
Immune discovery 'may treat all cancer' - sjcsjc
https://www.bbc.co.uk/news/health-51182451
======
ramraj07
Original article -
[https://www.nature.com/articles/s41590-019-0578-8](https://www.nature.com/articles/s41590-019-0578-8)

Very interesting finding indeed, these T cells seem to (not fully confirmed)
target cells with abnormal mrtabolism, which is one of the hallmarks of cancer
in general (most cancers at least).

This solves one of the biggest problems with immunotherapy, which is that if a
cancer is not different from regular tissue in any fundamental way that the
immune system cannot recognize, then it can't fight it. This is why melanoma
is the poster child of immunotherapies (skin cells get mutated a ton due to UV
so skin cancer has a lot of mutations to differentiate it by). If this cell
stands further scrutiny, it could potentially be a very general therapy option
indeed.

Potential caveat is that cancers typically find a way to generate resistance,
and markers of abnormal metabolism (at least as detected by this MR1 receptor)
night be easy to suppress, in which case this might just become one in a line
of multiple treatments. That might still be good enough though.

~~~
mabbo
> cancers typically find a way to generate resistance

Resistance is a neat thing.

I remember (and I'm sure someone will reply with a link to it, since I can't
find it) reading a story about a fellow with a very seriously antibiotic
resistant bacteria infecting his chest. It resisted everything they had.
Researchers found a phage that would attack that specific bacteria- but alas,
the bacteria became resistant to the phage as well!

Fortunately, the bacteria had limited dimensions in which to change. The
changes needed to become resistant to the phage made it no longer resistant to
at least one of the antibiotics. It could not have its cake and eat it to.
With both attacks against the bacteria ongoing, it was defeated.

What I'm implying with all this is that yes, the cancer may become resistant
to this therapy in question but in doing so it may be forced to become less
dangerous, or less resistant to other forms of attack. It does not change
merely from "not resistant" to "resistant" but from "form A, which is not
resistant" to "form B, which is resistant", and "form B" may have a lot of
other consequences.

~~~
lps41
It’s my understanding that cancer stems from malfunctioning of our own cell
processes, rather than from something that is viral/bacterial.

For that reason it seems wrong to think about cancer as “developing”
resistances - I don’t believe that cancer is something that evolves/mutates.

~~~
lps41
Turns out I’m wrong! Cancer does undergo natir selection and develops
resistance:

[https://en.m.wikipedia.org/wiki/Somatic_evolution_in_cancer#...](https://en.m.wikipedia.org/wiki/Somatic_evolution_in_cancer#Natural_selection_in_cancer)

~~~
nicwilson
and they can be viral in nature, see oncogenic viruses e.g. HPV (cervical
cancer)

------
ajarmst
I thought we learned our lesson about "paradigm-changing" scientific results
released to the media simultaneous with initial publication a while back. The
paper was published today, and only available behind a pay wall. Yes, this is
exciting, but what they appear to have is a better way of tagging cancer cells
so the immune system will attack them. This is one round of rodent studies in
immunosuppressed mice, for which the abstract only claims "enhanced survival".
There is no reflection or information from anyone who isn't actively on the
team. This is a press release before a funding cycle, not science. "May treat
all cancers?" Please.

~~~
headmelted
This.

How many times in the last 10 years have we gone bananas on HN for an
immunotherapy wonder drug just to find it’s another casualty of the current
unable-to-reproduce crisis in current science?

Remember when CD47 monoclonal antibodies from the Stanford trials were going
to save millions of lives? What a time to be not yet dead that was.

The poster above is correct. Wanting this to be something wonderful doesn’t
make it so, and anyone familiar with the subject matter knows this deserves
skepticism. This is getting upvoted because it sounds good, not because
there’s solid evidence it has legs.

I’d love for this to become a high efficacy treatment for millions of people,
but we’ve had the same thing play out _so many times_ now that it’s impossible
to be excited.

This is what usually happens:

They’ll try it in the lab, and it’ll kill cancer.

They’ll inject it in mice, and it’ll kill cancer.

They’ll try it on people, and it’ll reduce the size of their tumors for six-
to-eight weeks before they start growing again.

I’ll remember to check back in a year to to see if this is even still a thing.

* temporarily

~~~
ammon
Reducing the size of a tumor for six to eight weeks (especially via a new
method) could actually be an important result. Many cancer drugs only result
in temporary remission when used in isolation, before the cancer out-evolves
the drug and comes back. However, using multiple drugs simultaneously
(combination chemotherapy) and using the drugs after surgery to kill remnant
cells can have a far larger impact. Many of the drugs that can now 'cure'
certain cancers in combination only provide brief remission by themselves.
(Disclaimer: my only knowledge of this comes from the book The Emperor of All
Maladies)

~~~
headmelted
Fair point with regards to combined therapies.

The Emperor of All Maladies is one of my favourite non-fiction books. As long
as you can get through the human experimentation. That’s hard going (and
horrifying).

