September 18, 2011

September 18, 2011
HIV Research to Cancer Treatments Part 2

Welcome to another day in my life Today is Sunday and I hope you are having a safe and great weekend. Dab the AIDS Bear and I wish you the best always.

Yesterday, I started the first part of a blog about how HIV research is leading to more cancer treatments that I will finish today. This is important because long term survivors of HIV/AIDS are up to 300 percent more like to experience cancer some time during their life.

What the journal article did not mention was that Patient 3 was almost not treated.

Because of his illness and some production problems, the researchers said, they could not produce anywhere near as many altered T-cells for him as they had for the other two patients only 14 million, versus 1 billion for Patient 1 and 580 million for Patient 2. After debate, they decided to treat him anyway.

Patient 3 declined to be interviewed, but he wrote anonymously about his experience for the University of Pennsylvania Web site. When he developed chills and a fever, he said, I was sure the war was on I was sure C.L.L. cells were dying.

He wrote that he was a scientist, and that when he was young had dreamed of someday making a discovery that would benefit mankind. But, he concluded, I never imagined I would be part of the experiment.

When he told Patient 3 that he was remission, Dr. Porter said, they both had tears in their eyes.

Not Without Danger to Patients

While promising, the new techniques developed by the University of Pennsylvania researchers are not without danger to patients. Engineered T-cells have attacked healthy tissue in patients at other centers. Such a reaction killed a 39 year old woman with advanced colon cancer in a study at the National Cancer Institute, researchers there reported last year in the journal Molecular Therapy.

She developed severe breathing trouble 15 minutes after receiving the T-cells, had to be put on a ventilator and died a few days later. Apparently, a protein target on the cancer cells was also present in her lunShe developed severe breathing trouble 15 minutes after receiving the T-cells, had to be put on a ventilator and died a few days later. Apparently, a protein target on the cancer cells was also present in her lungs, and the T-cells homed in on it. gs, and the T-cells homed in on it.

Researchers at Memorial Sloan Kettering Cancer in New York also reported a death last year in a T-cell trial for leukemia (also published in Molecular Therapy). An autopsy found that the patient had apparently died from sepsis, not from the T-cells, but because he died just four days after the infusion, the researchers said they considered the treatment a possible factor.

Researchers hope to use T-cells against solid tumors, including some that are very hard to treat, like mesothelioma and ovarian and pancreatic cancer. But possible adverse reactions are a real concern noting that one of the protein targets on the tumor cells is also found on membranes that line the chest and abdomen. T-cell attacks could cause serious inflammation in those membranes and mimic lupus, a serious autoimmune disease.

Even if the T-cells do not hit innocent targets, there are still risks. Proteins they release could cause a cytokine storm high fevers, swelling, inflammation and dangerously low blood pressure which can be fatal. Or, if the treatment rapidly kills billions of cancer cells, the debris can damage the kidney and cause other problems.

Even if the new T-cell treatment proves to work, the drug industry will be needed to mass produce it. But the research is being done only at universities, not at drug companies. For the drug industry to take interest there will have to be overwhelming proof that the treatment is far better than existing ones.

The trial was a Phase 1 study, meaning that its main goal was to find out whether the treatment was safe, and at what dose. Of course, doctors and patients always hope that there will be some benefit, but that was not an official endpoint.

So it will be interesting to hear updates about this exciting news and I will let you know when I hear about them.

Hope you have a great weekend!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab