There was an exceptional example of a woman who recovered from an advanced colon cancer after being treated with her own cells. This offers new possibilities for other people who suffer from pancreatic or colon cancer. This was the primary example of a successful cancer mutation that the experts have been trying to cure for years.
Until now, the mutation was resistant to every doctor’s attempt and at least was described as something that could not be cured. Until the New England Journal of Medicine published an article for the National Cancer Institute, Dr. Steven A. Rosenberg, and his team.
It included the story of Celine Ryan, 50 years old database programmer, engineer and a mother of 5 who had an unusual genetic predisposition that enabled the treatment to succeed. Now she is cancer-free, but not regarded as cured.
This treatment is a kind of immunotherapy, a way where the patient’s immunity fights the disease. This is a really revolutionary treatment of cancer.
Although effective in some patients it could not be stated that it can be successful in others, while the doctors claim that it has great possibility to save the lives of many people.
According to Carl H. June, a doctor from the University of Pennsylvania stated in an interview that the treatment has huge implications. Although he had not taken part in the study, he wrote an article for the journal.
He claims that this research was the first of this kind that successfully targeted the defect in a gene called KRAS. This is a very important point because such mutation in the gene is very common. He also pointed out that every single patient who suffers from pancreatic or colon cancer has KRAS and the pharmaceutical companies has spent money and time to target KRAS, but unsuccessfully.
According to him, the only thing that matters is whether such case is a rare one or it can be applied to anyone.
On average over 53,000 cases of pancreatic cancer take place in the USA in a year and nearly 42,000 deaths. This is one of the deadliest types of cancer because less than 10% of patients survive 5 years. For example, in 2012, there were 330,000 people who died from colon cancer in the world.
From 30-50% of people with colorectal cancers have KRAS mutation and about 13% have the same mutation as Ms. Ryan. In 2016, 39,000 cases of rectal cancer and about 95,000 cases of colon cancer and 49,000 deaths from the two forms are expected to occur in the USA. For comparison, in 2012, there were 1.4 million cases and 694,000deaths on a global level.
If there wasn’t the case of Ms. Ryan, the new discovery may not happened at all. Although she was denied to enter the clinical trial, with the belief that her tumors were not as big as they should be and she didn’t give up and was finally allowed to enter.
The research included immune cells that fight cancer and tumor-infiltrating lymphocytes or TILs who gather around the tumor and attack the cancerous cells. Dr. Rosenberg has been analyzing these TILs for years in order to use them as a cancer treatment.
There was another attempt to treat patient with tumors like Ms. Ryan but without success because the experts weren’t able to produce enough highly targeted tumor-infiltrating lymphocytes.
These cells successfully fight the deadly type of skin cancer – advanced melanoma. Dr. Rosenberg’s team extracted the TILs from tumors, multiplied them in the lab and then returned to the patients, thus producing remissions in 20-50% of the patients.
Nowadays, the team has focused on even harder problems: tumors in the ovaries, digestive system, breast and other organs that consist more than 80% of the 596,000 cancer deaths in the USA every year.
Ms. Ryan had colon cancer which has reached her lungs despite radiation, chemotherapy and surgery. After some research, she came across this research at the National Cancer Institute. When she called the institute in 2014, she was told that her tumor is not big enough to yield TILs based on her scans and results. She was suggested by a nurse to send a set of scans and maybe the tumors will grow. She took the advice and was sure that she would get in.
But at home, she took screen shots of her scans and the measurements of the lung tumor seemed to match the criteria and she sent them to the institute. She asked if the tumor was not eligible she wanted to know why was that so.
In March 2015, she entered. In April, by surgery, the researchers removed several lung tumors to search for TILs.
Her tissue turned out to be the perfect example of medical success. She had a KRAS mutation and her TILs had killer T-cells. The T-cells could recognize the mutation due to the uncommon tissue type. Also, she had a specific protein on her cells’ surface that could combat the cancerous cells.
So, those patients who have the same tissue type are good candidates for the treatment with tumor-infiltrating lymphocytes. Researchers now have a model to create cell treatments for other patients too.
For the treatment of Ms. Ryan, the team selected TILs with high level of immune cells that were able to fight the mutation. They multiplied such cells in the lab to produce great numbers of them.
First, she was given chemotherapy in order to wipe out most of her white blood cells and let the TILs flourish. Then, through an intravenous line more than 100 billion TILs were inserted into her blood. The whole process took about 20 minutes and she was also given interleukin-2, another stimulator of killer T-cells.
Before the treatment, she had 7 tumors in her lungs. For the next 9 months, 6 of them reduced and then completely disappeared. The last one, the seventh one first reduced and then progressed. In order to remove it, the doctors removed the lower lobe of the left lung.
The results pointed out that the seventh tumor no longer had the tissue-type marker which allowed the T-cells to attack, although the process of mutation occurred.