~~~
ptha
Kindle edition appears to be £1.49 on Amazon.co.uk
[https://www.amazon.co.uk/Emperor-All-Maladies-Siddhartha-
Muk...](https://www.amazon.co.uk/Emperor-All-Maladies-Siddhartha-Mukherjee-
ebook/dp/B004MPR80E/)

------
kasperni
Some more details at [https://www.telegraph.co.uk/science/2020/01/20/immune-
cell-k...](https://www.telegraph.co.uk/science/2020/01/20/immune-cell-kills-
cancers-discovered-accident-british-scientists/)

> The team says human trials on terminally ill patients could begin as early
> as November if the new treatment passes further laboratory safety testing.

~~~
cchance
This is what I like to hear! People die daily from cancer, treatments like
this with promise should be an option even if it's a long shot, the people are
about to die anyway, it can only do good, for them or for science.

~~~
1shooner
I definitely agree making it available is a good thing.

However, I'd take exception to 'it can only do good'. I've had a loved one opt
for experimental treatment that was ineffective, and made the last months of
his life more painful and separated from his family (treatment was in another
city). I'm not saying we would choose differently if we were faced with it
again, but in some respects I wonder if it was more a service to our peace of
mind at having done all we could than it was for his comfort or happiness.

~~~
zeta0134
Mind here that it can also be for the _patient 's_ peace of mind. My
grandfather was faced with a similar dilemna, terminally ill from pancreatic
cancer, with a long-shot to try to cure it. The doctors were wonderfully frank
about the potential for failure and "time lost"; even still, he opted to go
down fighting. Alas, his liver wasn't strong enough to sustain the treatment,
and it just ended up killing him faster.

He was a spiritual man and didn't seem regret the decision, but his family had
a harder time with it. They were arguing for something closer to hospice, and
wanted to take him traveling to enjoy the last months of his life in relative
peace. In the end, that didn't get to happen.

There will always be a twinge of regret, I think. One can always look back and
ask, "what if we had done it this way?" But it was the way he wanted to go,
and I think the knowledge that he had tried everything that he could helped
him to find peace.

~~~
asdfasgasdgasdg
I'm glad that your grandfather was happy with his decision. But from a policy
perspective, there's a question to be asked about whether it makes sense to
spend tens or hundreds of thousands of dollars on treatments that likely kill
people faster. Even if that is what those people want, their needs have to be
balanced with others who need the scarce resources that are allocated to the
health system.

(On the other hand if this was an experiment and it just didn't go his way,
that's another story. We need brave people to accept these experimental
treatments sometimes to find whether they work.)

------
rosybox
I'm happy for all the progress being made with cancer. I wish we would also
make progress on diseases that attack the nervous system for which we seemed
to have made next to none. Alzheimer's, ALS, MS, Parkinson's, Hunnington's
Disease, Kennedy Disease, Muscular Dystrophy, small fiber neuropathy, even
benign issues such as essential tremors have no cure, and some of these are
painful death sentences.

We seem to know so little about how our bodies work. There are no bio markers
for some of these or early detection and little idea what are the causes or
the important details of what's happening as the disease progresses.

~~~
pmiller2
As a matter of public health, we should really be focusing the vast majority
of our efforts on cancer and cardiovascular disease. Odds are that most people
will end up dying of one or the other.

~~~
dwaltrip
Mental health [1] should be on that list. The amount of suffering as well as
economic losses from mental health issues are overwhelming.

[1] Ideally we should work towards broader / more fundamental goals such as
"well-being" and "meaning", but that is even more difficult.

~~~
Wowfunhappy
Psychology research is certainly important, but not in the same way as cancer
research.

For mental health, what's primarily needed is more access to therapy.

~~~
DanBC
We need better, safer, anti-psychotic medication.

We need better, more effective, treatment for entrenched eating disorder.

We need better treatments for treatment-resistant depression or anxiety
disorders.

~~~
penagwin
This.

Currently most mental health medicine is like throwing darts in the dark. We
clearly don't actually understand why some medications work for some people
but not others. If you go through the medicine path then I can only wish you
the best of luck - finding the right medicine is life changing but it's a long
arduous struggle to find it currently.

Not to mention the side effects...

