Immunology brings successes and sobering news

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Immunology brings successes and sobering news

Postby Damian » Fri Jan 06, 2017 1:52 pm

Cancer update - what the researchers do NOT research is the value of simply letting the immune system do its own stuff which is what we advocate on http://www.cansurviving.com - see esp 'severe side-effects' mentioned below... all your comments would be most welcome...

Immunology brings successes and sobering news
By Siddhartha Mukherjee (from the Guardian Jan 2017)

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Can the human body be taught to reject cancer cells? The biggest idea in cancer this year – and perhaps the most exhilarating idea in all of medicine – was that a dormant immune system could be roused to attack cancer.

It is an idea with a tortured history. In the 1890s, William Coley, a New York scientist and surgeon, had proposed injecting cancer patients with a mixture of bacterial toxins (called Coley’s toxins) to elicit an immune response that would attack cancer cells. But Coley’s initial results were hard to interpret and reproduce, and enthusiasm for the toxins waned. When I began to study immunology at Oxford in the 1990s, the field of cancer immunology was, frankly, languishing in neglect.

In the late 90s, however, the discipline took a surprising turn: scientists working on the immune system (led, particularly, by the visionary immunologist James Allison) began to discover that some tumour cells expressed specific factors to inactivate the immune system or render themselves invisible to immune cells. These invisibility proteins offered an opportunity for a counter-attack: specific factors were created to inactivate these cloaking signals so that tumours would become visible again. The first such drugs were deployed against melanomas, and some patients showed durable responses, albeit with severe side-effects.

Since those initial trials, dozens of strategies to activate the immune system have been discovered, and fleets of new immunomodulatory drugs have appeared in the clinic. In another twist on the same theme, a patient’s own immune cells were brought out of the body, manipulated with gene therapy to arm them to attack cancer cells, and reintroduced to the patient. These cells grow in the body once reintroduced, making them exemplars of a new generation of “living drugs”, as Michel Sadelain, one of the pioneers of this strategy, has described them.

Immunotherapy for cancer has had some sentinel successes – notably against melanoma, lung cancer, lymphomas and some leukemias. But this year also brought sobering news about unexpected side-effects of these drugs: patients suffered inexplicable fevers or life-threatening colitis. Broader questions about efficacy and cost remain.

Are these drugs going to be useful to treat only a small fraction of tumours? How much will they cost – and can that be contained?

One strange effect of immunotherapy is that tumours can often swell and become larger during the early course of treatment, as immune cells infiltrate the tumours and create inflammation. For decades, the traditional metric to judge tumour responsiveness was to measure the size of the tumour – yet here the cancers seemed to grow before some of them finally responded to the therapy. Will traditional metrics of tumour responsiveness need to be re-evaluated with immunotherapy? How will we understand why and when these cancers relapse – and can the immune system be retrained, over and over, to attack such perennially evolving cancers?

Siddhartha Mukherjee is an assistant professor of medicine at Columbia University and the Pulitzer prize-winning author of books including The Gene and The Emperor of All Maladies: A Biography of Cancer. (reviewed in the Library section of the cansurviving site)
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Re: Immunology brings successes and sobering news

Postby esperanzajpalmer » Thu Jan 19, 2017 10:02 am

Individuals with cutting edge melanoma ordinarily live for only six to ten months after conclusion. In any case, Gorman, then 49, had little persistence for the specialists encouraging him to get his undertakings all together. At the point when his sister educated him concerning a medication called interleukin-2 (IL-2) that was being utilized together with chemotherapy against melanoma at a clinic in Colorado, he went from his home in Silver Spring, Maryland, to try it out.
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