists in nature to prevent T-cells from recognising our own cells as foreign and killing them.

T-cells have a receptor called programmed cell death protein 1 (PD-1) that fits specifically with PDL-1. This is the signal to the T-cells not to attack the cell with PDL-1.

So, cancer cells that express PD-L1 are actually disguising themselves – or putting on a mask, as Dr Tho says – as one of the body’s normal cells in order to avoid being killed by our T-cells.

Dr Tho explains how cancer cells trigger the immune system. According to him, the problem is not that cancer patients do not have a strong enough immune system, but that the immune cells are unable to recognise the cancer cells due to a number of reasons. — AZLINA ABDULLAH/The Star

Pembrolizumab and nivolumab are immunotherapies that block PD-1 from fitting with PD-L1, allowing the T-cells to go ahead and kill the cancer cells.

Pembrolizumab was recently approved in Malaysia as a first-line treatment for metastatic NSCLC where over 50% of the cancer cells express PD-L1.

It is also approved as both first- and second-line treatment for unresectable or metastatic melanoma, and recurrent or metastatic head and neck squamous cell carcinoma, which has progressed while either on or after receiving platinum-containing chemotherapy.

Meanwhile, atezolizumab, also known by the brand name Tencentriq, is an immunotherapy that works by blocking PD-L1 itself, effectively “unmasking” the cancer cells and allowing the T-cells to recognise them as “foreign” and kill them.

It was approved recently in Malaysia for the treatment of metastatic NSCLC, which has progressed while either on or after receiving platinum-containing chemotherapy.

Another checkpoint inhibitor, ipilimumab, blocks the action of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4).

Explains Dr Tho: “This CTLA-4 inhibitor acts at the lymph node level. They basically cause the T-cells to be up-regulated.

“They are not specific (to the cancer), they turbocharge the T-cells, overwhelming the cancer with large forces.”

He adds that while ipilimumab, which is used to treat advanced melanoma, is not approved in Malaysia, it has been allowed to be used in certain cases.

Occasionally, our body’s T-cells do not even know that there is a cancer in the body as they cannot get to the tumour, due to various reasons.

In cases like this, Dr Tho says that radiotherapy comes in handy.

“Basically, you’re blasting it, you’re sending in a missile to kill the tumour cells, and in killing the tumour cells, the tumours release all these antigens, and these antigens are picked up by the T-cells, which now know who they are suppose to kill.

“This is why we now have a lot of studies combining radiotherapy with immunotherapy – this is the next wave.”

Caution needed

However, checkpoint inhibitors do not work in all situations.

For example, it does not work in NSCLC that have driver mutations like EGFR (epidermal growth factor receptor), ALK (anaplastic lymphoma kinase) and ROS1.

Dr Tho explains that a driver mutation is an oncogene that produces a protein all the time – it has no off switch.

“The normal proteins in our body, if it’s done its job, the body can send a negative feedback signal to say, ‘Ok, right, you’ve done your job, you can stop now.’.

“But these overactive proteins just keep working and working and never stop, and this causes the cancer to develop.”

He adds: “In those situations, immunotherapy doesn’t work. What you need is a treatment for that particular gene, to tell them to stop working.”

This treatment is known as targeted therapy.

Immunotherapy is also not without its side effects.

“The side effects of immunotherapy are basically ‘-itis’, which means inflammation, and it can happen in any part of the body, so that is a scary thing.

“We’ve had patients die from immunotherapy due to autoimmune lung damage, autoimmune liver damage, autoimmune gut damage.

“So, immunotherapy is not something benign, you can overstimulate the immune system to such an extent that it basically destroys the own body, so that is the caveat,” he explains.

Due to this, Dr Tho recommends that any doctor wanting to prescribe immunotherapy needs to be aware of how to manage its toxicities, adding that there are many guidelines available on this.

“So, I would say, if a hospital wants to embark on an immunotherapy programme, they must have a structure in which all the other clinicians are involved, so it’s not just oncology.

