
Cancer ‘vaccine’ eliminates tumors in mice - jv22222
https://med.stanford.edu/news/all-news/2018/01/cancer-vaccine-eliminates-tumors-in-mice.html
======
jcims
Writing this from a squeaky recliner set beside my wife’s bed in the oncology
department of a local research hospital.

Three weeks ago she had a radical hysterectomy and partial lymphadenectomy to
treat stage IIIc ovarian cancer, and we’re back to try to aid her in her
recovery to prepare for chemotherapy. Chemo should start next week, but we are
hoping to also participate in a clinical trial for atezolizumab. This is a
drug that essentially blocks the cancer cell’s immunosuppressive mechanism
(expression of PD-L1) and allows the body’s natural immune response to do work
on the disease.

Suddenly inspired to learn more of the nitty gritty around how cancer and the
associated therapies work, I’m shocked at how sophisticated the battle is. At
least in this case, the unregulated reproduction of cells is just the
beginning, and my lay mind can’t grasp how simple mutation is responsible for
it. If someone told me cancer was sentient with a will to thrive, I’m now much
less inclined to laugh them off.

Therapies that arm our own immune syatem in the fight against this monster
really seem like the light at the end of the long, dark tunnel.

~~~
hwillis
Squeeze her hand for a stranger. Every person who has lost someone to cancer,
and everyone who has survived it, and all of the people who watched that
fight- all of us have her back and stand with her. She's fighting one of the
hardest battles put to a person, and she has our respect and awe. I saw my
friend at his weakest, and also when he was stronger than anyone I've ever
known. It's been years but still, I'm crying. Cancer is personal. Once it
touches you, and you see the enemy, you see how everyone is fighting _your_
enemy. I'm grateful to her. We'll be cheering when the bell rings for her- all
of us.

Fuck cancer.

~~~
jcims
Thanks so much for this heartfelt comment. The personification of cancer as an
enemy didn't really click with me until my family was directly threatened by
it. Reading through the drugs in her chemo cocktail, I come across
bevacizumab. A little bit of googling and:

    
    
      A cancer needs a good blood supply to provide itself 
      with food and oxygen and to remove waste products. When
      it has reached 1 to 2mm across, a tumour needs to grow
      its own blood vessels in order to continue to get
      bigger.
    
      Some cancer cells make a protein called vascular
      endothelial growth factor (VEGF). The VEGF protein
      attaches to receptors on cells that line the walls of
      blood vessels within the tumour. The cells are called
      endothelial cells. *This triggers the blood vessels to
      grow so the cancer can then grow.*
    

Wait...what?!?!

OK, what about this trial...atezzolblablblah.. What's it do?

    
    
      Programmed cell death protein 1 is a cell surface
      receptor that plays an important role in down-
      regulating the immune system and promoting self
      tolerance by suppressing T cell inflammatory activity. 
      PD-1 is an immune checkpoint and guards against
      autoimmunity through a dual mechanism of promoting
      programmed cell death in   T-cells in lymph nodes while
      simultaneously reducing cell death in regulatory T
      cells.
    
      ...
    
      PD-L1, the ligand for PD1, is highly expressed in
      several cancers *and hence the role of PD1 in cancer
      immune evasion is well established*.
    

Seriously?

This thing isn't just some dumb pathogen floating around that just DoSes your
body. It's digging tunnels and cutting phone lines. It has strategy.

~~~
vkou
> This thing isn't just some dumb pathogen floating around that just DoSes
> your body. It's digging tunnels and cutting phone lines. It has strategy.

The cancers that haven't mutated to emit VEGF don't survive to grow and kill
you.

It's natural selection, not intelligence.

~~~
jcims
Of course, but it doesn’t feel that way.

------
perlgeek
This seems to be the actual paper:
[http://stm.sciencemag.org/content/10/426/eaan4488](http://stm.sciencemag.org/content/10/426/eaan4488)

I hope this translates well to humans and other mammals.

~~~
mbag
I see that authors are from Stanford University. Can someone from the US
clarify if this will be in public domain/knowledge, or is it possible some
drug company will patent this later on?

~~~
afarrell
Conflating public domain with public knowledge risks a meaningful error. To
patent something requires that you make it publicly knowable _, but this
knowledge would not be usable by other companies.

_ well... you can write a patent that is so obfuscated that the public cannot
learn from it...

~~~
mamon
>> well... you can write a patent that is so obfuscated that the public cannot
learn from it...

In such case the patent office should reject your patent claim as patent laws
usually require that the description of the invention being patented should be
understandable to professionals of relevant domain, who should be able to
replicate it based solely on that description.

~~~
tossaway1
I assune you can patent _part_ of an overall process (certainly that's the
case in virtually all software patents), which could be a way to prevent
others from replicating your process without explaining the whole thing, no?

------
Odenwaelder
We see similar effects when we irradiate tumors with X-rays, called 'abscopal
effect'. Sometimes, when you irradiate a tumor, the unirradiated metastases
also shrink. It is hypothesized that the immune response is triggered by the
irradiation, and there are currently studies being done that try to stimulate
the immune system even more.

What I wonder is why this is being discovered only now.

~~~
0wing
Yes but can it be done with minimal side effect?

Curing cancer with a bullet works too but the host suffers some adverse side
effects.

~~~
Odenwaelder
I'd be careful calling the immune approach easy. Triggering a systemic immune
response can also kill you very quickly.

~~~
Iv
Considering that chemotherapy is basically feeding poison to your organism in
the hope that cancer cells (which are more active) will ingest it in higher
quantity, I'd say that we have a pretty high tolerance threshold in term of
side-effects while we are looking for an alternative.

~~~
suddenseizure
As I understand it, most chemotherapy targets only dividing cells. In adult
humans there are relatively few of these: cancer cells (which you want to
kill), bone marrow (produces blood cells, so you have to monitor blood cell
counts during chemo), and reproductive organs (produce gametes, so you may
want to freeze sperm/eggs before chemo).

------
King-Aaron
Forgive me if this sounds ignorant, but would it not be considered a
'treatment' instead of a 'vaccine' if this is a treatment to the pre-existing
condition?

~~~
allenz
It is indeed a cancer treatment that needs a tumor to work. The authors call
their technique "in situ vaccination" because it stimulates antibodies against
that specific cancer, which can work throughout the body to destroy
metastases.

~~~
King-Aaron
Cool, thanks for your reply (and those replies below also). I briefly skimmed
the article however was sidetracked with work, and admittedly a lot went over
my head anyway.

~~~
allenz
The article is really nicely written. I'd be happy to answer any questions
about it.

~~~
dazc
As a regular man in the street, how excited should I be about this?

What's the chance of this developing into a regular treatment for most types
of cancers, within, say, the next ten years?

~~~
cryoshon
as a former immunooncology scientist i'd say you should be guardedly
optimistic. you should be aware that there probably won't be a generalized
cancer cure, but i think we'll be starting to tackle a lot of different
cancers in the next 2-3 years, just like we have been for the previous 3-5
years. beyond that, who knows.

immunotherapies don't work for 100% of people or 100% of cancers, and some
cancers seem to grow resistant to some immunotherapies after multiple rounds
of treatment.

there are a lot of limitations and strengths of immunotherapies that we don't
even have a clue about yet-- by my totally made up estimation we have about
10% of the puzzle figured out, an additional 30% which we have partial or
incorrect understandings of (but at least we realize it and are working to
clarify things), and 60% remains unknown unknowns.

but remember: we don't need to understand quantum gravity or have much
knowledge of how gravity works whatsoever to make an airplane that defies
gravity at our will. it's the same way with immunotherapies, except replace
"gravity" with "cancer." we can do an awful lot with what we know.

immunotherapies are incredible-- literally the data is often unbelievable at
first glance.

~~~
invalid-access
Thanks for the info!

For people outside this field of work like me (a software / cleantech guy), is
there a concise spreadsheet to show the state-of-the-art?

i.e. Listing different types of cancers with the most promising immunotherapy
treatments for each type, expected confidence and success rates, trials that
one can enroll into?

