As a pharmacist, Kathy James sticks on the importance of regular cancer screenings are well trained. Although the 55-year-old had no history of cancer in her family, she never lost her regular mammograms, and she gave me regular breast examinations. So she was stunned when, during one of these self-exams in May 2017, it is a marble-sized lump she felt in her left breast. A visit to the doctor confirmed. “The radiologist came out with his hands in his pockets and looked down and said, ‘It looks good”, “James said after a biopsy, James and her husband learned metastatic breast cancer had was their wedding anniversary … 26 James immediately wanted both breasts surgically removed what they thought the opportunity would drastically reduce the cancer would spread. “I wanted to do with all this,” he says. “I was anxious to get to the double mastectomy.” if James had been diagnosed five years earlier, had radical surgery probably crossed, even if it would not be their cancer would not spread, or guaranteed return. a friend, a cancer doctor advised her to get to the surgery and them which Dr. Brian Czerniecki at Moffitt cancer Center, who have a pioneering study describes a new way to fight breast cancer, not only for test, carried on c On Chemot herapie, but to make radiation or surgery can be used by the power of their immune system. The study and dozens of others as it could rewrite the manual for the treatment of breast cancer patients have given unprecedented opportunity to control their disease and possibly even cure it. The supports of the immune defense system of the body and attack against unwanted interventions: bacteria, viruses and cancer cells also. However, cancer poses a difficult problem. Malignant cells develop from normal cells to start growing out of control, and the immune system specifically programmed not to attack the body’s own cells. But scientists have found a way to retrain the body to recognize and destroy cancer cells so that the immune treatments based on the latest promising weapon against many types of cancer. The first of these immunotherapy drugs approved for the treatment of cancer began in the laboratory of James Allison MD Anderson Cancer Center and Dr. Tasuku Honjo of Kyoto University in 1990. They discovered independently several ways in which the immune system blocked and attack cancer cells only in 2018 they were awarded the Nobel Prize in Physiology or Medicine. their discovery of a new class of drugs called Checkpoint inhibitors that the immune system allows cancer cells are seen as the disease-causing villain them and attach them to dramatically improve remission rates. Over the past five years, the Food and Drug Administration (FDA) has approved a dozen new cancer drugs and therapies that use the immune system. “All cancer patients are likely to [immunotherapy] received in five years, so it is for many of them is his salvation,” says Allison. immunotherapy treatments are particularly effective against lung cancer, skin cancer and blood cancers such as leukemia and lymphoma. But the immune-based treatments have not been so successful or so abundant for the most common cancers: colon, prostate, and particularly breast. Of the more than 600,000 people who died of cancer in the United States last year, he has had most of these types of solid tumors. The problem, says Dr. Robert Vonderheide, director of the Abramson Cancer Center at the University of Pennsylvania, is that “most breast cancer in a form called wir category kalte’immunologische tumors, the tumor has meant the possibility of a exclude the immune system or hide from it all, this type of cancer is easily treated with existing immunotherapies. at least not yet. “are building they established on the basis that Allison and Honjo with checkpoint inhibitors to find researchers creative ways to get to stimulate the immune system cancers such as breast cancer as “hot” and not as cold “targets”, the same way the insects of infectious diseases such as measles or to see influenza viruses flag an answer. You can do this through a combination of successful treatments for diseases such as tuberculosis and HIV learning what treatments; against cancer, they adapt to improve immune-based treatments with the most traditional such as chemotherapy, surgery or radiation therapy, which is the immune response. While chemotherapy and radiation in his immune cells destroy the form of electricity with harmful, can modify the formulas just enough to stimulate an inflammatory response which can be seen, the tumor cells wake of the immune system. researchers in breast cancer are testing ways to distribute drugs and immunotherapy trigger the strongest immune response against tumors as checkpoint inhibitors. James was fascinated by the idea of his body exercise their cancer as a more sustainable solution than the short-term cycles of chemotherapy or radiation fight alone. “Because my cancer tends to recur, and why is aggressive, I could not just stop once my year of treatment was,” he says. “I had to move on.” And now, for patients like her, more creative ways to emerge trigger the immune