“So when a patient develops lung problems, they need the lung specialist to be involved; if they develop a liver problem, the gastroenterologist must be involved; if they develop skin problems, a dermatologist needs to be involved.

“And the accident and emergency doctors need to be aware that the symptoms the patient gets may be due to immunotherapy,” he says.

He shares that there have been certain cases where a cancer patient on immunotherapy has come in with a cough to the emergency department and been prescribed antibiotics.

“Then they go home and they die. Because they didn’t have a chest infection, what they were having was an autoimmune reaction – the right treatment is steroids,” he says.

“So this has to be disseminated throughout the whole hospital, not just the oncologists. We give patients alert cards, so that they know what they are on and can present it to the physician that they see.”

Dr Tho also notes that because immunotherapy is quite new in Malaysia, there are two things patients should be aware of.

One, that there are some unscrupulous people offering what purports to be immunotherapy, but is not – “they’re just trying to make a fast buck”.

And two, that there are doctors prescribing immunotherapy, who might not be trained to do so, and this can be very dangerous for patients due to the side effects.

Other immunotherapies

The tuberculosis vaccine is now also used as a cancer vaccine to prevent the recurrence of
early-stage bladder cancer.

The tuberculosis vaccine is now also used as a cancer vaccine to prevent the recurrence of early-stage bladder cancer.

While checkpoint inhibitors have proven to be the most successful form of immunotherapy, there are also other types of immunotherapy being developed.

Cytokines are proteins that are important in cell signalling and can affect the behaviour of other cells.

Cytokines like interferon-alpha have been used to treat kidney cancer, melanoma, multiple myeloma and certain types of leukaemia, while interleukin-2 has been used for kidney cancer.

However, Dr Tho says: “In kidney cancer, cytokine therapy such as interferon-alpha has largely been superceded by newer and more effective targeted agents (such as VEGF inhibitors) and checkpoint inhibitors.

“Older therapies such as high dose interleukin-2, even though associated with very good responses in some patients, resulted in significant side effects, and sometimes even ICU (intensive care unit) admissions and fatalities.”

Cancer vaccines are another form of immunotherapy under development.

Similar to how normal vaccines for infectious diseases stimulate the immune system to recognise the germs that cause these diseases and attack them, cancer vaccines stimulate the immune system to recognise certain cancer cells and attack them.

In fact, one familiar vaccine – the BCG (Bacillus Calmette–Guérin) vaccine for tuberculosis – has been repurposed to prevent recurrence in early-stage bladder cancer.

Dr Tho adds: “Limited success has been achieved with the vaccine sipuleucel-T, which is prostate cancer- specific, and talimogene laherparepvec (T-VEC), an oncolytic virus therapy, and both therapies are now approved by the US FDA (Food and Drug Administration).”

However, various vaccines for lung cancer have failed at the clinical trial stage.

According to Dr Tho, the most innovative and exciting type of immunotherapy currently under development is adoptive cell therapy, specifically chimeric antigen receptor (CAR) T-cell therapy.

This therapy involves removing the body’s own T-cells and genetically-engineering them to express a CAR that only fits a certain protein on the cancer cell.

With this specific recognition ability, the CAR-T cells can zoom in and kill the cancer cells when infused back into the patient.

“CAR-T cells have seen dramatic successes in haematological malignancies, especially acute lymphoblastic leukaemia and lymphomas. It’s science fiction come true!” he says.

Dr Tho adds that certain Malaysian cancer centres have collaborated with Singapore’s National Cancer Centre to offer the first-ever CAR-T cell therapy for advanced nasopharyngeal cancer patients, which is a disease prevalent in this region.

“The trial has completed recruitment in Malaysia and we are all eagerly awaiting the final results,” he says.

https://www.star2.com/health/2018/09/05/boosting-immune-system-treat-tumours

Children offered ‘game-changing’ NHS cancer treatment after funding deal

Children and young people with a form of leukaemia will have access to a groundbreaking treatment after NHS England secured a deal with the drug manufacturer.

SEPTEMBER 5, 2018



Tisagenlecleucel, a form of chimeric antigen receptor T-Cell (CAR-T) therapy, has been shown to cure some patients with B cell acute lymphoblastic leukaemia.

