James P Allison and Tasuku Honjo win Nobel prize for medicine
theguardian.com
theguardian.com
The realisation that our immune system is important in protection of cancer is only really just starting to blossom, and there is a lot that still isn't understood. We don't know how many cancers are routinely cleared by our immune system. Some researchers think it might be in the order of 10s a day.
Well, then I hope one day that treatment will become cheap enough so it can benefit everybody.
Cancers which grow to a detectable/dangerous population have to find some way to evade this immune surveillance and hitting off switches like "immune checkpoints" is one way to accomplish this. So, blocking the off switches helps the immune system resume its everyday task of killing weird cells.
And it works well in conjunction with other therapies that guide or otherwise help the immune system find the cancer. In particular, a style of designer gene therapy just approved by the FDA, of which one is called a Chimeric Antigen Receptor - https://en.wikipedia.org/wiki/Chimeric_antigen_receptor
These are in patients now, and curing people today.
If, for instance, the chimeric receptor (a designed synthetic cell-receptor) is able to enable immune cells to better sense the cancer, and that is coupled with the checkpoint inhibitors to prevent the cancer from disabling those immune cells, one's own immune cells will then be able to directly kill the cancer.
The checkpoint inhibitors (associated with the Nobel here), take the brakes off of the immune system. This can of course be dangerous, but generally one of cancer's first tricks it learns is how to apply those brakes to hide from detection. So by tuning down the sensitivity to the immune system's 'brake pedal', one's own immune system becomes more capable in fighting cancer.
"Inactivation of the Ctla4 gene in mice, performed in the laboratories of Arlene Sharpe and Tak Mak, confirmed and further substantiated its negative regulatory role, since these mice developed very severe autoimmune disease associated with proliferating T cells (Tivol et al., 1995; Waterhouse et al., 1995)."
"In the first-in-man study MDX-010 was given to 9 patients in a phase I clinical trial at a single dose of 3 mg/kg and a response was observed in some melanoma patients (Hodi et al., 2003). The same year complete regression was reported in another trial in some treated melanoma patients, while severe autoimmune side effects were also observed (Phan et al., 2003)."
So I wouldn't take it "just in case" like a daily multivitamin. Plus, monoclonal antibodies are expensive!
https://www.nobelprize.org/prizes/medicine/2018/prize-announ...
Don't mean to get political, but when many U.S. administrations talk of throwing billions towards military weapons, but nowhere near as much towards positive research like this, it just gets me frustrated. (Caveat: I do understand and support some types of military research that lead to positive technologies such as GPS, etc. I'm referring to governments spending billions on stupid projects like the F-35 joint strike jet fighter.)
Anyway, kudos and hearty congrats to the Nobel winners!
I picked up an adage from an old engineer once:
“It doesn’t matter how many men or how much money you have, it still takes 9 months to make a baby”.
I do agree that science is underfunded, but sometimes money isn’t the problem, things just take time.
There are a ton of areas of research that we know will yield a lot of future benefit but since the NIH is actually funded at a lower inflation-adjusted rate compared to 15 years ago [1], the research is held up greatly. Grants to young scientists are diminishing and many promising researchers are leaving the field.
Building a bridge is a serial process, studying the metallurgy of hundreds of compounds is massively parallel.
[1] - http://faseb.org/portals/2/images/opa/FederalFunding/Graph%2...
> From FY 2003 to 2015, the National Institutes of Health (NIH) lost 22% of its capacity to fund research due to budget cuts, sequestration, and inflationary losses.
The US benefits much more from developing cutting-edge weaponry than a cure for a deadly but rare health problem. It should be noted that military programs like the F35 involve both research in many fields of hard science and engineering, and generates demand for highly technical and highly specialized areas of expertise.
These military programs may not cure cancer but improve the lives of a whole lot of people within the US.
The US benefits probably far less from developing cutting-edge weaponry than from curing a deadly but rare health problem that kills a couple of hundred thousand people each year.
It should be noted that scientific programs like cancer immuno therapy involve both research in many fields of hard science and engineering, and generates demand for highly technical and highly specialized areas of expertise.
These scientific programs may not result in the next GPS but improve the lives of a whole lot of people (directly through treatment and indirectly through being paid) within the US.
As an aspiring medical researcher, stories like these are humbling and inspiring.
I think there are lots of medical treatments involving custom genetics that might not be as profitable as drug production but would rather involve a lot of lab work. Things that are initially not as easily automated and profitable (but certainly economically feasible given the prices of drugs imposed by patent monopolies).
I don't think investment in these approaches will occur without government sponsorship and kickstarting.
Are there any medical applications in use today?
Warren Alpert Foundation Prize: Allison, Honjo et al. (2017). CRISPR researchers (2016).
Tang Prize: Allison, Honjo et al. (2014); CRISPR researchers (2016).
Albany Medical Center Prize: Allison et al. (2018); CRISPR researchers (2017).
Gairdner Foundation International Award: Allison et al. (2014); CRISPR researchers (2016).
Gabbay Award: Allison (2011); CRISPR researchers (2014).
Breakthrough Prize in Life Sciences: Allison (2014); CRISPR researchers (2015).
That doesn't mean they'll win the Nobel, but they're definitely in the same awards realm recently. It might be Emmanuelle Charpentier, Feng Zhang, and Jennifer Doudna.