
Killing cancer like the common cold - interconnector
http://www.cnn.com/2013/12/07/health/cohen-cancer-study/index.html?hpt=hp_t2
======
JunkDNA
I've commented on this around here before. You read lots of junk about cancer
"cures" in the popular press. They are almost always in mice or something and
I or someone else with a similar background always feels compelled to weigh in
and remind folks that it's a long way from curing lab rats to curing people.

This however, is the real deal. It's quite remarkable and there's likely more
stories like this for other diseases on the way.

I went to a gene therapy session this fall at the American Society of Human
Genetics conference in Boston and was blown away by some of the success people
are having. I quipped to colleagues that I felt like I was in a science
fiction movie. The most remarkable one was where they used an approach similar
to the one here to cure a fatal metabolic disorder (relaying this from memory,
so some of my recollection may be off). Kids with the disorder have a busted
enzyme that causes slow degeneration of neurons. They don't live past 6 or 7
if I recall. The team showed how modifying a certain kind of stem cell found
in the body normally to have the correct copy of the enzyme cured several
patients. The corrected cells naturally move to the brain where they
differentiate into glial cells and produce the correct copy of the enzyme. It
turns out that because the neurons in the brain are starved for this enzyme,
they express receptors that allow them to take it up from the environment. So
the repaired glial cells supply enzyme to the entire brain (i.e. it's not
necessary to modify every neuron in the brain to have a correct copy of the
enzyme). They can completely cure kids with this approach. All of their
muscular and neurological tests are 100% normal.

They had videos of these kids running around and playing just as if nothing
was wrong. In one case, a younger brother lived but his older sister (who was
too old when the therapy came out) had died. It was hard not to get choked up
looking at their smiling, happy faces as they ran around, thinking that if
this therapy hadn't existed, they would be in a nearly vegetative state.

Gene therapy had a rough start with the early setbacks, but I'm getting the
sense that the tide is rapidly turing.

~~~
lmg643
I'm not an expert, just an interested layperson, but from what I read, I am
starting to wonder whether cancer cures might be more basic than we realize,
we're just not looking at the right things.

The example that keeps coming to mind is HPV - it can cause cervical cancer
etc. And, since there is an immunization for HPV, the disease is preventable,
and to the extent it is the "only" cause of certain cancers, would also
prevent those cancers.

So is HPV the "only" virus which causes cancer? Seems unlikely. I just don't
know how much research is focused on bacterial or viral origins. Maybe it is
not glamorous or mysterious enough to justify funding.

The 2005 nobel in physiology went to Barry Marshal for discovering that
stomach ulcers, long a mystery, were caused by Helicobacter pylori bacteria.
And in fairness to history, he wasn't even the first person to discover it,
just the most recent person in western society.

[http://westhunt.wordpress.com/2012/02/22/low-hanging-
fruit/](http://westhunt.wordpress.com/2012/02/22/low-hanging-fruit/)

~~~
pak
Viruses are only one potential cause of cancer, and there are several known
tumorigenic viruses (HPV, adenovirus, EBV, polyomavirus, etc.). There are
still researchers that believe that all remaining cancers are caused by yet
undiscovered viruses (the "viral hypothesis"), but these researchers are
becoming scarce.

It seems more likely that cancer can also be a disease of aging and
degeneration. As we get older, things break. Cellular division is liable to be
one of those things. There are identified mutations that dramatically
predispose people to cancer, because one of the genes controlling cellular
division is already broken (the "Knudson hypothesis").

Some researchers do prefer to use the viral cancers as a model for studying
the others, because they luckily have a singularly identifiable cause, and
therefore seem more likely to point to the causative mutations behind cancer
as a general process. This is the premise for a paper that I helped author:
[http://www.nature.com/nature/journal/v487/n7408/full/nature1...](http://www.nature.com/nature/journal/v487/n7408/full/nature11288.html)

Nitpick: in the same vein, not all gastric ulcers are caused by _H. pylori_.
Another common cause is chronic NSAID (e.g. ibuprofen) use.

~~~
Double_Cast
Your link lost me at the first sentence. But the word "phenotype" reminded me
of this 11 minute Khan Academy video. Maybe I'm just repeating the same thing.
But I thought Sal's video was worth sharing and easily digestible.

[https://www.khanacademy.org/science/healthcare-and-
medicine/...](https://www.khanacademy.org/science/healthcare-and-
medicine/healthcare-misc/v/systemic-thinking-about-cancer)

tl;dr

For whatever reason, Breast Cancer prefers to metastasize bone (which is a
phenotype). Something as simple as giving cured Breast Cancer victims a
calcium supplement can significantly reduce remission. Phenotypes >=
Genotypes?

Scientific article cited in comment section:

[http://www.nejm.org/doi/full/10.1056/NEJMoa0806285](http://www.nejm.org/doi/full/10.1056/NEJMoa0806285)

------
antirez
Great news but bad title as there are no treatments for the common cold.

~~~
cromulent
Your own immune system kills the common cold. That's the point :)

~~~
ttflee
Yeah, there is no cure for the common cold, except immune system, so far.

------
nroose
Does anyone know if this can be applied to other cancers too? I think they
only mentioned leukemia, but they seemed to imply that it would be applicable
to other cancers. But would the therapy have to be for each cancer or broadly
for all cancers? And I am guessing they would have to choose between this and
chemo, since I think chemo hurts your immune system. And that would be a
difficult choice, no?

~~~
JunkDNA
The reason this works is that there happens to be a protein on the outside of
leukemias that allows you to uniquely target only the cancerous cells, leaving
everything else alone. Provided a similar molecular signature could be found
in other cancers, it might be possible to do this elsewhere.

