
Although the real science is fascinating, doctors didn't "inject HIV into a dying child"
We’ve recently noticed an inspiring short film circulating on the internet about how doctors in the US have apparently cured a child of leukaemia by “injecting her with HIV”.
But while the actual science behind this story is fascinating, the treatment is still at an extremely experimental stage and has only been tested in a handful of patients.
And while we’re always keen to welcome exciting experimental cancer treatments, we also want to clear up a few misconceptions about what the research actually involved.
To be absolutely clear, the doctors in the video did NOT inject HIV – nor a “deadly disease” – into a child.
So who are these people, and what did they actually do?
[Note – the headline of the Upworthy page hosting the video has now been changed to reflect that it was a modified form of HIV. KA 13/05/14]
Turning the immune system on cancer
The research comes from Professor Carl H. June and his team in Philadelphia in the US. He’s a highly-respected scientist working on cancer, HIV and the immune system, and has published his work in hundreds of papers in many leading scientific journals over several decades.
The immune system is an incredibly hot topic in cancer research. Cancer is an illness that starts from our own cells going rogue within us. Our immune system is pretty good at recognising and attacking foreign invaders – such as bacteria or viruses – but it doesn’t do so well at tackling tumours.
A huge amount of research effort around the world is focused on trying to understand why the immune system doesn’t recognise and fight off the disease. And there’s also a lot of work aimed at harnessing this powerful force for treating cancer, and this is leading to new ways to treat the disease.
Professor June and his team are taking an interesting approach to this challenge. In particular, they’re developing new ways to turn the power of the immune system on leukaemia – a cancer caused by white blood cells (usually B cells, also part of the immune system themselves) growing out of control.
They’ve developed a technique in which they collect special ‘killer’ immune cells, called T cells, from a cancer patient. These are then ‘reprogrammed’ in the lab using a modified virus, which is very good at smuggling genes into the T cells.
In this case, the researchers added genes carrying instructions that tell the T cells to make a new protein called a “chimeric antigen receptor” – this lets them lock on to molecules found on the surface of cancer cells, killing them in the process.
These reprogrammed T cells are then injected back into the patient, where they grow and multiply, creating an army of killer cells to fight the disease.
At least, that’s the theory.
From the lab to the clinic
The Philadelphia team has been working on this technique for many years, developing it first in the lab then testing it in animals with promising results. They’re now taking this a step forward, into clinical trials with cancer patients.
The situation described in the video, where a little girl called Emily Whitehead (referred to as Emma in the film) undergoes modified T cell treatment, isn’t the first time this approach has been tested in people. There’s more than a decade’s worth of data looking at the safety and effectiveness of virus-modified T cells in clinical trials for treating people with HIV as well as cancer.
In 2011, Professor June’s team treated three adults with chronic lymphocytic leukaemia (CLL) with virus-modified immune cells as part of a small, early-stage clinical trial. All three had undergone several rounds of chemotherapy, yet their cancer kept coming back. For two of them, their cancer completely went away after the T cell therapy – something known as “complete remission”. This was an important and impressive result, although one that was probably over-hyped in the media at the time.
Further results from the trial – totalling 10 adult patients with CLL and two children with a different type of leukaemia (acute lymphoblastic leukaemia, or ALL) were announced at a scientific conference at the end of 2012. The researchers claimed that nine out of the twelve patients had been treated successfully – presumably three of the adult patients are from the 2011 paper, while the two children are likely to be from the paper we’ll discuss shortly.
And in March this year, a team at Memorial Sloan-Kettering Cancer Centre in New York published results testing a similar approach in five adults with ALL. In all five, the cancer vanished, although four of them went on to have further treatment so it’s hard to say whether this therapy was solely responsible for curing them. And for the final patient, the cancer came back once the reprogrammed T cells had died off in their body.
From what we can tell, the girl in the video – Emily/Emma – is being treated as part of another small-scale, early-stage clinical trial for children with leukaemia and lymphoma, testing the virus-modified T cell treatment. This is primarily a trial to find out whether the treatment is safe, rather than how well it works.