NHS patients will be the first in Europe to have routine access to the treatment, which costs £282,000 per patient at full list price, following the agreement with pharmaceutical company Novartis.

The deal comes less than 10 days after the therapy was granted European marketing authorisation and represents one of the fastest funding approvals in the history of the health service, NHS England said.

It will be announced by Simon Stevens, chief executive of NHS England, at the Health Innovation Expo in Manchester on Wednesday.

“CAR-T therapy is a true game changer, and NHS cancer patients are now going to be amongst the first in the world to benefit,” Mr Stevens will say.

“Today’s approval is proof-positive that, in our 70th year, the NHS is leading from the front on innovative new treatments.

“This constructive fast-track negotiation also shows how responsible and flexible life sciences companies can succeed – in partnership with the NHS – to make revolutionary treatments available to patients.”

Sorry, this content isn't available on your device.

CAR-T cell therapy is the most exciting advance in treatment for childhood leukaemia for decades

Dr Alasdair Rankin, Bloodwise

CAR-T therapy is a personalised treatment, which reprogrammes a patient’s immune system cells to target the cancer.

Tisagenlecleucel, also known as Kymriah, has been shown in trials to “cure” some patients, even those with advanced cancers who have not responded to other treatments, NHS England said.

The therapy is licensed for use in patients up to the age of 25 with B cell acute lymphoblastic leukaemia that is refractory, in relapse post-transplant or in second or later relapse.

It has been approved for use by the National Institute for Care and Excellence (Nice) through the NHS Cancer Drugs Fund.

Three UK hospitals in London, Manchester and Newcastle are awaiting approval to provide CAR-T therapy and, if successful, could begin treating patients with Tisagenlecleucel within weeks, NHS England said.

Dr Alasdair Rankin, director of research at blood cancer charity Bloodwise, said: “CAR-T cell therapy is the most exciting advance in treatment for childhood leukaemia for decades.

“Intensive chemotherapy can now cure the vast majority of children but a significant number still tragically die every year because they do not respond to treatment.

“CAR-T cell therapy offers the genuine chance of a long-term cure for children who otherwise would have no other hope.”

Last updated Wed 5 Sep 2018

http://www.itv.com/news/2018-09-05/children-to-receive-cancer-treatment-on-nhs-after-funding-deal/

NHS to treat young cancer patients with expensive 'game changer' drug

The NHS is to treat children and young people with an expensive new cancer drug which has the potential to transform how the disease is treated.

Sarah Boseley Health editor 

37 mins ago

© PA Simon Stevens, NHS England chief executive, will announce a deal with Novartis to provide the immunotherapy drug.

Simon Stevens, the NHS England chief executive, will announce on Wednesday that a deal has been done with the drug company Novartis, which makes the immunotherapy drug under the name Kymriah.

How does CAR-T therapy work?

CAR-T therapy is a new type of immunotherapy. The novel idea is to collect T-cells from the blood of the patient and engineer them to recognise the cancerous cells that have been hiding in the body unnoticed and that they have failed to destroy.

T-cells are lymphocytes or white blood cells. They are key players in the immune system, moving around the body to attack infection and diseases. 

They should attack a cancer, but sometimes fail to identify cancerous cells as the threat they are. CAR-T therapy aims to teach the T-cells to recognise and attack the target. 

A child with acute lymphoblastic leukaemia (ALL) which has returned in spite of a number of different treatments would be eligible for CAR-T therapy (CAR stands for chimeric antigen receptor and the T is for T-cell). 

The first step is to insert a tube in each arm. Blood is then withdrawn from one arm and T-cells are removed by passing it through an apheresis machine. The rest of the blood returns to the body through the tube in the other arm. 

In a lab, the T-cells are genetically engineered to recognise and target a specific protein on the cancer cells. The CAR-T cells, as the changed cells are now called, multiply in the lab, while the patient is given chemotherapy to kill off any remaining T-cells in the body.