------
girvo
I've read about this before. I'm excited and cautiously optimistic about it
moving forward. One hopes that it can save other people in the future. Even
some is better than 0. Personalised immunotherapy is cool :)

------
jroseattle
My mom had cancer surgery at Sloane Kettering in NYC. After surgery, which
removed _most_ of the cancer, she was put on a treatment regimen that involves
a certain type of medicine (which she'll be on for the rest of her life.)

Because she matched a gene, she's able to take a medicine called Tarceva. In
essence, this medicine makes her lung cancer a chronic illness -- it's
present, but doesn't spread or metastasize. It's a similar strategy to the one
now employed with people who are HIV positive.

Mom is still kicking, so this stuff is working.

------
troymc
Here's the Penn webpage about their T-Cell Immunotherapy for Leukemia:

[http://www.penncancer.org/tcelltherapy/](http://www.penncancer.org/tcelltherapy/)

------
guelo
The sad part of this story is how this publicly funded research is being
licensed to Novartis.

~~~
refurb
Why is that bad?

If I had a promising new drug, I'd want someone with years of experience in
getting a drug approved helping me out and the billions in capital to get it
done wouldn't hurt either (which of course is available because Novartis sold
a number of profitable drugs).

The professor who came up with this science is going to get a cut of that, as
will the university.

------
j2d3
This approach seems roughly similar to what Sangamo Genetics has been trying
for HIV - with some recent success -
[http://www.aidsmeds.com/articles/Sangamo_genetics_1667_24579...](http://www.aidsmeds.com/articles/Sangamo_genetics_1667_24579.shtml)

~~~
j2d3
Um, actually, on the other hand - re: Sangamo Genetics:
[http://seekingalpha.com/article/1705622-sangamo-a-fiery-
biot...](http://seekingalpha.com/article/1705622-sangamo-a-fiery-biotech-with-
a-product-poised-to-go-down-in-flames)

Yikes!

~~~
dekhn
Zinc finger nucleases are effectively obsolete; CRISPR systems do the same
thing, but you don't have to develop custom proteins- just supply the
approprately synthesized complementary DNA.

------
fraXis
There will never be a cure for cancer.

My wife was diagnosed in September with stage 1 breast cancer. She has triple
negative breast cancer which is the most aggressive kind to get. She is on
week 6 of a 16 week Chemotherapy regimen. Then she has 8 weeks of radiation.

Insurance has already spent over 100k on her lumpectomy and chemo drugs and
doctor appointments since September.

Every week when we go to her oncologist office, the waiting room is always
full with patients we have never seen before. More than half of them are new
patients filling out their new patient paperwork. And they are getting younger
and younger in age. We have seen teenagers in his office with breast cancer.

There is just too much money (doctors, surgery, drugs) to be made from
treating this disease. What are all of these trained oncologist
surgeons/doctors going to do if cancer gets cured? What are the drug companies
that make these expensive chemo drugs going to do if cancer gets cured?

There is no way they are going to cure this horrible disease. There is no
money to be made in the cure.

~~~
Retric
Unlike infectious diseases there will always be new cancer patents so you
really can make a lot of money from a cure.

~~~
fraXis
I don't feel that way. I see all the money that is being made from the ongoing
treatment of Cancer. Drugs, surgery, scans, follow up appointments, radiation,
and then the cycle repeats when the cancer returns or comes out of remission.

------
fbarriga
[http://www.scientificamerican.com/article.cfm?id=genetically...](http://www.scientificamerican.com/article.cfm?id=genetically-
engineered-immune-cells-found-to-rapidly-clear-leukemia-tumors)

Old news ?

------
caycep
I vaguely recall this being posted before a few months back, but in a long-
form journalism writeup in a local Philly paper...I can't recall exactly where
but I remember it was well written.

------
msie
I hope that all these promising therapies somehow make it out of their trials
and more people can benefit from them.

------
boyaka
Here's how you deal with cancer:

[http://m.vice.com/weediquette-show/stoned-
kids](http://m.vice.com/weediquette-show/stoned-kids)

------
gerhardi
If/when the cure makes it through the final tests to the market, the sad thing
is that they are probably going to rip off everyone who needs it, no matter
what are the real costs.

But anyway, a life is worth everything(?)

~~~
JunkDNA
The "real" costs of making ordinary drugs are small in terms of manufacturing.
It is very inexpensive to synthesize the chemicals that make up most drugs.
You're paying for the R&D of the drug as well as all the ones that failed
along the way. In the days when software used to be sold in cardboard boxes
and came on CD's, nobody was making the argument that someone like Microsoft
should charge a few dollars since CD's and cardboard are cheap.

All that said, in this _specific_ case, the therapy is enormously complex,
time consuming, and expensive. It's not a simple chemical compound that can be
manufactured in bulk. Furthermore, it has to be tailor-made in a lab under
highly controlled conditions for each individual receiving the treatment. As a
result, it is likely to be extremely costly when it finally makes it out of
the experimental phase.

~~~
twobits
"It is very inexpensive to synthesize the chemicals that make up most drugs"

Can I ask a stupid q? How exactly inexpensive is it? Thinking in line of 3d
printing, how possible could it be to get the chemicals needed, and the
machines needed to mix them appropriately, to make a known drug? Ie, how
possible would be to "download a pill"? The recipe, and you make it yourself
at home?

~~~
refurb
It depends on how complicated the drug is. Some drugs are actually kinda
pricey to manufacture while others can be made for pennies a dose.

Yes, you can make many drugs at home with the right setup and technical
knowledge. No, robots don't actually help that much.