~~~
dodobirdlord
> We clearly don't actually understand why some medications work for some
> people but not others.

There are plenty of psychoactive drugs where we have no understanding of why
they work _at all_. Lithium is one of the oldest, most successful, and best
known medications for bipolar disorder, major depression, and schizophrenia,
and we have _no idea_ which of the many effects it has on the body actually
contribute to stabilizing mood.

------
aaavl2821
this describes a t cell receptor that recognized and killed cells from several
cancers while sparing healthy cells

theoretically this could may made into a therapy by taking t cells from
patients, modifying their DNA to express this receptor, and then
readministering the modified t cells to patients

there are two FDA approved drugs that use this basic approach. however, this
only works currently in "liquid tumors", not "solid tumors" like breast
cancer, lung cancer, prostate, etc

This article gives a nice, simple explanation as to why solid tumors are more
difficult (scroll down to the chart): [https://www.the-
scientist.com/features/the-next-frontier-of-...](https://www.the-
scientist.com/features/the-next-frontier-of-car-t-cell-therapy--solid-
tumors-65612)

if this works, then the first challenge listed in the chart would be
mitigated. however the challenges of a suppressive tumor environment and
sufficient delivery to tumor cells is still a major unsolved challenge

~~~
aduitsis
One more good article: [https://www.newyorker.com/magazine/2019/07/22/the-
promise-an...](https://www.newyorker.com/magazine/2019/07/22/the-promise-and-
price-of-cellular-therapies)

and:

[https://www.novartis.com/news/media-library/car-t-cell-
thera...](https://www.novartis.com/news/media-library/car-t-cell-therapy-
infographic)

------
gus_massa
The title says _may_ , but it's a very optimistic title anyway. From the
article:

> _However, the research has been tested only in animals and on cells in the
> laboratory, and more safety checks would be needed before human trials could
> start._

> _Lucia Mori and Gennaro De Libero, from University of Basel in Switzerland,
> said the research had "great potential" but was at too early a stage to say
> it would work in all cancers._

~~~
OJFord
The abstract closes:

> These findings offer opportunities for HLA-independent, pan-cancer, pan-
> population immunotherapies.

So it hasn't come (to the journalists) from nowhere.

------
_wldu
A vlogger I follow on Youtube (Mark Carriker) was diagnosed just over a year
ago. He's recorded everything. From first diagnosis, surgery, radiation,
chemo, immunotherapy, trial drugs and now Hospice. It's heart breaking to see
someone go through this. Hopefully, a cure will be found soon.

[https://www.youtube.com/watch?v=CZ5Sk7x7VwY](https://www.youtube.com/watch?v=CZ5Sk7x7VwY)

------
davidchua
This sounds very promising and also sounds like this case just a couple of
days ago where a young boy was removed of cancer cells. I'm not sure if it's
the same kind of treatment.

[https://www.channelnewsasia.com/news/singapore/oscar-
saxelby...](https://www.channelnewsasia.com/news/singapore/oscar-saxelby-lee-
cancer-leukaemia-experimental-treatment-12269276)

------
jfk13
One key quote:

> "At the moment, this is very basic research and not close to actual
> medicines for patients."

~~~
toomuchtodo
At the same time, this could make chemo and radiation therapies obsolete long
term.

Leaches and amputations without anesthetic were once “state of the art”, and
it feels like that’s where we’re currently at with cancer therapies. CRISPR is
knocking on the door of amazing potential.

~~~
rzzzt
I'm wondering if there's a "Can I use"-kind of summary for proposed cancer
treatments available somewhere; presenting the various methods attempted,
which kind they target, do they work in vitro, in animal models, are they
currently in clinical trial, effectiveness results, link to papers, etc.

~~~
crystaldev
Can we just get an npm package already?

~~~
ThalesX
Ugh... have you stopped following the Javascript ecosystem for the last three
hours? We use YARN or NPX now. /s

------
aazaa
> The findings, published in Nature Immunology, have not been tested in
> patients, but the researchers say they have "enormous potential".

then later:

> However, the research has been tested only in animals and on cells in the
> laboratory, and more safety checks would be needed before human trials could
> start.

The abstract for the original article notes:

> ... An MR1-restricted T cell clone mediated in vivo regression of leukemia
> and conferred enhanced survival of NSG mice. TCR transfer to T cells of
> patients enabled killing of autologous and nonautologous melanoma. ...