It'd be a good first place to go to whenever we hear of someone who has
'cancer' \- that word is so generic that it's hard to figure out what our
action item should be.

~~~
cryoshon
> is there a concise spreadsheet to show the state-of-the-art

doubtful imo. the state of the art is rapidly changing, and plenty of things
are happening behind closed doors.

clinicaltrials.gov is your best bet but the expected success rates is not
something anyone would willingly have as public information.

------
randcraw
I'm impressed at how precisely and locally targeted the therapy seems to be.

Many of the cancer immunotherapies I've heard about are systemic and risk
overengaging a diffuse immune response against multiple tissues. This approach
trains in-situ using strong signatures from individual tumors _first_ , before
the antigens spread out across the body. Perhaps this localizes the cancer
antigen signature better, so antibodies cause less collateral damage?

But CAR-T therapy should do something similar, though re-introduction of the
antibodies is systemic (untargeted). Is the administration of this therapy
directly into the tumor somehow essential to its specificity?

------
headmelted
I've passively followed this field as a layman observer for the past several
years. I'd be interested in getting a lot more information on this work.

Generally I view these press releases with a skeptical eye, as the researchers
have a need to "talk up" their work in order to keep the funding coming in.

On the other hand, Irving Weissman and the labs at Stanford are well respected
and not known for spurious claims - often though, the problem with these
therapies isn't so much potency as it is persistence, with recurrences being
relatively common longer term (and many therapies simply don't translate from
mice to humans well).

I'd be interested in having someone with in-depth knowledge of this field
explain how the OX40 receptor work here differs from the CD47 work also being
carried out at Stanford (besides being a different target protein), and
existing CAR T therapies being tested elsewhere - although certainly this
seems very encouraging in any case.

------
cup-of-tea
Obviously not as important as the main cause but I wonder if a similar thing
could be used to treat warts. I had a wart once and successfully got rid of it
by applying a trick I read on the internet which is putting a little square of
duct tape on it. Surprisingly it really worked. The Wikipedia page used to
list the method with dubious citations and said that one theory for why it
worked was that the duct tape stimulated the immune system and caused it to
attack the wart when it normally wouldn't.

~~~
johntb86
Apparently they can now inject candida antigen into warts, which is supposed
to trigger the immune system to attack them.

------
staunch
To the people working on this: please keep at it. You can do it!

------
rado
Please invest your billions in this instead of apps that open the door by
voice command.

------
meri_dian
As someone very far removed from the medical field, immunotherapy has always
seemed to me to be the most logical programme of cancer treatment.

The animal immune system has evolved over hundreds of millions of years to
target and destroy pathogens. Why use an indiscriminate chemical treatment to
destroy cancer when our body already has a self defense system that operates
with pinpoint accuracy, unparalleled target recognition capabilities, and
ubiquity throughout the body. All these things make it a terrific candidate to
destroy cancer.

Using it just makes so much sense.

~~~
djsumdog
> has a self defense system that operates with pinpoint accuracy, unparalleled
> target recognition capabilities

This isn't always true. You body can start attacking itself if cells start
misidentifying one another. This can lead to Lupis, MS, Ruhtomotide Arthritis
and various other auto-immune diseases.

------
Oras
The fact that it reached distant metastasis is incredible! Hope this will work
well on human with few effects comparing to chemotherapy.

~~~
zaroth
The activated T cells completed their training on the target/injected tumor,
and then circulated through the body until they found their next target.
Trained cancer ninjas.

------
moring
Another layman's question: As far as I understood, the T-cells recognize
cancer cells and kill them because the two agents get injected directly into
the cancer site, where the T-cells are surrounded by cancer cells. Doesn't
this have a risk of the T-cells misjudging normal body cells as dangerous if
they happen to have any of them around, or if the injection happens wherewhere
else than the cancer site?

I'm thinking of (1) lower but high enough numbers of normal cells somewhere
between the cancer cells, and (2) plain accidents like the needle pushed too
far / not far enough.

------
tritium
Wow, this stops and reverses cancer in progress (in mice).

It's not just a preventative measure to eliminate the potential of possible
cancers from emerging. The cancers the mice already have goes away.

~~~
jcl
If I'm understanding the article correctly, it actually can't be used as a
strictly preventative measure. It relies on the fact that the subject already
has a tumor and that the subject's immune system has made progress in
targetting the tumor.

~~~
mark212
It also seems like that particular cancer mutation is permanently targeted,
but yes it’s not like this shot will be given to four year olds as a general
prophylactic

------
twouhm
Reminded me of this post on reddit[0] about injecting an ethanol gel into
tumors (so it has nothing to do with modifying the immune system as in this
tactic, just happens to have a similar means of application).

