Saturday, 15 September 2012

Immunotherapy - if it were an album it would win the Mercury Prize.

Writing about the world of cancer research is a much more controversial and barbed subject than I ever realised. Setting up a new charity to fund a fairly new and very specific area of research is even more so, as I have recently found out. Many people do set up new charities related to cancer, but many are to fund the treatment of an individual patient,  sometime because, as in the US, not all treatments are covered by medical insurance, and sometime because those treatments may be outside the realm of conventional medicine.  People are more forgiving when faced with an individual adult or child desperate for a last chance of help when orthodox medicine has failed them, and more generous when they see the real face of one person suffering. I am starting up this charity for a deeply personal reason, but prefer not to put a face to it. What people like to see most of all though, is an established charity or medical institution being funded - it gives them confidence that the money is going to the right place. The problem for cancer immunotherapy and academic labs that research immunotherapy is that they are very much the new kid at school that looks funny, doesn't like sport and listens to Danish shoegaze on their headphones constantly- even if they are going to grow up to be, er, bigger than Radiohead. 

Why have I started up a new charity to fund cancer research, specifically cancer immunotherapy research? I will answer by posing questions and statements that have either been put to me directly or intimated by discussion I have had with people on Mumsnet or twitter or other internet sites.

1] 'Cancer immunotherapy is an 'alternative' and unreliable way of treating cancer.' 

Cancer immunotherapy research is not, as some might still think, an 'alternative' way of treating cancer. Well it is an alternative way of treating cancer, but the world 'alternative' is now used pejoratively through its association with homeopathy and acupuncture and other 'alternative medicine' disciplines. Now whilst I do not knock the benefit some people may find through these latter disciplines, homeopathy and acupuncture have as much to do with immunotherapy as Jeremy Hunt has to do with Che Guevara. Immunotherapy involves engineering the body's own immune cells to recognise a specific or multiple cancer antigen target, so that the body can seek and destroy cancer cells as it would a virus or bacteria, even if it has metastasized. Unlike homeopathy and acupuncture, it is cutting edge science, immnotherapy researchers in academic labs publish their results in peer reviewed scientific journals. Immunotherapy research can be measured, in terms of its efficacy and success. In labs it is already wiping out numerous varieties of cancer, and in small clinical trials it is creating non- toxic and significant high quality extensions of life for advanced cancers resistant to all known drugs. I often wonder why Steve Jobs, a brilliant and highly intelligent man, decided to try 'alternative' treatments such as acupuncture and SPIRITUALISM [what the fuck?] to treat his pancreatic cancer, a cancer that has a 5 year, 5% survival rate, when patients given an immunotherapeutic vaccine for pancreatic cancer in a current clinical trial at the Cancer Institute of New Jersey in  are defying all expectations, with 4 of the 6 patients treated still alive and feeling well after 2 years.
Other academic labs are having amazing success with immunotherapeutic treatments for brain tumours, many small clinical trials are doubling the survival times for patients with advanced brain tumours, and these are patients who have already received all available treatments. The aim is, in the future, to refine these vaccines and adapt them as the tumour adapts and mutates so that the vaccines can be even more effective.

 2] All the good research gets funded. If researchers are struggling for funds, then there is a reason

Professor Carl June at UPenn recently published the results of a small clinical trial of 3 man with advanced, refractory chronic lymphoid leukaemia. He only managed to secure funds to treat 3 men. His strategy was revolutionary in the world of immunotherapy research - not only did he take immune cells [T-cells] from the patients, modify those T-cells to recognise a particular cancer antigen, in this instance a protein called CD19 and then multiply those T cells in huge numbers in the lab before injecting them back into each patient, but he used a chimeric-antigen-receptor that enabled those T cells to persist much longer in the body.

''We saw at least a 1000-fold increase in then number of modified T cells in each of the patients. DRUGS DON'T DO THAT'' June says.  [caps my own] ''In addition to an extensive capacity for self-replication, the infused T cells are serial killers. On average, each infused T cell led to the killing of thousands of tumour cells- and overall, destroyed at least two pounds of tumour in each patient.''