Results from two children with ALL were recently published in a paper in the New England Journal of Medicine. Of the two kids, one seems to have had a complete remission – we can only assume this might be Emily, though she isn’t mentioned by name in the paper. Sadly, the other child didn’t do so well. The cancer came back just two months after the T cell treatment.
Obviously, for Emily and her family this experimental therapy has been nothing short of a miracle. But from the handful of cancer patients treated so far, it’s clear that it doesn’t work for everyone – something that’s rightly pointed out in the film.
The therapy also causes significant side effects, dramatically described in the video. Several of the patients who receive the modified T cells seem to experience what’s known as a “cytokine storm” – a potentially fatal immune reaction. Subjecting weakened cancer patients to such a barrage is highly risky, so researchers need to proceed with great caution as the clinical trials continue recruiting patients.
How does HIV fit into the picture?
Promoting the video, the Upworthy website boldly states that the doctors are injecting “HIV into a dying girl”, and that she received a “deadly disease”. This is a serious bending of scientific truth, and very misleading.
In fact, the researchers are using a type of virus called a lentivirus to reprogramme the T cells. This family of viruses – of which HIV is a member – are particularly skilled at sneaking into cells and embedding their genetic code within the cell’s DNA. Unsurprisingly, this makes them a good vehicle for smuggling in the genetic instruction telling T cells to attack the cancer.
According to the video, Professor June says that the virus used in these experiments was originally derived from HIV, and we hear the film-maker asking off-camera “So you’re taking the HIV virus and infecting healthy cells with it to help kill cancer?” However, the virus has undergone significant genetic tinkering, meaning that it is no longer harmful (as June does go on to explain). And it’s arguable whether it should even be referred to as HIV at all, given how much it has been altered.
And the researchers didn’t inject any virus into anyone. As we’ve explained, they took immune cells out of the patient, treated them with the virus in the lab, then injected the modified cells back in.
To sum up
Broadly speaking, we feel that this film is inspiring, and we’re always happy to see the fruits of promising new therapies for cancer. But to promote “injecting HIV” as a treatment is misleading.
One child surviving ‘incurable’ cancer is an amazing event, but there is a lot more work to be done to find out how best to use this new technology. At the moment it’s still highly experimental and expensive. It’s only being trialled in a very small number of patients, primarily to make sure it is safe, and so far we’ve seen that it doesn’t work for everyone.
In the case of the child whose cancer came back after treatment, the researchers found that her cancer cells had somehow stopped carrying the T cells’ target molecule. So it’s likely that other targets will need to be identified, to make the treatment more effective for more patients in the future.
On a positive note, there’s no reason why this type of treatment should be restricted to cancers affecting the immune system (namely leukaemia and lymphoma), although they’re much more accessible to the killer T cells. Researchers elsewhere are investigating how to target a range of different types of cancer with this approach.
There are several similar therapies being tested in the lab and in clinical trials around the world, including in the UK. And Cancer Research UK scientists are finding out whether harmless genetically-engineered viruses could be used as therapeutic vaccines, training the immune system to seek and destroy cancer cells.
It’s still early days for these exciting new approaches and there are many hurdles to jump, but we’re looking forward to the day when they can be used to treat patients on a wider scale.
Kat
Reference:
Grupp S.A. et al (2013). Chimeric antigen receptor-modified T cells for acute lymphoid leukemia., The New England journal of medicine, PMID: 23527958
Comments
Clervis November 25, 2013
This article is misleading. Writing about medical science is difficult, but this article’s title leads you to believe that the mentioned video is incorrect, taken out of context, or misleading. The scientists used a virus that was derived from HIV to reprogram a girl’s T-cells which went on to cure her cancer. And, as the article admits, the video explains all of this. Thanks for the explanation, Kat, but this article is more poorly delivered than the video.
Kevin November 24, 2013
So, you’re just playing semantics over their semantics. /eyeroll
Zachary Stoddard November 13, 2013
Well you they explained all this in the video. I never once thought they injected the child with HIV while watching this. How this article is written is what I took from the Video.
Brooke November 9, 2013
I am all for this new science and approach . I understand it’s still experimental and doesn’t work on everyone but there’s not many medications/ treatments that do work the same on everyone and even if right now it’s only developed enough to cure 25-50% of people that’s still less people dying and it’s for people with no other options .