Then the child is given a transfusion of CAR-T cells, which will hopefully attack and kill the cancer cells in the blood. 

The list price of the drug is £282,000 per patient and treatment costs for the NHS could double that. In the United States, the total cost of the therapy can reach $1m.

But Stevens and others have said this form of cancer treatment, known as CAR-T therapy, is the future. It works by genetically engineering the patient’s own immune system’s killer T-cells to recognise and destroy cancer cells.

“CAR-T therapy is a true game changer and NHS cancer patients are now going to be amongst the first in the world to benefit,” Stevens will say in a speech at the Health and Care Innovation Expo in Manchester.

However, only 15 to 20 children with acute lymphoblastic leukaemia (ALL) are expected to be eligible for the drug. It will be given only to those who have failed a series of earlier treatments, including stem cell transplants.

Kymriah has also been licensed to treat adults with a more common blood cancer, diffuse large B-cell lymphoma (DLBCL), but a decision is yet to be made by the National Institute for Health and Care Excellence (Nice) on whether the NHS can afford it. The bill would be substantially higher because about 200 adults could be eligible. A similar drug for adults, Yescarta made by Gilead, has been turned down because of the cost, which is $373,000 (£290,000) in the US.

When Stevens revealed his intention to make CAR-T available to the NHS in April, he appealed to Novartis to reduce the price of Kymriah. Any discount that the manufacturer has offered is a commercial secret.

CAR-T therapy has to be developed for each patient. It involves taking blood and engineering the patient’s own immune system T-cells to recognise and fight the cancer before transfusing them back into the body.

There have been spectacular results in clinical trials, with response rates in blood cancer patients with advanced disease of over 80%. But there have also been deaths, when patients’ immune systems have overreacted to the therapy.

Alasdair Rankin, the director of research at the blood cancer charity Bloodwise, said he was very pleased that children and young adults would get the treatment. “It is very exciting for children with leukaemia,” he said.

This use of CAR-T therapy was “only the tip of the iceberg”, he said, and there were other cancers, from myeloma to solid tumours, that it could help. He likened the arrival of CAR-T therapy to that of radiotherapy, which transformed cancer treatment and substantially improved long-term outcomes.

Prof Charles Swanton, Cancer Research UK’s chief clinician, said: “It’s fantastic news for children and young people with this form of leukaemia that CAR-T cell therapy will be made available on the NHS, making them the first in Europe to have routine access to this exciting new type of immunotherapy. We applaud NHS England, Nice and the company for working together to make this immensely complex treatment available to patients quickly, through the Cancer Drugs Fund.”

The process of producing such a treatment is immensely complex but preparations are in their final stages, according to NHS England, and the first children could be treated within weeks. Three NHS hospitals are going through the international accreditation process for the provision of CAR-T therapy for children, in London, Manchester and Newcastle.

“Today’s approval is proof-positive that, in our 70th year, the NHS is leading from the front on innovative new treatments,” Stevens will say. “This constructive fast-track negotiation also shows how responsible and flexible life sciences companies can succeed – in partnership with the NHS – to make revolutionary treatments available to patients.”

https://www.msn.com/en-gb/news/uknews/nhs-to-treat-young-cancer-patients-with-expensive-game-changer-drug/

Reengineering your immune cells to fight cancer

In a step that heralds a new era in cancer treatment, the US Food and Drug Administration (FDA) said it had approved a form of gene therapy that is highly effective at fighting an aggressive form of leukaemia in young patients with no other options.

SEPTEMBER 30, 2017

An illustration of the body's T cells attacking a cancer cell. — 123rf.com

The treatment, to be marketed under the name Kymriah, is neither a pill nor an injection, but a personalised medicine service that functions as a “living drug”.

Patients would have their body’s own disease-fighting T cells fortified and multiplied in a lab, then get the cells back to help them fight their cancer.

In clinical trials of 88 patients with a relapsing or treatment-resistant form of acute lymphoblastic leukaemia, 73 went into remission after receiving the experimental treatment.

FDA Commissioner Scott Gottlieb, himself a survivor of blood cancer, predicted that this new approach to cancer treatment would “change the face of modern medicine”.