[0]:
[https://www.reddit.com/r/Futurology/comments/6xsokg/duke_uni...](https://www.reddit.com/r/Futurology/comments/6xsokg/duke_university_researchers_show_that_injecting/)

------
nautilus12
i feel like i see a new 'cure' every week. How is this different aside from
the pedigree?

~~~
skohan
It might seem like noise, but there is progress being made. My cousin's
girlfriend takes a pill every day which has basically eliminated her lung
cancer for all intents and purposes because it targets the specific mutation
which is in the problem in her case.

Relatively new T-Cell therapies "train" the body's own immune system to
recognize and delete cancer cells with much fewer negative effects than
traditional treatments like radiation or chemotherapy.

Stories like this don't mean an end to cancer, but it's still very good news.

------
brockers
I hate these "XXX found to eliminate cancer in mice" news blurbs. I really
want there to be an easy, effective, and inexpensive solution to one of the
worst medical conditions imaginable; but they make these kind of announcements
3-4 times a year and 99/100 times they don't pan out because humans are not
mice... and medicine is hard.

~~~
kkleindev
I'm curious as to why you think that lacking impact is due to dissimilarities
between humans and test subjects. My best guess would have been that a lack of
incentives for parties with the power to realize such advancements are
overweighing.

------
seannyg
It's hard to overstate the significance of this news.

------
sdpurtill
This sounds groundbreaking. Could someone with a medical background explain
what this might mean?

~~~
lwhalen
We have cured cancer in mice many times. The trick is getting it formulated
for humans in ways that are similarly effective and non-lethal. Put another
way, signs of efficacy in mice is necessary, but not sufficient, of a human-
applicable treatment.

~~~
danieltillett
As far as I know we aren’t able to cure cancer in mice. Sure we can cure them
of artificial cancers we give them in the lab, but actually curing spontaneous
mouse cancer in outbred mouse populations (i.e. something like human cancer)
is not something I have ever seen anyone try, let alone succeed.

~~~
taneq
Wouldn't that just mean we don't know whether it works or not?

~~~
danieltillett
Yes, but I was responding to the OP that claimed we know how to cure cancer in
mice, when we have never tried. I suspect that we are actually a lot better at
curing real cancer in people than in mice.

~~~
taneq
Fair point, I was just saying there's still a good chance it'll work (at least
if the induced tumors are anything like 'natural' tumors.) Very interested in
seeing how this goes, either way.

------
shadowtree
If they’re at mice this is, at best, 10 years away from getting approved for
humans.

Immuno-Oncology is the hot new shit, a huge wave of biotech startups is
betting everything on it.

Celgene bought Juno for 11bn recently, Gilead bought Kite for 12bn.

Puts tech startups into perspective :) Tres commas...

~~~
josu
>10 years away from getting approved for humans.

Isn't there a fast-track for experimental treatments for late stage cancer?

~~~
matte_black
Not sure, but in the United States there may soon be easier access for any
person with a terminal illness to get access to any experimental treatment if
they so desire, even treatments that are in early stages with no human trials
yet.

~~~
epmaybe
Yeah there's a lot of talk about "right to try" laws doing what you have
described.

Personally? It had better be an airtight law accounting for the edge cases
that could allow certain populations to be taken advantage of. For example, if
anyone with a terminal illness can try an experimental drug, could a
pharmaceutical company charge for said treatment? Or use the data from trying
this treatment on the patient to further their own research?

I guess it just doesn't sit well with me since researchers in the US have had
a history of taking advantage of certain populations in furthering progress
(Tuskeegee, prison populations, mental institutions).

~~~
Udik
> Or use the data from trying this treatment on the patient to further their
> own research?

What would be the problem with it, provided that the treatment is given for
free and the patient has no other options?

~~~
epmaybe
My gut tells me that if the treatment is given for free (my original comment
mentioned I was concerned if the company was charging for said treatments)
then there's far less of a problem. However, there's still this incentive for
a company to take advantage of this situation. Giving the treatment for free
could technically be cheaper than providing the drug in a trial while also
paying a participant.

~~~
matte_black
So? Earlier human trials means faster to market drugs means competitive
advantage.

~~~
epmaybe
Without being as vague, my main concern is that a pharmaceutical company could
find value in business practices that put patients, even those with terminal
illnesses, at an unacceptable risk of harm that the patient may not be
cognizant of. If the company begins a campaign of fraudulent kickbacks to
healthcare professionals we end up with a corrupt system in which we take
advantage of patients and their families.