system against cancer begin. At the National Cancer Institute, Dr. Steven Rosenberg, chief of surgery, studies the mutations that drive her breast cancer patients, isolate the few immune cells that are trying to fight cancer cells increases their numbers in the laboratory and infuses them back to his patients. He believes that the strategy could be the model for the translation of the same success they have immunotherapies in the blood, lung cancer and skin was the most common malignant tumors in the breast, prostate and colon. There’s a reason doctors their first immunotherapy efforts on tumors such as melanoma and cancers of the lung focus. These diseases generally arise because the cells grow many mutations or defects in their DNA that instruct them to begin growing abnormally and out of control. Normally, make it difficult mutations treating cancer because they allow the cancer new ways to dodge the treatments against them launched to do. But when it comes to immune therapies do work, they are more precise. In 1980, Rosenberg was the first indication that these mutations motivate the attention of the immune system, and certain immune cells begin to infiltrate tumors. At that time, Rosenberg says, “no one knew that an immune response against human tumors was there.” He decided to try to use it to his advantage and finally developed a way to isolate these immune cells fight against cancer, such as T cells we know of 195 people with melanoma to expand their number and infused back the patient. So far, 30% of them have a complete response to therapy, the existing cancer cells perceive gone, and they saw no tumors in almost seven years after treatment. Encouraged by this show doctors immunological force we began looking for ways to use the immune system to treat other cancers. Leukemia and lymphomas that when the blood cells form, does not turn evil can with a task included and are usually even after chemotherapy and radiotherapy recurrence. But they are particularly suited for one type of immune therapy, which involves the replacement of a patient’s malignant blood with a population of T cells that they are treated often attack a receptor in the blood of cancer cells. Up to 90% of people with certain types of leukemia, cancer recurrence after repeated cycles switched from standard treatments in remission after this form will receive immunotherapy. This success, the FDA introduced the first immune-based cell therapy, called the CAR T, for a type of leukemia and other blood cancers in 2017. But solid-tumors are much more common to have fewer mutations and invade the tissue to approve it (such as those in the chest) may not have the blood cells are replaced, the difficult immunotherapy. Vonderheide has determined that listed in a 7000 national genetic database tumors, breast cancer in the bottom 25% of tumors fell when it came to how many mutations they wore. For this reason, carcinomas of the breast of the lower half of all cancers is also when it comes to immune reactions of the body is to produce. “The notoriously protect me breast cancer by the immune system,” he says. Now Rosenberg way for breast cancer unlock the possibilities of immunotherapy to explore. Based on his early work with T-cell responses to cancer, it has designed an experimental treatment for each cancer patient adapted and tested first in people with liver, colon and cervical cancer. Early breast cancer patients in his study, Judy Perkins had stage IV cancer that has relapsed within it into blocks and spread to the liver and, despite tens of chemotherapy and hormonal treatments and even a mastectomy. Tapping into the growing awareness of how cancer genes unit, Rosenberg turn a thorough genetic analysis of her tumor and found 62 mutations responsible for large malignant cells Perkins. Then he looked for the few brave immune cells, and four of these genetic alterations attacks could see, already facing their cancer. He took these immune cells are grown in large numbers in the laboratory and gave them Perkins IV as an immune-based treatment for their breast cancer. After all exhausted their treatment options, Perkins said loving farewells and was “waiting for the end,” he says. But received within one month after a single infusion of cells, they felt breast cancer get “softer and smaller.” Within two months had gone growth tennis ball size in his liver and breast cancer had nothing small. Nearly three years later, doctors say it is a permanent regression. “I’m thrilled total. It ‘s great,” he says. But Perkins now knows that she is an exception. So far only 14% of the 42 persons treated as Rosenberg who responded Perkins. Rosenberg believes that percentage increases as he and others find better ways both mutations behind every cancer patient and the immune cell population against them LOCATE targeted. As someone who has developed the science, only people could not get breast cancer, but those with other solid tumors and lead immunotherapy. “This could in practice a plan for the treatment of any type of cancer,” he says. “And I think, frankly, that has a good chance of working.” There