T cells are important fighters against disease. T cell Credit: NIAID/NIH (public domain), via Wikimedia Commons
The undoubted promise of cancer immunotherapy is never far from the headlines. And waking up this morning, we heard claims that a new immune therapy may offer hope of ‘lasting cures’ for cancer.
The news comes from a conference in Washington DC in the US. And while the science is extremely exciting, the media’s response has jumped the gun a little.
At the conference, researchers from the Fred Hutchinson Cancer Research Center in Seattle described how they’d taken specialised immune cells from patients with certain blood cancers, and re-engineered the cells in the lab to attack and kill cancer cells when injected back into the patient’s body. You can read all about the science behind this particular approach – called Chimaeric Antigen Receptor T-cells, or CAR T-cells – in this blog post.
The researchers also summarised the results of several small, early-stage clinical trials, where they’d begun seeing some impressive responses in some very sick patients. But these trial results are yet to be published in a scientific journal, so are still to be scrutinised by experts in the field.
Nevertheless, harnessing the power of the body’s own immune cells, and focussing their attack on cancer in this way, is a really promising area of research, and something our own researchers are working hard to perfect. And several immunotherapy drugs are already being used on the NHS, showing some incredible results in a certain groups of patients – as this article shows.
But as is often the case with media stories heralding potential cures for cancer, we also need to add a note of balance.
‘Extraordinary’ responses… but not cures
The early stage trials in today’s reports involved patients with different types of blood cancer – including acute lymphoblastic leukaemia, chronic lymphocyte leukaemia and non-Hodgkin lymphoma. While these are often very treatable forms of cancer, the patients on these trials had diseases that had become resistant to all other treatments.
Many media reports focused on the patients with acute lymphoblastic leukaemia, more than nine in 10 of whom are reported to have entered remission following the immune cell therapy.
The researchers are also reported to have seen similarly impressive responses in around half of patients with the other blood cancers too.
These are indeed truly impressive results.
But these responses – where patients see their symptoms disappear – don’t necessarily mean a patient has been cured. And without a scientific paper to back up the reports, we don’t yet have the full details on these responses rates – notably exactly how they were measured.
So once the data have been scrutinised and published, there will need to be longer-term follow-up before it’s clear if these patients get lasting benefits.
Lead researcher Professor Stanley Riddell has been widely quoted as calling the results ‘extraordinary’. But he has also made it clear that the results are in patients where all other treatments have failed. “The response is not always durable, some of these patients do relapse,” he said.
Find out more:
- ‘Engineering a cancer fighting super-soldier’
The science of engineered T-cells explored in depth
- ‘Expert Opinion – Prof Peter Johnson’
We catch up with our chief clinician on the past, present and future of immunotherapy research
And this raises an important point. The patients recruited to these studies had very advanced cancers. “Most of the patients in our trial would be projected to have two to five months to live,” said Riddell. But for most people with these cancers, there are highly effective treatments available.
So it’s important to view these latest findings as part of a bigger picture. Only with further research will we truly understand the role this type of immune cell therapy might play in treating these cancers.
And it’s also important to focus on where this type of approach could be used to target other cancers in desperate need of new treatments. As we said above, the results reported today focus on blood cancers, which – for a range of reasons we discussed in this post – are likely to be much more responsive to this type of immune-boosting treatment.
So it’s vital to find ways to adapt this approach to treat so-called ‘solid’ tumours – a much bigger challenge, but one that our scientists, along with others around the world, are already looking at closely.
While many reports made a big deal of the benefits for patients who did respond to the immune cell therapy, most early reports missed some important details about some of the risks.
The immune system is a powerful weapon, and this type of approach unleashes its full force within the body. And because of these powerful responses, patients offered this type of treatment as part of a trial can occasionally see very serious side effects.
In these latest trials, reports have emerged that seven of the 35 patients on one trial experienced severe side effects that left them in intensive care, with two dying as a result. Clearly, there’s a lot more to learn about how the body reacts to these powerful treatments.
There’s also very little known about this treatment’s long-term effects in those who benefitted.
All this just serves to illustrate how much more there is to learn about this type of therapy.
Many of today’s reports were also quick to mention the potential of this treatment to offer an immune ‘memory’ of cancer.
This is a tantalising prospect, as it’s possible that cancer-targeting immune cells might persist in the body, preventing cancer coming back. And the team behind today’s headlines are exploring this by using T-cells which they hope will survive in the body for many years.
This was thanks to another study, also discussed at the Washington meeting, where Italian scientists showed that transplanted ‘memory’ T-cells could persist in the body for more than a decade. While this wasn’t ‘cancer’ research, it was looking to improve the safety of stem cell transplants for patients with a variety of diseases. But the findings were adapted and used to inform the US trials discussed above.
