Five kids in the first trial.
Then eleven.
Now thirty (ultimately 39):
Chimeric Antigen Receptor T Cells for Sustained Remissions in Leukemia
Slowly but surely, HIV genetically modified to genetically modify relapsed acute lymphoblastic leukemia (ALL) patients T-cells are prolonging (saving?) kids lives.
Ive written about this treatment a couple times before:
‘Dismal prognosis’ with leukemia? Nothing a GMO virus cant fix.
GMO virus vs B-Cell Acute Lymphoblastic Leukemia: Why is this not a standard therapy yet??
Basically, scientists get HIV to teach cancer patients Cytotoxic T-cells how to kill the cancer that is killing them. Normally T-cells bumble around, using random mutation and natural selection to 'figure out' how to kill cells infected with a pathogen. But due to the nature of our immune system, they dont like/cant 'figure out' how to kill some cancer cells. Why? Because cancer is us gone wrong, and CTLs are trained not to kill *us*.
CTLs would never figure out how to target the protein these GMO T-cells see: CD19.
CD19 is a totally normal protein on the surface of B-cells. There is no *way* T-cells would start recognizing CD19-->killing CD19+ cells... even if those CD19+ cells were a cancer killing us. CD19 is *normal*.
Here is where HIV comes in handy!
Get HIV to deliver the gene coding for a protein that recognizes CD19, and has the signaling capabilities of a T-cell receptor! Its a cheat-sheet. "Here, CTL. You will never figure out how to do this on your own. Here is the answer."
In this trial, they treated 30 kids/adults with relapsed acute lymphoblastic leukemia (they had ALL, got various treatments, nothing was working at keeping the ALL at bay).
27 of 30 responded to the initial therapy to achieve remission. These patients entered this trial out of options, and in all doubt, this therapy bought them some time. And this time was bought with not-too-bad side-effects-- cytokine-release syndrome. You feel like crap for a bit while your GMO T-cells are killing the cancer. But that resolves, and even severe cytokine-release syndrome is manageable.
This group just presented new results, saying that 10 of their (ultimately) 39 patients relapsed. This therapy did not 'cure' everyone. But like I said, it bought time... for some (five of those ten relapsed patients died).
However, 69% of the patients were relapse-free at 6 months. This allowed the researchers to do some statistics-- They estimate a ~70% chance of survival at 2 years post-treatment. Basically, with this treatment, if you make it 6-months, they think youre going to do okay, at least for a while. This treatment is mainly for kids, and who knows what is going to happen in 20, 40, 80 years.
But for all the time HIV has stolen from people, from families, its nice to see it giving some time back.
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"We are the Borg. Your biological and technological distinctiveness will be added to our own. Resistance is futile."
Interesting work. In the trial was there not a danger that the CTL could start killing normal cells since it initially perceived the cancer cells as "normal" ? Do you perhaps know what could have caused the ten patients to relapse? In those ten patients what further went wrong in the five that died?
It's about time HIV is used for good after all the hurt it caused the world. Good work , good work indeed.