Hacker News Reader

Comment by bambax | Hacker News Reader

Is this real? Can anyone with actual knowledge of the history of fighting cancer with modified virus provide input?

From my completely uninformed point of view it seems that if it's real, it changes everything...

There is a long history of cases in which a patient with cancer has made a miraculous recovery following an infection, and especially with fever (cancer cells have massively disrupted heat shock proteins which are usually mutated into non-existence in the pathway to uncontrolled replication and loss of cell cycle regulatory proteins) - additionally, fever increases the function of immune cells.

The earliest case reports I remember date back to the 1600s and for a short time in the late 19th early 20th century there were doctors that practiced that way however the results seemed highly variable and generally fell by the wayside.

It is great to think that this might be true, there is certainly evidence to suggest it is somewhat credible but like anything we will require more evidence before we can claim that it 'changes everything'. We can always hope though.

- ps apologies for lack of sources, I'm on mobile, I'm a doctor working on an oncology ward and I just had my worst day in my 5 month long career today and hardly in the mood to do the research legwork required to substantiate my claims. Google will help - start with hyperthermia therapy if interested in going down the rabbithole

Thank you for the link, this is quite interesting. If I may ask a stupid question, wouldn't this imply that cancer rates should be lower in tropical countries, where the ambient temperature is consistently >40°C ?

I've never heard anything like that, but you must remember that it is body temperature that is important and it is never normally above ~37.5

Thee is actually a really interesting paper, tangentially related, on sepsis (blood borne infections) which randomised ICU patients to have either aggressive temperature management (ie fans, active cooling and paracetamol) vs allowing the temperature to rise as high as 39.9. Although the study was small in size(I think there were roughly 15 in each arm) the 'permitted fever' arm had only 2-3 fatalities vs 14 in the aggressive fever management arm. I actually have that paper on my desktop and will dig it up

Seems so?

"Within the next several years, it is likely the technique will become a standardized treatment for cancers such as myeloma or pancreatic cancer, Tanios Bekaii-Saab, a researcher at James Cancer Hospital and Solove Research Institute in Ohio, told the Star Tribune. Still, the study must be confirmed in large randomized clinical trials. “Unless we get to the third stage of development, we are cautiously optimistic,” he said."

Source of source: http://www.mayoclinicproceedings.org/pb/assets/raw/Health%20...

More on reddit/science: http://www.reddit.com/r/science/comments/25j3je/mayo_clinic_...

Cautiously optimistic is the right wording. Seems like the patient has a severe reaction to the injection - if they get patients with even worse reaction or even dying from it, it could kill the therapy for good in Phase I.

Even if they get to Ph3, cancer trials usually take several years to enroll and to reach results, and it wouldn't be a therapy before 6-7 years down the road at the earliest, since you'd want to demonstrate PFS and OS improvement and that takes time in certain forms of Cancer.

EDIT: Patients experiencing complete remission is not completely exceptional in Phase Is. it happens, but it's usually very rare that it occurs in MANY patients. So, effectively speaking, this is n=1 datapoint at this stage, unless demonstrated otherwise.

>if they get patients with even worse reaction or even dying from it, it could kill the therapy for good in Phase I.

Perhaps. Or perhaps not. It depends. If it shows to be safer than a bone marrow transplant (insanely dangerous) its got potential.

It's all a benefits/risk analysis.

You are thinking of allogeneic bone marrow transplants (bone marrow is transplanted from a donor) where there is a 20% chance of death. Typically, myeloma patients get autologous transplants (the patient self donates bone marrow stem cells) which are much less dangerous (less than 5% death rate). I know someone who has had five ASCTs (autologous stem cell transplants) and he is still kicking. It's not a cake walk but at least you don't die.

If they get to phase 3, that means the stuff probably works, and it means people really sick can probably get it via compassionate use. So that'd be good news.

Yes, this is real. Take a look at the actual source (which I hope HN is able to link to): http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

The video that's included with the full text explains the study in layman's terms and is very accessible to the general public. Lots of good info there.

Edit: Here's a link to the editorial article that goes along with the original paper and video: http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

I see no reason why it isn't real, unfortunately a trial of 1 does not a cure make, however it does seem very hopeful, even if there is a long way to go with more extensive trials.

Indeed. We see these kind of n=1 reports every now and then and media jump on the hype gun without understanding drug development at all.

Statistically and probabilistically speaking, we can make an estimate (with error bars) of the value of the treatment, even with a trial of only a few people.

it was a trial of two, and the success ratio was 50%. so there is some actual statistical data there.

Take a look at http://www.mayoclinicproceedings.org/article/S0025-6196(14)0... and the included video.

The first patient did have a recurrence of a single tumor that was treated locally, with her marrow remaining completely clear. The second patient had his marrow cleared and all but a couple tumors in his legs resolved. And the virus penetrated those tumors and allowed full 3D mapping of them due to tags attached to the virus itself (it sounded like a thyroid produced chemical was attached to the virus as a tag). The implication was that because of the detailed mapping that it would be possible to resolve/remove the remaining tumors in the leg muscles of the second patient.

So, the answer is quite a bit much more complex than 50%. Both patients cleared the myeloma from their marrow. Almost all (numerous!) tumors were removed, from a single treatment in each patient.

Edit: Here's a link to the editorial article that accompanies the paper: http://www.mayoclinicproceedings.org/article/S0025-6196(14)0...

yeah so in that case 'a trial of 1 proves nothing' is especially misleading. this seems like very strong evidence.

What happens if it turns out that the treatment is fatal in 30% of cases? A trial of 2 would not necessarily show this type of thing. That is why one cannot extrapolate this without much more information i.e. more trials.

nobody is saying that more trials are unnecessary. my point is to emphasize the limited data so far is compelling, and that it goes beyond a 'trial of 1'.

Here's one that i read last week. It relies on HIV.

http://www.forbes.com/sites/matthewherper/2014/05/07/is-this...

Virus therapy has been on the table for a long time in the cancer fight. Because we can manipulate a virus and have it deliver highly targeted attacks, the idea of destroying cancers while ignoring healthy cells is sort if the holy grail of cancer treatment research.

> the idea of destroying cancers while ignoring healthy cells is sort if the holy grail of cancer treatment research.

More like: it's the problem that every effective cancer therapy solves in some (so far always limited) way.

There isn't a single thing called "cancer". There are many many different types of cancer. What might work for one type might be helpless against all others.

Reply on news.ycombinator.com