Dr. Weeks’ Comment: Finally doctors and oncologists are abandoning chemotherapy and radiation therapy. I predicted that swing …. once profits could be made on drugs offering immune enhancement (onco-immunology) and anti-inflammation (seed nutrition).
Immune recognition of somatic mutations leading to complete durable regression in metastatic breast cancer
Nature Medicine (2018) | Download Citation
Abstract
Immunotherapy using either checkpoint blockade or the adoptive transfer of antitumor lymphocytes has shown effectiveness in treating cancers with high levels of somatic mutations—such as melanoma, smoking-induced lung cancers and bladder cancer—with little effect in other common epithelial cancers that have lower mutation rates, such as those arising in the gastrointestinal tract, breast and ovary1,2,3,4,5,6,7. Adoptive transfer of autologous lymphocytes that specifically target proteins encoded by somatically mutated genes has mediated substantial objective clinical regressions in patients with metastatic bile duct, colon and cervical cancers8,9,10,11. We present a patient with chemorefractory hormone receptor (HR)-positive metastatic breast cancer who was treated with tumor-infiltrating lymphocytes (TILs) reactive against mutant versions of four proteins—SLC3A2, KIAA0368, CADPS2 and CTSB. Adoptive transfer of these mutant-protein-specific TILs in conjunction with interleukin (IL)-2 and checkpoint blockade mediated the complete durable regression of metastatic breast cancer, which is now ongoing for >22 months, and it represents a new immunotherapy approach for the treatment of these patients.
Experimental breast cancer treatment allows Florida woman to return to normal life
Published Monday, June 4, 2018 3:20PM EDT
A woman with late-stage breast cancer that had spread throughout her body is now completely clear of the disease, thanks to a treatment that used her own immune cells to destroy the cancer.
The doctors who treated the woman say while their approach is still experimental, they believe it could be adapted to treat other kinds of cancer as well.
“…Because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is, in a sense, a blueprint we can use for the treatment of many types of cancer,” said Dr. Steven Rosenberg, the chief of the surgery branch at the National Cancer Institute’s Center for Cancer Research.
The team reports the case of a Florida woman named Judy Perkins, who was diagnosed in 2003 with breast cancer when she was still in her 30s. The disease returned 10 years later, creating tumours throughout her liver and chest.
Perkins underwent several rounds of chemotherapy but the cancer kept spreading and doctors gave her just months to live.
She agreed to take part in a clinical trial with the National Cancer Institute to try a new treatment involving immunotherapy. This growing area of medicine involves using the body’s own immune system to destroy cancer cells and has shown great promise in treating advanced melanoma.
The research team took a sample of Perkins’ tumours and sequenced her cancer’s DNA, as well as the DNA of her normal tissue, to see which mutations were unique to her cancer.
The found 62 mutations, including four they knew could be targeted with T-cells called TILs, or tumour-infiltrating lymphocytes, which are white blood cells that attack invaders.
The team then grew large numbers of the TILs in the lab – 90 billion of them – and prepared to inject them back into Perkins bloodstream. But first, she had to undergo grueling medications to suppress her immune system and tamp down her other white blood cells. That then allowed the doctors to inject the lab-grown TILs to mount an attack against the cancer.
Perkins tells the BBC she began to feel better almost immediately, and could even feel the tumours shrinking in her chest after just one week.
The treatment is not only expensive but physically demanding and several other patients in the clinical trial died during treatment, including several who succumbed to side effects.
But almost two years later, all of Perkins’ cancer cells have disappeared and doctors say she is in remission. The now-52-year-old has returned to backpacking and sea kayaking, and even recently went on a five-week kayaking trip around the tip of Florida.
“This is an illustrative case report that highlights, once again, the power of immunotherapy,” said Tom Misteli, the director of the CCR at NCI.
“If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers.”
The team is now using the same approach to try to treat patients with advanced liver cancer and colorectal. Their full findings are published in Nature Medicine.