Cancer researchers and physicians outside the agency shared Gottlieb’s enthusiasm.

Dr Crystal L. Mackall, associate director of Stanford University’s Cancer Institute, called it “a transformative therapy… It represents an entirely new class of cancer therapies that holds promise for all cancer patients.”

Acute lymphoblastic leukaemia is the most common form of paediatric cancer, affecting some 3,000 children and young adults yearly in the United States.

Though it is considered highly curable in most patients, about 600 each year either do not respond to chemotherapy or see their leukaemia return after an initial round of successful treatment.

“Those patients don’t make it – none of them do,” said Dr Stephan A. Grupp, director of the cancer immunotherapy programme at Children’s Hospital of Philadelphia, who administered the first course of Kymriah five years ago when it was an experimental treatment called CTL019.

Emily, shown here in 2014, was the first paediatric patient to receive the CAR-T therapy. Now 12, she was among those calling on the FDA to approve the treatment for other patients like her. — TNS

That initial patient, seven-year-old Emily Whitehead of Philipsburg, Pennsylvania, saw her leukaemia remit completely within three weeks of getting the treatment.

Now 12, she was among those calling on the FDA to approve Kymriah for other patients like her.

“Certainly for blood cancers, this is a game-changer,” Grupp said. Adapting this therapy for patients with solid tumors, he said, will be “the work of the next five years”.

The new approach was designed to fight some of the most stubborn cancers by giving the body’s immune system a very specific assist.

It starts by harvesting a cancer patient’s T cells, the warriors of the immune system.

The cells are delivered to a specialised lab where scientists alter their DNA, essentially reprogramming them to target cancer cells.

These re-engineered cells are called chimeric antigen receptor T cells, or CAR-T cells.

The new and improved cells are copied millions of times before they’re sent back to the patient.

Once infused into the bloodstream, the CAR-T cells are much better equipped to hunt down and kill cancer cells, wherever they may hide.

Novartis, the Swiss pharmaceutical company that developed the drug, intends to have 32 certified treatment centres up and running by the end of 2018. Patients up to the age of 25 would go to one of these centres to have their T cells harvested and later reintroduced in their modified form.

The cells themselves will be genetically engineered at a manufacturing facility.

Kymriah is the first CAR-T treatment to come before the FDA, but it won’t be the last. No fewer than 76 CAR-T treatments are currently under review at the FDA, and Gottlieb predicted other approvals would follow.

Therapies that would operate in similar ways – engineering T cells to fight disease more effectively – are under investigation for a host of other conditions, including HIV/AIDS, genetic and autoimmune disorders and other forms of cancer.

“Today’s FDA ruling is a milestone,” said Dr David Maloney, medical director of cellular immunotherapy at Fred Hutchinson Cancer Research Center in Seattle.

“This is just the first of what will soon be many new immunotherapy-based treatments for a variety of cancers.”

Novartis, which is gearing up to provide Kymriah to as many as 600 patients a year, said it would charge US$475,000 (RM1.99mil) for the treatment.

Novartis representatives said they calculated a “cost-effective price” for the therapy that fell between US$600,000 and US$750,000 (RM2.5mil and RM3.14mil).

But the company chose instead to charge a price that it said would “cover costs”, and to introduce a novel approach to billing.

Chief executive Joseph Jimenez said the company would not charge hospitals for the therapy if the patient didn’t fully respond in a given period of time.

The company also said it would launch a patient assistance programme for those who were uninsured or underinsured, and provide some travel assistance for patients and caregivers seeking the treatment.

Novartis’ application for Kymriah came just seven months ago.

The agency tagged the application with two designations that ensured its speedy review.

First proposed in 1972, the idea of correcting or enhancing genes to treat disease has a history buoyed by promise, but also buffeted by failures.

With recent advances in genomic medicine, cell biology and genetic engineering, efforts to locate and edit the genes and cells that play a key role in disease have injected new hope for such treatments.

Gene and cell therapies that target the immune system for enhancement have been particularly promising.