Medicine and medical research goes slowly and cautiously because we wish to
protect people. To end this comment, I wish to go back to my statement that if
this country goes in the direction of right to try, I sincerely hope lawmakers
ensure protection of the patients that could benefit.

------
westurner
The article is about this study:

"Eradication of spontaneous malignancy by local immunotherapy"
[http://stm.sciencemag.org/content/10/426/eaan4488](http://stm.sciencemag.org/content/10/426/eaan4488)

> In situ vaccination with low doses of TLR ligands and anti-OX40 antibodies
> can cure widespread cancers in preclinical models.

------
skate22
87 out of 90 mice cured after the first treatment... very impressive. Hope
this works as well for humans.

------
erl
"Mice genetically engineered to spontaneously develop breast cancers in all 10
of their mammary pads also responded to the treatment."

Woha, I had no idea that we can genetically engineer animals to develop
cancer. That is impressive, and a little scary...

------
justinclift
Hmmmm, wonder if they could inject the two drugs into a portion of the biopsy
sample and re-implant that, assuming the biopsy cells are still viable at the
time?

Hmmm, not sure keeping the biopsy cells viable until biopsy results arrive
though would be practical.

------
vadimberman
A layman's question: is it implied to be a universal cure, or for a specific
type?

~~~
yetihehe
Both. It's targeted by injecting into one tumour, but many different tumours
can be targetted. Once targetted, this tumour is eliminated along with all
"copies" in body. If you had breast cancer and colon cancer you would need two
injections.

~~~
randcraw
Yes, but it's hard to say yet how much different the therapy process might be
in humans. The treatment regimen could differ from mice significantly. (Human
tumors may be buried a lot farther away from the surface than in a mouse, and
thus, harder to dose accurately with a long needle.)

It's also not clear what toxicities were incurred with this therapy (in mice),
which is a significant concern for the approval of any drug in humans.

------
murukesh_s
I hope this will work out for humans as well. Wondering if we can have
something for diabetes as well, it seems to be affecting a large portion of
the population and growing rapidly.

~~~
oculusthrift
we have a vaccine for that. it’s called diet and exercise.

------
pl4u
This kind of reminds me of coley's toxins treatment a little, although a bit
different. Really hoping this is successful and can be available in the near
term.

------
darth_mastah
This is great. Does it mean we finally have cure for cancer? My granddad died
because of that shit, and so did my uncle. Maybe there is still hope for me.

------
kerneldeveloper
Thanks for these researchers. They can save the world. Looking forward to the
human-applicable treatment!

------
jhiska
Whenever you hear about amazing breakthroughs in medicine, look to see if it
is an animal study. Those usually do not translate into results in humans.

Do not get your hopes up just yet.

~~~
mitchtbaum
> Those usually do not translate into results in humans.

Why would that be the case?

~~~
jhiska
Because what works in animal studies doesn't often work in humans. This is why
you hear about a novel cure for cancer in the news every month -- it's always
animal studies.

If you want something to get your hopes up, look for stuff undergoing human
studies. They're not new(s) -- in fact, it's stuff that is known and has shown
promise for years -- but they're more likely to eventually work.

------
tzahola
I hope this is not like those vaporware revolutionary battery technologies we
see time to time.

------
rbanffy
Maybe we could find a way to transfer our consciousness into mice bodies ;-)

------
daveheq
Hey as long as Big Pharma can add their own useless ingredients and nonsense
pretty packaging to extort as much money as they can out of patented cancer
vaccine flavors, we'll never have to worry about those pesky natural cures
that can't be patented and aren't as profitable

~~~
smellf
What natural cancer cure would you suggest? Maybe tumeric, or fasting, or
acupuncture?

------
acrive
I'm happy when solutions for cancer are found. A little less when the way is
genetic engineering. From my ignorance I imagine the genetics like a big
complex self programming software and the genetic engineering a way to change
little variables in a wide enviroment. In other words: Butterlfy effect,
you're welcome.

~~~
afarrell
If applied to an individual person, how does this present any risks of
ecological damage? Alternately, does this concentrate control of the food
supply into the hands of people who might decide to starve some population out
of greed/apathy/prejudice?

~~~
acrive
What are we talking about?

~~~
afarrell
genetic engineering and the validity of people's objections to it.

~~~
acrive
I have no objections to genetic engineering but I think it is necessary to set
limits. It's only my opinion.