Now from what I’m still aware of HIV is not cure able so I’m confused if they know how to make it not harmful , how do they not know how to cure it
Either way if my options were wait and die painfully and slowly by cancer or take this treatment I would do the treatment in a heartbeat
Don Johnstone November 6, 2013
The video was about a treatment for cancer. I understand what the above article is saying but for me, even as a layman I could understand the basics of the science involved, including the risks. What pains me is that any apparently successful treatment, discovered by one group is immediately criticised by other groups in the same field. I know the competition for funding is very important but this sort of article, which is more about protecting funding, than extending science demeans the organisation making it.
Ricky November 4, 2013
This is amazing research. It was a great video, with a misleading title. This is a great article,obviously written to give a little clarity to anyone who needed it. Also it elaborates on background and gives examples of some related research. I understood the video, and after reading this, I have more information than I did before.
I see no need for everyone’s crying and complaining about this article. You did not pay to read this. If you didn’t need to read it, then congratulations. That is no need to take the time to complain and bash it. I understand the need for some of you to have a “look at me, I’m smart enough to be condescending in order to show it off” … guess what, going around complaining about things does not make you look brilliant… it makes you look like an arrogant person, who believes that just because they didn’t need to read this, then it shouldn’t exist. There are people who will appreciate this, and enjoy it. If that is not you, there is this thing on your browser called a back button. Click it, and go in peace. Thankyou for the article Kat. I know there are many people who probably were misinformed by that title.. Or, if nothing else, there are probably more than a few facebook comment wars between green, holistic, overzealous dyno-moms that can benefit from a link to this.
kerryfrank73 October 29, 2013
I don’t personally think that the video was in anyway misleading. I am not sure why the uproar. Why do we have a need to make everything look pretty? They took an HIV cell, they modified it, renamed it, they attached it to a t-cell and they sent it in. The engineered/renamed cell put the cancer in remission;.I like the simple CHOPS researcher explanation. I get sick of the other doctors and researchers clarifying it. Its stupid, the first explanation was clear enough. If someone actually thought it was HIV, then they didn’t read the article or watch the video – Mom to a Childhood Cancer Survivor
I think we are all over analyzing the point. Who cares if actual modified HIV was used or some version of it? The point is, we learned this technique of treatment from what something bad (HIV) does to the body. We learned how to do something good from something bad.
That is a miracle to me. God needs to not be mentioned in the video for me to see God in it. Open your eyes and think outside of the box.
If something good is coming from our knowledge of something bad then we should praise that. HIV is claiming many lives in our world, can we even begin to believe that it might have a higher purpose? I think these doctors are brilliant and exploring new ground of treatment.
I’m living with HIV, maybe for now I can’t be cured… But maybe this amazing little girl can. Stop focusing on rather actual HIV is in her body or not, there is no doubt that HIV research is what led these doctors to start exploring this type of cancer treatment in the first place.
We need to stop this behavior of criticism, she is healthy now… Science similar to HIV based science led to that, and I am thankful for it. It was the knowledge surrounding HIV that led to this, period.
Amazing work doctors. Keep it up.
botto October 6, 2013
it looks like this is the same thing as on loiter.co. http://loiter.co/v/doctors-take-a-long-shot-and-inject-hiv-into-dying/
how is the hit virus being used to cure leukaemia?
Matt September 25, 2013
People need to understand that this article isn’t out to bash the video or the scientists involved, they just want to make sure people understand you can’t just get HIV and cure yourself, as the one website’s title suggested. I think it was a very informative article that gave a little more background on the science that the video itself did not have time for, but the video was also very well made for describing the very basic theory of what happened.
Like Luke’s point, the title is deceiving and could lead to bad scenarios!
Michael Joynt September 13, 2013
Does anyone know of any current studies using this same experimental technique to combat myeloma?
My previously very healthy and hard working step-father aged 64yrs has recently(Feb 2013), been diagnosed with having myeloma and amaloidosis.
Naturally this has devastated our family. He was told he probably only had 6 months to live and the chemo treatments have been intolerable.
Any information regarding current clinical studies against myeloma would be greatfully accepted.
Many thanks.
Michael Joynt.
Cassam Achilah September 12, 2013
The research is fascinating and inspiring to a young medical-research student like me.Please keep me posted on new developments on cancer research.