[https://www.nature.com/articles/s41590-019-0578-8](https://www.nature.com/articles/s41590-019-0578-8)

What does that second sentence mean?

~~~
acqq
Also: TCR == T cell receptor

Here are some the descriptions of the related methods currently researched:

[https://www.cancerresearch.org/immunotherapy/treatment-
types...](https://www.cancerresearch.org/immunotherapy/treatment-
types/adoptive-cell-therapy#tcr)

------
alan-crowe
Perhaps this discovery could end up going the other way, with those newly
discovered T-cells being the culprit in auto-immune diseases. Boosting their
action would be too dangerous to use as treatment for cancer, but knowing that
they are there may lead to new treatments for auto-immune diseases.

And where does this fit into transplant rejection? Perhaps MR-1 differs enough
between people to cause problems. This reads like the early days of a
discovery that could lead anywhere.

~~~
geerlingguy
As someone with Crohn's and who knows people with all sorts of similar
(maybe?) autoimmune diseases, any nugget of hope for something besides
immunosuppressant treatment (meaning our bodies are always welcoming of other
infections/sickness) is welcome.

------
symplee
Anyone know how we HN readers can help this effort?

Is there some open source scientific community/repository like GitHub? (Where
people can pull down the latest data and ideas, and add to them, then push our
changes back to the main scientists.)

~~~
jeswin
> Where people can pull down the latest data and ideas, and add to them, then
> push our changes back to the main scientists.

A repository of ideas from non-experts will probably slow down things rather
than help them. I'm not dismissing the idea outright; perhaps there's a way
structured inputs from patients and caregivers can be helpful (again with some
review mechanism so that real researchers don't have to wade through
irrelevant data.)

~~~
symplee
Thanks for the feedback. So maybe the main scientists would host the
repository, with their ideas and data. Then we could review and perhaps add to
the main scientist's ideas, or find problems with the data. Or add more data
with our own experiments. In other words, a collaborative approach. Maybe the
main scientists could limit contributions to people who met a certain
threshold of earlier verified contributions. Or let other people corroborate
and verify before the main scientists even saw the layperson's contributions.
Just an idea, open to improvements!

~~~
pc86
How do you feel about opening up your company's git repositories to non-
experts? I think an adequate example of the difference in expertise between an
average software developer and a _cancer researcher_ means we should probably
open up your git repos to a 9 year old.

Most of the people in this thread have about as much reason to "share ideas"
with cancer researchers as a 9 year old has to share ideas about your line-of-
business form-over-data web application.

------
jonplackett
It’s not quite a ‘one size fits all’ if you have to take cells and genetically
modify them for every patient. Sounds like it would be very expensive. Amazing
nevertheless if it really works.

~~~
jonstewart
There’s a similar treatment already, CAR-T. The “one size fits all” aspect
here is that this receptor mechanism may possibly work with many common solid
tumor types (*in mice), whereas CAR-T’s efficacy is limited with solid tumors,
but can be dramatic with leukemias and lymphomas. There’s a related therapy
for prostate cancer, Provenge
([https://en.m.wikipedia.org/wiki/Sipuleucel-T](https://en.m.wikipedia.org/wiki/Sipuleucel-T)),
but it’s merely a life-extending treatment and not the cure that CAR-T can be.

------
chefkoch
Couldn't one develop BiTEs (Bi-specific T-cell engagers) for this receptor?
That would be cheaper and off the shelf for every patient.

------
codekansas
My girlfriend (who is in medical school) actually brought this up to me when I
was talking to her about how it seemed that not only the rate of R&D was
increasing, but the time to market was also falling dramatically. It's cool to
see these kinds of developments being utilized so much faster

------
DoreenMichele
_The upgraded cells would be grown in vast quantities in the laboratory and
then put back into the patient._

What I would like to see is a world in which doctors and researchers ask "Why
isn't your body already making enough of these and what can we do to help it
crank them out in sufficient quantities?"

~~~
Nitramp
My understanding is that cancer kills you late enough in your life to has
little impact on your ability to reproduce, and thus fitness in the
evolutionary sense.

[https://www.cancerresearchuk.org/health-
professional/cancer-...](https://www.cancerresearchuk.org/health-
professional/cancer-statistics/mortality/age#heading-Zero)

These are deaths / 100'000 people. It's a bit difficult to judge precisely in
that resolution, but death by cancer is <1%/year before the age of 40. That
was roughly the life expectancy (assuming you made it past childhood, big if),
for humans during most of their evolution.

So the likely answer is that it never mattered to our body (or survival) to
combat cancer effectively.