They do, however, come with risks – specifically, that the activation of immune cells will run amok, sparking reactions ranging from rash and itching to fever and flu-like symptoms that can lead to death.

In approving Kymriah, the FDA warned it had the potential to cause severe side effects, including cytokine release syndrome, an overreaction to the activation and proliferation of immune cells that causes fever and flu-like symptoms, and neurological events. Both can be life-threatening.

The FDA called for continuing safety studies of the new therapy. — Los Angeles Times/Tribune News Service

Read more at http://www.star2.com/health/wellness/2017/09/30/new-revolution-in-cancer-therapy

Promising immunotherapy helps adults with leukaemia

MIAMI: A cancer treatment that genetically alters immune cells has shown success in 71% of adults with the most common form of leukaemia, and for whom other medicines had failed, US researchers said Monday.

Posted on 18 July 2017 - 11:58am

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A cancer treatment that genetically alters immune cells has shown success in 71% of adults with the most common form of leukaemia, and for whom other medicines had failed, US researchers said Monday — AFP

The treatment, known as experimental chimeric antigen receptor (CAR) T-cell immunotherapy, has made headlines in recent years, particularly after it helped beat back paediatric leukaemia in the first US child to undergo the treatment.

The latest study involved 24 adults, aged 40 to 73, with chronic lymphocytic leukaemia (CLL) that had failed to respond to between three and nine other kinds of treatments and were not expected to live long.

Among the treatments that failed this group was ibrutinib, a targeted cancer drug approved in 2014 for CLL by the US Food and Drug Administration, according to the findings in the Journal of Clinical Investigation.

"It was not known whether Car T-cells could be used to treat these high-risk CLL patients," said lead author Cameron Turtle, an immunotherapy researcher at Fred Hutchinson Cancer Research Center in Seattle, Washington.

The patients' T-cells were extracted from their blood and modified in a lab to recognise CD19, a target on the surface of leukaemia cells.

The altered immune cells were then re-infused into the patients, where they swiftly multiplied and began to kill cancer cells.

Seventeen out of 24 (71%) members of the group saw their tumours shrink or disappear after the infusion, according to scans of their lymph nodes performed four weeks after the infusion.

"Our study shows that CD19 Car T-cells are a highly promising treatment for CLL patients who have failed ibrutinib," said Turtle.

But side effects were common.

Twenty of the 24 (83%) experienced cytokine release syndrome – a cluster of symptoms that can include fever, nausea, chills, irregular heartbeat, headache, rash and low blood pressure.

"For the most part the side effects were reversible, but two patients had side effects severe enough to require being admitted to the intensive care unit and one of those patients died," said the report.

The study is still in its early stages.

More research is needed to determine how long the patients can live cancer-free.

After treatment, a subgroup of 12 patients underwent a genetic test called IGH deep sequencing, which allows researchers to track cancer cells in the body.

Seven of the 12 were found to have no malignant gene sequences in their bone marrow.

All seven of these patients were alive and free of disease at a median or midpoint, follow-up of 6.6 months after CAR T-cell infusion, said the report.

Last week, an advisory panel to the FDA urged regulators to approve the treatment for paediatric leukaemia.

Experts say concerns about side effects are legitimate, but that the potential of the medicine to wipe out cancer heralds a new era for treatment.

The United States is expected to see about 20,000 new cases and 4,600 deaths from CLL this year alone. — AFP

http://www.thesundaily.my/news/2017/07/18/promising-immunotherapy-helps-adults-leukaemia

New cell therapy offers hope of a leukaemia cure

Early trial of pioneering treatment eradicated the disease in 94% of cases

• Procedure is administered during three or four hospital outpatient appointments
• It has shown particular promise for leukaemia and blood cancers

By Sophie Borland Health Editor In Chicago For The Daily Mail

PUBLISHED: 01:03, 7 June 2017 | UPDATED: 01:11, 7 June 2017

A revolutionary cancer treatment that alters the body’s cells so they attack tumours has offered hope of a cure.