THIS is cutting edge science. It is revolutionary, it is unheard of in the field of cancer research. Why this man and his team are not featured on TED and haven't won the Nobel Prize for medicine yet is BEYOND ME. And hardly anyone knows about it either. One good thing, Novartis are now falling over themselves to to a deal with June. 

“I never thought this would happen, that the pharma industry would get into ultra-personalized therapy,” said June. Yet many other academic labs researching cancer immunotherapy, and producing stunning lab results, still struggle for clinical trial funding. 

3] There are so many different varieties of cancer, each one is like a different disease, there won't be any one cure. 

Immunotherapy is unlike all other treatments. It harnesses the ability of the body's own immune system to seek and destroy cancer cells. T- cells in the body already do this - watch this amazing footage from Professor Gillian Griffith's lab in the UK.

All cancer cells posses many proteins/antigens that mark them as unusual and different to normal cells. They often manage to evade the body's own immune defence strategies. Immunotherapy works by enabling these immune defence strategies to 'see' the cancer cells as foreign, and therefore to destroy them.

 Professor Brad Nelson is currently using next generation-sequencing in research involving over 100 ovarian cancer patients to identify all the mutations in each patient's tumour. 

''In laboratory models, we have been able to eradicate even advanced tumors within a matter of weeks. While there is still considerable work to be done before this approach is used in the clinic, the results so far are very encouraging" says Professor Nelson.  And if the cancer mutates, another personalized vaccine can be created. “There really is no limit to how long you can play this strategy” he says.

Because cancer cells mutate into hundreds of DNA sequences, the vaccine would target five of the mutations, giving the patient’s immune system a good chance of winning. “The chance a tumour will be able to bypass all five is very low”
So immunotherapy can be modified to address a vast range of different cancers, and a vast range of different mutations in each different cancer - it has the potential to be the magic bullet that everyone dreams of - but needs MORE FUNDING. 

4] There are many other cancer charities out there, we don't need a new charity. 

There are many charities in the UK funding something to do with cancer, it is true. Many of the most established ones, like Macmillan and Teenage Cancer Trust, both FANTASTIC charities, do not fund research into a cure or new treatments, but they raise funds [which is at present crucial] to provide support and advice to cancer patients and their families, and the latter for better environments and better specialist care in hospitals for teenagers with cancer. Macmillan does fund Macmillan nurses for a set time, sometimes up to 3 years, but after that they are paid for by the NHS. Let me re-emphasise that these charities are vitally important to the support of cancer patients in the UK and MUST be funded - but they do not fund the pursuit of a cure. Cancer Research UK funds world class cancer research in the UK. They spread their funds over a very wide area of research and many world class researchers depend on them for their work. Interestingly, they have just been given a 20 million pound anonymous donation to specifically plough more funds into cancer immunotherapy research, which is fab news. But Cancer Research UK have a responsibility to fund many areas of cancer research and education - research into the causes of cancer, basic laboratory research, research into how to  make radiotherapy more effective in hospital settings, and of course, the biggest, drug- based research.  Drugs that have emerged recently like Avastin and Temodar heralded as huge breakthroughs, have sometimes had huge benefits for patients but often only extend life by a matter of weeks. And the main problem with the drug treatment for cancer is that almost ALWAYS cancer becomes drug resistant, as has been seen with Gleevec. Cancer Research UK is again a CRUCIAL organisation and one that fosters brilliant academic research in the UK. But a charity to fund purely immunotherapy research does not exist. Just as I'd rather my taxes went to education and health but not to 'defence' I would like the money I raise for cancer research to only go to the best immunotherapy research, and not drug-based research.  I don't want to compete with Cancer Research UK [and will never be able to] but I would like to try to raise funds for the best immunotherapy research worldwide. Hence this:

And because I smashed up my pelvis in a road accident as a child, I'm not very good at sponsored cycle rides or marathons. So instead I've done this:

Have been featured on BBC Introducing and all proceeds from the album to come will go to above charity. 

Ok. That's it folks. Fanks.