~~~
jcranmer
> death by cancer is <1%/year before the age of 40. That was roughly the life
> expectancy (assuming you made it past childhood, big if), for humans during
> most of their evolution.

My understanding is that Paleolithic peoples generally had a life expectancy
of about 50-60, assuming that you survived childhood. The development of
Neolithic probably lowered life expectancy somewhat (since, basically, people
eating an agricultural diet are essentially chronically malnourished until
sometime in the Early Modern).

Nowhere have I seen any indication that the life expectancy of humans, at any
point in time, was as low as 40.

~~~
Nitramp
I'm not by any means an expert, but the very first Google hit (wikipedia as
usual) gives:

> Based on Neolithic and Bronze Age data, the total life expectancy at 15
> would not exceed 34 years.

[https://en.wikipedia.org/wiki/Life_expectancy](https://en.wikipedia.org/wiki/Life_expectancy)

Which in turn cites this article:
[https://onlinelibrary.wiley.com/doi/abs/10.1002/ajpa.1330300...](https://onlinelibrary.wiley.com/doi/abs/10.1002/ajpa.1330300314)

------
SubiculumCode
I wonder if this could have anti-aging uses to identify and remove cells
dealing with metabolic dysregulation.

~~~
xiphias2
One anti-aging speedup would be that long term safety of HGH therapy would be
much less important if cancer would be easy to cure.

Peter Thiel started HGH therapy in 2014 because ,,cancer would be cured in 10
years anyways''.

It seems to me like his prediction is coming true (maybe we'll need 5 extra
years though).

------
Vysero
Why does more testing need to take place? I would be willing to bet the
majority of people currently dying of cancer within the next month or so would
have zero problems testing it for them. So much bureaucracy. People need help
now.

~~~
randcraw
Like most new cancer therapies, this will surely get “expedited” status from
the US FDA, which will enable as fast a development as imaginable, like FIM
(first in man) within the year. If it delivers on its promise, it will receive
initial approval for those with advanced metastases of the initially targeted
forms of cancer within a year after that.

A major question is the cost of the therapy. If it equals CAR-T, which it
closely resembles, it will NOT see rapid adoption until the price per
treatment falls below CAR-T's current bill of $500,000 US.

~~~
NotSammyHagar
Beating 500k/patient seems like an approachable target. When my mom had lung
cancer, when it recurred it came so fast there was never any time to think
about speculative treatments. Of course you'd pay anything to save your loved
one.

------
jl2718
What is the theory here with MR1? They say it’s a metabolic indicator, but
it’s a MHC. Looks to be involved with B3/NAD. Does a cancer cell just run out
of NAD so MR1 doesn’t get presented?

~~~
jl2718
Side note: I’ve been self-experimenting with high doses of niacinamide, and
experiencing some weird side effects, possibly immune-related, like angular
chelitis. Probably unrelated.

~~~
1996
Please tell us more.

High dose of NMN are supposed to be helping develop some cancers.

angular chelitis is totally new to me. Are you on retinoids by any chance?

~~~
jl2718
I took a lot of cod liver oil once it started, maybe a little bit before too,
so I suppose it could be that. I did a lot of research into what would
increase NAD levels, and it’s all pretty inconclusive, so I figured
niacinamide was as good as any other B3 in the pathway. I later found that it
chelates with some minerals, so I may be giving myself a deficiency.

~~~
1996
Yes a deficiency is far more likely than an autoimmune disorder

------
msie
Neil Peart, David Bowie, Gordon Downie. I’ll know we’ve made significant
advances if a celebrity can use his/her status to get cured.

~~~
jonstewart
How’s a former President?

[https://abcnews.go.com/Health/remarkable-cancer-treatment-
he...](https://abcnews.go.com/Health/remarkable-cancer-treatment-helped-jimmy-
carter-combat-brain/story?id=37467459)

(Although there’s no indication his status led to his cure, of course. With
immunotherapy, the requisite status seems to be “can become patient of a
decent clinic,” not “former leader of the free world” and/or legendary rock
god.)

------
Ericson2314
So who has the mutation in their T cells already?

------
OrgNet
If I need this right now no matter the outcome, what do I need to do?

------
classified
Did they find a cure for Dunning-Kruger syndrome yet?

------
jjgreen
Er, wasn't that the plot of I Am Legend, "... three years later ..."