The procedure is administered during three or four hospital outpatient appointments which last up to four hours each.

It has shown particular promise for leukaemia and blood cancers which collectively affect 30,000 new patients in the UK each year.

+2

Mike Brandon, 32, is now disease free after having CAR-T cell therapy last summer. He is pictured with his partner, Kate

Early trials presented at the world’s largest cancer conference showed that treatment was able to eradicate all traces of cancer for almost all patients.

Known as CAR-T cell therapy, it involves doctors taking a sample of blood and then genetically altering the body’s own killer cells.

These cells are then injected back into the body whereupon they multiply and start attacking the tumours.

One trial presented to the American Society for Clinical Oncology Conference in Chicago showed that it had eradicated tumours in eight out of nine patients.

The patients had an aggressive type of leukaemia which is considered incurable – chronic lymphocytic leukaemia.

Yet six months after receiving the cell treatment they still have no traces of the disease in their bodies.

Dr Saar Gill, assistant professor of medicine at the University of Pennsylvania in Philadelphia, who lead the trial, said he hoped they would remain cancer-free ‘forever.’

‘Our hope is that this disease is so deeply in remission that it never comes back.’

+2

A second trial showed that the treatment eradicated leukaemia in 33 out of 35 patients – 94 per cent

A second trial showed that the treatment eradicated leukaemia in 33 out of 35 patients – 94 per cent.

These patients had multiple myeloma, a type of blood cancer, and were followed for two months after their treatment.

Dr Wanhong Zhao, the lead author from the Xi’an Jiaotong University in Xi’an, China, said that the treatment may offer ‘a chance for a cure in multiple myeloma.’

‘We will need to follow patients much longer to confirm that.’

Leukaemia, which affects the bone marrow, and myeloma, a blood cancer, are particularly hard to treat as unlike solid cancer tumours like breast and prostate they cannot be surgically removed.

About half of patients do not survive beyond five years and many of those who live longer have to take drugs for the rest of their lives.

These trials have offered hope that a one-off treatment – administered over three or four hospital visits – could offer a permanent cure.

The procedure is a form of immunotherapy, a class of drugs or treatment which involve teaching the body to fight the cancer itself.

They have been hailed as the ‘new era’ of cancer treatment and have shown particular success for harder to treat tumours.

CANCER-FREE AFTER JUST FIVE MONTHS

Mike Brandon, 32, is now disease free after having CAR-T cell therapy last summer.

He was only able to have the breakthrough procedure after his wife Kate raised more than £450,000 through a social media campaign.

Mr Brandon, from Bristol, was diagnosed with acute lymphoblastic leukaemia in January 2014.

The illness was so advanced that his consultant told him that ‘all NHS routes were exhausted.’

He began CAR-T therapy in May at the University of Pennsylvania, and in October announced that he was cancer-free.

Mrs Brandon said at the time: ‘We have more tests ahead but, right now, we couldn’t be happier.

‘Prior to starting the trial, Mike’s bone marrow was made up of 90 per cent leukaemia cells and he was given weeks to live but thanks to the cutting edge CAR T-cell therapy he received in the US he is now cancer free.’

When launching the campaign, she had described her husband as a ‘kind, sincere and witty’ man who ‘deserved to have a chance at living life.’  

The procedure is currently only being developed by a handful of hospitals around the world, including the Great Ormond Street Hospital in London.

But charities hope that the success of these trials will result in the treatment becoming much more widespread.

Dr Áine McCarthy, senior science information officer at Cancer Research UK, said the results were ‘promising.’

‘Modifying cells from a patient’s own immune system and using them to treat cancer, called CAR-T cell therapy, has been showing potential in leukaemia and lymphoma in recent years.’

Dr Alasdair Rankin, Director of Research at the blood cancer research charity Bloodwise, said the findings were ‘clearly very promising.’

‘More follow-up time and further studies will be needed to establish whether its effects are long-lasting and if a wider range of patients could benefit from this specific approach.’ 

http://www.dailymail.co.uk/health/article-4579164/New-cell-therapy-offers-hope-leukaemia-cure.html