Release date: 2017-11-14
Hope and waiting for cure cancer
Each generation will experience some technological breakthroughs, claiming to bring hope for curing cancer. In the past five years, the rapid advancement in the field of genetics has long proved that immunotherapy can activate the natural anti-cancer ability of the immune system and is expected to "cure" cancer in many patients. Cancer immunotherapy has produced many incredible successes, and immune checkpoint inhibitors, CAR-T cell therapy, have been approved in series, bringing hope to many cancer patients.
Can immunotherapy eliminate cancer?
But for some patients, there is still a long wait for scientific and technological progress to save lives.
In 2015, Mr. Vlad of Norway was diagnosed with lung cancer. After several months of surgery, radiotherapy and targeted drug therapy, it did not delay the growth of the tumor. The cancer spread to his brain, and the doctor announced that he had only a few months left.
Vlad's wife, Elen's younger brother, Jo, is an IT engineer who accidentally saw an academic paper on the Internet. This article reports on a small study in China, an experimental immunotherapy that produced a "fast and significant tumor regression" in an 85-year-old lung cancer patient. This is a very early clinical study involving only one patient.
With the popularity of the Internet, medical knowledge has been released from the isolated islands of scientific research institutions and academic journals. People can easily access the information and can find the same information as the doctor. The medical literature is full of incredible cases in which the tumor suddenly shrinks and the end-stage disease miraculously reverses.
In addition to accessing information to participate in the treatment of self-disease, there are now countless online communities around the world where patients can exchange and share treatment experiences. Some groups of patients with rare diseases have even begun to fund academic research and drug development on their own diseases.
Homemade peptide vaccine
In March 2015, Ms. Dyame of Norway was diagnosed with stage IV lung cancer, only 30 years old. Her husband, Lars Sorass's younger brother, is a doctor who searches the world for promising treatment information via the Internet and finally contacts a German professor who is working on a study called "personalized peptide vaccine". project. Ms. Dyame regularly goes to Germany for peptide vaccine injections. After treatment, Ms. Dyame is currently in stable condition. Her family recorded the entire treatment process on Facebook and eventually attracted a group of patients with the same disease.
Elen and Jo are seeing a case of Ms. Dyame in the patient community, which gives confidence in the peptide vaccine. They want to take Ms. Dyame's road.
Coincidentally, in July of this year, Nature published two heavy research results on "individualized cancer vaccines." One of them is a team from Professor Ugur Sahin of the University of Mainz, Germany. In response to mutations in different tumor patients, the researchers customized individualized cancer vaccines for them, which was a great success in clinical trials of melanoma patients! After 13 patients received the vaccine, 8 tumors completely disappeared and there was no recurrence within 23 months. The other 5 patients had tumor spread when vaccinated, and 2 of them had tumor shrinkage. One of them received PD-1 antibody drug and the tumor was completely ease.
Elen and Jo wrote to immunotherapists to get the suggestion that the peptide vaccine mentioned in the literature might be effective against Vlad's cancer and also match his HLA type. HLA is a genotype that is important for immune cells to recognize and attack tumors.
However, it takes a long time to get help from the researchers. After all, Professor Ugur Sahin spent more than three months developing individualized vaccines.
But Vlad is getting worse. Can't wait any longer.
As a result, they are headed for the extremes that end-stage patients will go to – treating themselves.
At first Elen and Jo hesitated. Because peptide vaccines have potential side effects, they can cause severe allergic reactions. Although there are various unknown risks, Elen decided to let go. Because Vlad is dying, their two children are about to become orphans.
Later, with the help of many people in the scientific community and the patient community, they found a laboratory that could synthesize peptides based on the sequences provided for about $1,000. They ordered these peptides and ordered a phosphate buffer in the pharmacy to dissolve the peptide. They also bought adjuvants that help improve the efficacy of the vaccine. Finally, they received a vial filled with white powder and carefully packed in a foam box.
Elen works in the hospital and she is a nurse. In accordance with the instructions provided, she completed the operation of mixing these things together in a laboratory.
Vlad began receiving this homemade peptide vaccine injection from August this year, once a week. They were relieved when they found no serious side effects. Now Vlad's condition is stable. But he also received targeted therapy.
Everyone who insists is amazing.
In addition to unpredictable risks, the effects of homemade peptide vaccines are equally unpredictable.
Susanna Greer, director of clinical research and oncology at the American Cancer Society, said "the probability of such a DIY program being effective." Indeed, many related studies have shown that a single peptide is unlikely to slow the progression of cancer. A single peptide targets only one amino acid mutation sequence in a tumor, but many ongoing clinical studies currently combine several different peptides while targeting multiple different tumor mutation sequences to trigger a stronger attack. In addition, peptide vaccines often need to be combined with other treatments to work, and now science is still determining the best combination with other treatments. For example, one potential approach involves the use of peptide vaccines in combination with PD-1 inhibitors. After all, the peptide vaccine received by Ms. Dyame in Norway is much more complicated than the vaccine made by Elen, and she also received other therapies.
However, more and more mainstream medicine believes that when a person's life is dying, they should be entitled to high-risk treatment. Last month, the US Senate unanimously approved a bill that would allow end-stage patients to receive experimental drugs that have been initially tested by humans but have not yet received FDA approval. Thirty-seven states have passed similar right-to-try laws, some of which even allow trials of patients with severe, rather than end-stage, disease. The trial method originated during the HIV epidemic in the 1980s, when little was known about HIV virus research, and diagnosed AIDS patients obtained experimental drugs through illegal means.
A well-known film, Dallas Buyers Club, restores the story of this era. In the mid-1980s, Ron Woodroof of Dallas, USA, found himself suffering from AIDS by accident, with only 30 days left. In order to survive, he began to study various anti-Ai prescriptions and alternative therapies to extend his life. Ron not only tried his own medicine, but also worked hard to survive. He also set up an underground organization called “Dallas to buy a club†to provide more “unconventional therapy†for AIDS patients and save thousands of people facing the same situation. Ron eventually died in September 1992, and he was told that only 30 days left to live has passed 2557 days.
When receiving a homemade peptide vaccine, Vlad's cancer has spread to the brain, making him unable to move. Elen and Jo hope that the vaccine will stop his cancer from spreading, but they are worried that it is too late.
Despite this, Elen still believes and expects the peptide vaccine to save her husband. As another patient with advanced lung cancer said, “I need to know that even after I have come to an end, I have tried my best.â€
Reference material
[1] When Hope Runs Out, Cancer Patients Are Making Their Own DIY Immunotherapy Treatments
[2] Personalized RNA mutanome vaccines mobilize poly-specific therapeutic immunity against cancer
[3] Wikipedia-Dallas Buyers Club
Source: WuXi PharmaTech (Wei Signal WuXiAppTecChina)
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