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| Cytotoxic T-cell |
This idea
was inspired by a technique known as checkpoint blockade. This technique, used to treat lung and skin
cancer in clinical trials, takes advantage of T-cells that are dormant in
tumors. In order to utilize these cells,
the checkpoint blockade is turned off in order to let these cells destroy the
tumors. The downfall of this technique
is the idea that it could cause the over stimulation of T-cells and later cause
autoimmune diseases. Using
protein-specific markers, this could focus the T-cells to only attack the cancer cells.
The
immunosuppression in people with cancer is often mediated by cytotoxic
T-lymphocyte associated antigen-4 (CTLA-4) and programmed death-1 (PD-1). These are receptors expressed on T-cells. In murine trials, using anti-CTLA-4 and PD-1
causes reactivation of T-cells with treatment-specific profiles. (Gubin et. al, 2014)
Dr. Gerald
Linette and Dr. Beatriz Carreno at Siteman Cancer Center are using this
vaccine-therapy in clinical trials on patients with metastatic melanoma. Soon, they are looking to using vaccine
therapies on breast, brain, lung, and head and neck cancers. (Purdy, M 2014)
This type of immune specific therapy could make our current chemotherapies and radiation treatments look archaic. I have no doubt that the technology required to identify the surface proteins of a patient's own tumor cells and then production of a vaccine against it is not far off. This seems like it would be simply leading a horse to water, the immune system being the horse. If the horse is still alive then it will do what horses do and drink, that being the immune system attacking an invader. An elegant solution of providing an identity for the immune system to pursue.
ReplyDeleteI completely agree with you and your horses Austin!
DeleteI agree with Austin. I believe that the body has an incredible ability to heal its self. By assisting the body in its own self healing is better then any form of cancer treatment we have. Our immune cells already seek out defective cells and destroy them and anything we can do to assist that would be fantastic. I think that within our carers personalized medicine will become the standard of care, and hopefully when we are old and gray we will be able marvel about how barbarically we treated disease like cancer.
ReplyDeleteI feel that if you talked to physicians that you shadowed, they could tell you some pretty archaic stories already! I agree the world of medicine is constantly evolving and we're going to be the ones who will push the envelope of medicine even further.
DeletePersonalized medicine is definitely the route to go and this research could have profound effects in the future. My concern with these types of treatments are the associated costs. Was there any indication of what the patient would expect to pay if this becomes an FDA approved treatment? Luckily if this turns out to not be feasible financially, traditional therapies will still be around, hopefully. You had also touched on the idea that this type of therapy could lead to over stimulation and the development of autoimmune diseases. Could this same technology, checkpoint blockade specifically, be used in autoimmune disorders but actually shut down overactive T- Cells? Or would you speculate that this would do more harm than good by putting the patient in a critical immunosuppressed state that is worse than what current autoimmune therapies do?
ReplyDeleteShalacia, I seriously think you're on to something. There was no indication about cost (since it's in clinical trials right now), but I could totally see it becoming a huge market for big pharma.
DeleteI also think that your ideas about autoimmune disease is something that should be explored. Maybe we could do some research on this if we have another physiology project and win a Nobel. I would think that if researchers could figure out a way to reactivate the checkpoint blockade, then they would also be able to shut down the immune cells causing autoimmune diseases. The only problem I could foresee is the idea of timing, such as with Type I diabetes, the immune system has already killed the cells that we would try to save in childhood. We would need to find a population of young children that begin to show symptoms of Type I before it's too late. (most likely would not be IRB approved. :( )
I love this topic, Allyson! It is actually what I am writing about for my project! The idea of a "cancer vaccine" is definitely on the rise. Some of the current trials combine the tumor antigens with bacterial/viral components to elicit an immune response to combat immunosuppression. Side note/fun fact: Dr. Penheiter told me about a couple of neurosurgeons at UC Davis, I believe, that injected fecal matter into a patient's brain to eilicit an immune response near their brain tumors. Needless to say, those doctors are being heavily sued, but the potential of cancer immunotherapy is vast!
ReplyDelete