Tony L September 10, 2013
This verifies how HIV itself is a lab creation to begin with
ruth September 10, 2013
er, no it doesn’t.
Luke September 10, 2013
To those criticizing THIS article, I have to wonder: did the video you watched have the same headline I just read? Namely, “Doctors Take A Long Shot And Inject HIV Into Dying Girl”
Because, as this article rightly clarifies, there is a VAST difference between that, and what actually happened.
I agree absolutely with Ardath and others who’ve cautioned about the mentality of certain people who would read a headline and think they knew the whole story.
Take for example a nation so rife with internet conmen, it has a whole class of scam named for it: Nigeria.
You know what else Nigeria has a lot of? HIV & AIDS. The second highest infection rate in the world.
Suppose one of these individuals who spends 18 hours a day online trying to part westerners from their nest eggs, reads a headline in passing, and now offers his newfound oncological expertise to anyone who’ll listen…
Can you really say that would never happen?
bonnie September 8, 2013
I found it informative.. children being used is a concern. Media is causing a lot of concern.
angela September 7, 2013
Personally, they need money to do their research and if a video helps so be it. They did not lie and they used their words right and even if one child survives with the treatment then it is all worth it. Even conventional treatments don’t cure everyone and they are not safe for everyone. But they do cure some and that is what counts. Saving peoples lives is what matters. The only way to learn is by doing.
Anon September 6, 2013
A major factor in why we are so far behind and so slow in the battle against cancer today can be seen in the comments and arguments on this article. People caring more about their educated opinion and the purity of ‘science’. Your arrogance is appauling and you care little for patients and more about the process. The primary reason given for this cure being held back is ‘we need to make sure it’s safe’ ? The patient is already dying and when they get to a certain stage medical scientists will overdose them with morphine and end their life anyway. Chemo doesn’t work on 75% of people and is known to be poison, how long did they wait on rolling out that one ? There are a couple things these ‘intellectuals’ and doctors are more concerned with than morons injecting themselves with HIV, being sued and being WRONG !
Bríd September 5, 2013
CSC, are you serious? Reread your own comment. I counted 9 mistakes, although they were mostly grammatical, not spelling.
Kat Arney September 4, 2013
Hi CSC, We’re a UK-based research charity and use British English spelling on our blog. The correct spelling is leukaemia.http://oxforddictionaries.com/definition/english/leukaemia
i loved that your challenging something, but can you do a proofread before you submit the article… this is usually the first sign of a credible article. Not only was it a typo, but you misspelled the main word of the article, Leukemia (not Leukaemia), even in this form is shows me this is a misspell. thank you.
Mitchell Repp August 28, 2013
Why would they use such a misleading title? They in fact DID cure cancer with hiv… Putting it simply. Most people would Google information about this topic, see “scienceblog” and “no, they did not cure cancer with hiv” listed at the top of their search results, and simply move on with their life.
Colins2 August 17, 2013
A lot of the comment on this article comes from people who appear to be educated and well informed. They either praise the article for clarifying matters or denigrate it as unnecessary. A few just rubbish it for no good reason that I can see. I speak as a non-medical person, reasonably well educated and intelligent and with no axe to grind on the subject; I have no relatives or friends suffering with any of the diseases mentioned.
I saw the article mentioned in a Facebook post from a non-UK country. Most posters were well informed already and corrected the misconception that the headline implied but there were those that believed it and were suitably sceptical or horrified by it.
I’m in favour of accurate information being promulgated and am therefore grateful for the detail in the article. To those who already knew – why bother reading this article and more to the point, why bother trying to rubbish something you know to be accurate. This article was necessary and was interesting IMHO.
ruth August 16, 2013
One more thing – CRUK’s press team attitude as evidenced here is paternalistic in that old fashioned medical sense and needs to change. Nothing wrong in clarifying the science. Lots wrong with the assumption in the headline that people will misunderstand the science, and in patting people on the head telling them not to get too excited about research they don’t understand.
Matt Brooks November 25, 2013
Thanks for clarifying. This was fascinating reading and in no way does it diminish (or make less interesting) the work these physicians are doing. SEMANTICS MATTER.