So it appears that the truly ‘new’ element of this latest approach was using these ‘memory’ T-cells to treat the patient’s cancer. The hope would be that, in the case of a patient who responds, the immune memory cells would ensure the cancer would be killed again if it returned.
This could be an exciting development, although it’s still too early to tell how long the patients on this trial will retain these reengineered immune cells. And with some patients already relapsing, it’s clear there is a lot more to learn.
Why talk about prevention?
But some media outlets took this ‘long-lasting immune response’ a step too far, claiming immune memory could be turned into a ‘vaccine’ that could ‘prevent cancer’.
Unleashing these cells on a patient’s cancer is very different to developing a surveillance system that would spot and kill cancer cells in their earliest stages in healthy people as some of today’s headlines suggested.
But while a cancer-preventing vaccine is likely a way off, it’s absolutely something to work towards – and it’s an idea that forms a key part of our Grand Challenge to transform cancer prevention and treatment in the future.
But to be clear, the research discussed in the media today didn’t aim to develop this sort of preventative approach.
Part of a growing arsenal
Immunotherapy will play a huge part in cancer treatment in the future. That’s something we know for sure.
But whether it will come in the form of drugs that release the ‘brakes’ on the immune system, cell therapies like those in the news today, or something completely new, working out exactly how it will be used, and in which patients, is an urgent challenge for researchers,
What we do know is that it will need to find a place among other, successful treatments that are already available. And today’s reports are a great example of this – offering a way to treat patients for whom current approaches don’t work. So we’re eagerly awaiting the full publication of the US team’s findings.
But we also need to focus on immunotherapies that target other cancers in desperate need of new treatments.
Hopefully then, with larger, longer-term studies, we will be able to talk about immunotherapy truly offering lasting cures for patients with cancer.
- This is just one approach to treatment. As we’ve mentioned above, there are many ways to treat cancer. For up to date information about how different cancers are treated and clinical trials go to our website.
diana April 10, 2016
Admin, if not okay please remove!
Our facebook group “selfless” is spending this month spreading awareness on prostate cancer & research with a custom t-shirt design. Purchase proceeds will go to cancer.org, as listed on the shirt and shirt design.
An American living in Italy March 21, 2016
Heres the article in an Italian newspaper telling it straight. Just translate and you’ll have the truth. http://m.repubblica.it/mobile/r/sezioni/salute/ricerca/2016/02/16/news/tumori_da_ricerca_italiana_cellule_killer_contro_il_cancro-133545187/
An American living in Italy March 21, 2016
What a bunch of liars!!! This discovery is thanks to a study and research at San Raffaele hospital in Milan, Italy!!!! How unfair is this that Italian researchers, doctors, scientists have their credit stolen from them in this article?!?!
Don’t believe me, look it up!!! LIARS! No wonder Americans are so misinformed. What a disgrace!
Claire March 7, 2016
Very interesting article which puts the press reporting into context. Headline grabbing is all well and good but tv and newpaper reporting generally seems to fail to report a balanced story. As a survivor of NH Lymphoma I welcome the potential of this research in the hope that it will provide alternate treatments in the future.
Angela Poyser March 6, 2016
I think that anything you find and manage to achive is a fantastic miracle and another step forward for modern day science. Keep up the good work. You will still have my support and together we will beat it. We will get there.
Derek Mealor March 3, 2016
A very interesting article but as stated a lot more work will be needed on side effects and known drawbacks. Of course there are other forms of cancer and it might offer some hope if the scientific work was spread over other forms of cancer.
mark wilkinson March 3, 2016
fantastic, keep up the good work. this is still very exciting news for all people with or without having that dreadful disease. the media always jumps the gun but the trials are real and the result a fantastic step forward.
Charlene MacPherson March 3, 2016
It’s all very exciting but as you point out should be treated in the infancy stages with caution. I’m sure in the next ten years it will be perfected and be a far quicker cure for patients. I had ALL diagnosed in 2012 and whilst it is a long arduous treatment followed by stem cell transplant it takes your body to hell and back ..the treatment ha also given me a second chance at life now. I’m cancer free and putting my life back together.
Andree Dyke March 3, 2016
Brilliant article,am glad it puts results in context.Sad that Media jumped on it with such fervour.
Christiana March 2, 2016
Thanks again cancer research for clearing up the waters that can be muddied by the press. However as a stage 4b acute lymphoblastic lymphoma patient (18 months post stem cell transplant) I thank you from the bottom of my heart for the continued work you do to make these discoveries mainstream! ❤️
My blog (new) telling my story is christianasaberton.wordpress.com
William Wallis March 2, 2016
I thought they were bringing out a form of immunotherapy to treat myeloma which is the one I’ve got.I do hope they will.