are limits. Rosenberge method of immunotherapy is a time consuming and expensive treatment, and because it requires a tailored approach, can not be mass-produced as a universal, off-the shelf procedure for each patient. It should in other ways an immune response that should be the reason why the Czerniecki typing test possible “vaccines” to James and other patients who might seek and destroy cancer cells before they experience the new tumors. Breast Cancer James’ HER2-positive for the protein called protein that dominated a cancer cell that initially attracts an immune response, but then is lost in time. Czerniecki create a vaccine that stimulates even after the reaction. “We try to recover some of immune responses that eliminated or reduced over time,” he says. E ‘useful, but not enough to be in the event that James’. As the progress of the disease, the cancer cells actively protect the immune system, so that cancer cells and normal I can kill in the detoxification proteins, which are found in abundance in the neighboring healthy cells. “With invasive cancer, we have to play with their environment, because it’s almost like a wall, state of the immune system that we have to go,” says Czerniecki. One way to get that, ironically, is the help of the old methods to win for the treatment of breast cancer. At Penn, Vonderheide experimenting with ways to combine them with conventional treatments such as chemotherapy and radiation with drugs immunotherapy the latest hope, that the synergistic effect will make the tumors more visible and vulnerable to immune attack. The idea of the Nobel Prize Allison says, is to “turn the radiotherapy and chemotherapy in a sort of vaccine.” The key is not to standard chemotherapy or radiation, but refine the treatments that are right for the activation of an immune response, Too chemotherapy or radiation suppresses the immune system, but just enough, they can act as a stimulant to activate . “It ‘s almost as if chemotherapy can roughen the surface of cancer cells and released proteins [] get that attract the immune system,” said Dr. Peter Schmid, clinical director of the breast center at St. Bartholomew Cancer Center London. Schmid will be expected results at the end of October from a study known in combination with an inhibitor of combined checkpoints for cancer triple negative advanced breast for the treatment of a chemotherapeutic agent, an aggressive, difficult to treat the disease. The chemo is supplied in the form of nanoparticles more soluble and better equipped to scroll inside of cell membranes makes to activate an immune response. “Patients ask me every day, ‘Why do I need chemotherapy? It will not bring my immune system down?” Schmid says. ‘We just have to understand that just may have a subtle and positive effect on the immunity against cancer. “There are similar emotions of shorter schedule of radiation with combined Checkpoint inhibitors. This approach shows more promise to reach a tissue have as a way to target tumors that spread common dilemma with breast cancer. The researchers believe that radiation as given in a few days instead may be sufficient the standard program of a week in an immune response against a particular trigger tumor, which is then directed to the tumor cells to attack other parts of the body. in the case of breast cancer, the researchers hope that this response will find growths that have spread to the breast there and those targeting. this new way of thinking, says Allison, is “really disturbing, because we have seen with chemotherapy and radiation that every last cell cancer, they do not need to kill, but things just enough to stir the immune system portarl the outside. “Studies like James could also be involved in the current thinking about the fall on how to address one of the persistent challenges of breast cancer recurring tumors. If you wake immune cells against cancer it develops vaccines are effective, so breast cancer patients potentially protected their cancer returning may have anti-cancer with periodic “booster” shots. Your immune system would essentially be triggered all the cancer cells to find and eliminate them before they can join in tumors. James Perkins is confident that their participation will accelerate immune-based treatments in regular rotation for future breast cancer patients. James received six vaccinations of their immune cells fight cancer during the summer and is scheduled to receive three booster begin in January. “I can not change the change that I have breast cancer, but can I submit pays through part of a clinical trial to be hoping that there is a vaccine my children and grandchildren to get, they would not have endured what I went through,” she says . Perkins just want their case Miracle, the routine rather than the exception. “The immune system has so much potential, and we begin to break even this door,” he says. “I hope that the door is completely open and we better treatments. I would like some companies in the gold guinea pigs.” This seems to October 15, 2018 issue of time.
As scientists in the treatment of breast cancer using the immune system