Nick Peel February 23, 2016
Thank you for your comment, which perfectly summarises the tough line we have to tread when discussing important research findings like this.
We agree that this approach has the potential to offer a new treatment option for people with blood cancers that have stopped responding to other treatments. But, as you say, there is still some way to go in testing it – particularly to work out how to minimise the serious side effects some of the participants had.
Writing this type of article can be tough, as we have to balance the technology’s undoubted potential – and the genuine excitement we all feel at that progress – against the hopes of others who may read the news and interpret it as a treatment available for their form of cancer (and we know that this does unfortunately happen). We hope, as you have alluded to in your comment, that we have provided that balance.
But ultimately we also hope that with further research, the field of immunotherapy will fulfil its potential, helping patients with other forms of cancer too. And we’ll be following the publication of the results of this study – and others like it – closely.
Nick, Cancer Research UK
George February 21, 2016
Thank you, Nick and CRUK, for this – really helpful and interesting. I fear, though, that you may have fallen into the same trap as the worst newspaper headline-writers – while they may over-egged the pudding in leaping to conclusions of a ‘cure’, your downgrading of the story to ‘fascinating science’ understates the promise and potential that you go on to explain so eloquently in the article. I say this as someone who has benefited from similar immunotherapy trials after relapsing with acute lymphoblastic leukaemia and struggling to get into remission. I prefer to go for ‘cautious optimism’: it’s great to see that potential new treatments for those who have run out of other options are showing early promise, but I’m very aware of the limitations of the study, the uncertainties and the timescales. That doesn’t stop me getting excited at signs of progress, though!
Thanks again for a great article, which shows this is more than just ‘fascinating science’.
Lee February 19, 2016
Sometimes I feel as if cancer research don’t want it to be true. We understand that there’s a long way to go but shouldn’t you at least be happy for once that we’ve made a small step further instead of thinking if we find a cure for cancer your business will go bank corrupt because no one will donate money anymore..
Dangerous Dave February 18, 2016
When I saw this on the news, I was thinking to myself it wouldn’t be as straight forward as the news media made out. I have been checking the CRUK site since then hoping for clarification.
Thank you for providing it.
Ronny February 18, 2016
excellent summary – thanks
a mc February 18, 2016
Most people don’t research their selves they just wait for the mighty t.v to tell them, its just lazy, not thinking for yourself.
Prof.Kantharaj February 18, 2016
The great work often criticised by some nincompoops as nothing; we cannot have such people around us.
John McMaster February 17, 2016
I would be interested to know exactly how much money has been donated to support this research further? I must admit there are a lot of raised eyebrows when people criticise tests that save the lives of people with less than 2 months to live and focus rather on the ones that died as they were in fact all going to die without the treatments.
Catherine S. Wilson February 17, 2016
Nick, I think this is a well-written and nuanced approach to this news, which has been the talk of friends and family all day. As someone who has suffered with cancer before, I thank you for providing some much-needed perspective outside of the media’s usual overly-positive spin, and I look forward to seeing what this therapy holds in the future.
Deborah February 17, 2016
I don’t see this article as negative, I think it’s a good explanation of dust us behind the headlines. In particular I think it is important to flag that these results have not yet been published and peer reviewed.
Jamie February 17, 2016
Just saw a Cancer Research UK spokesman commenting on this story on the news and thought he had a very negative and cynical undertone to an otherwise positive story. I visited the website and feel this article has the same tone. Think most will see this as an attempt to downplay positive news to protect the millions donated to Cancer Research UK each year. What exactly did CRUK achieve with their £620m turnover last year, apart from paying out £152m to employees and directors? I’ve had a look online and genuinely can find any major developments/ breakthroughs apart from donating £160m to build a research centre and more ‘research’ blah blah. About time CRUK were making their own headlines and not just downplaying the achievements of others.
JC February 16, 2016
This writer sounds like your typical traditional scientist who’s pissed off that someone else is making some real progress and calls it unreliable of its not been published in the journal.
Grant February 16, 2016
CAR T cell therapy is a big deal. It has achieved complete remissions in patients with number of different hematologic malignancies and is being adapted against even more cancers, including solid tumors. The flurry of commercial activity around this technology (as yet unapproved by any government medical agency) provides an indication of the promise that this approach to cancer treatment. I predict that this therapy, or a close derivative, will become a game changing treatment over the next 10 years in may different cancers.
Moire gemmell February 16, 2016
There’s nothing like destroying a person’s hope which is what this article has done to me.