Saturday, May 17, 2014

Measles and Lymphoma

The big news in the cancer world this week was the news that the measles cured cancer.

Well, not really, but that is, naturally, how a lot of people took the news.

What actually happened was Mayo Clinic researchers changed a measles virus so it would attack the cells of Multiple Myeloma (a blood cancer). They tried the treatment on two patients, giving them a single intravenous dose that was the equivalent of about 10 million doses of a measles vaccine. Both patients responded well at first. They had some immediate reactions (fever, headache, etc.), but they were taken care of quickly. Of the two patients, one didn't do well, with the cancer returning after 6 weeks.

But the other did better -- much better -- and has been in remission for 9 months. The modified measles virus took out most of the cancer, and some local radiation took care of the rest.

There are lots of commentaries online about this research, some of them inaccurate, so better to read directly from the Mayo Clinic Proceedings, or watch this brief video from Dr. Stephen Russell, lead researcher for the project:

There are definitely some things to be excited about here, but also some things to be cautious about.

First, the cold water:

As lots of commentators have noted, this study involved two patients, and only one of them had success. And that one patient has only been in remission for 9 months. That's excellent, especially when compared to the other patient in the study, but we certainly can't call her "cured." The researchers are very open about the fact that this is "proof of principle" study. In other words, they want to show that it is possible to change a virus and have it recognize and attack specific cancer cells. There will still be a lot of work to do, and a lot of testing to conduct, before we know for sure that this will work on a large scale.

So now, the "warm water" -- some things to be excited about.

First, Dr. Russell is pretty excited. I always get a charge out of seeing a researcher get excited about results. Now, everyone is going to excited about his own work, and his excitement is no guarantee that this will all play out the way he wants it to, but I can get a little hop out of it anyway. He made a statement in the video that is very exciting: "We believe it can become a single-shot cure" -- one shot of 10 million vaccines, not six months of infusions like with chemo. Very cool.

Second, also very unlike chemo, the side effects were relatively mild, and were treatable immediately. Dr. Russell describes the patient being given Benadryl to take care of the side effects. That immediately reminded me of my own experience with Rituxan, which had relatively mild side effects for me. You have to love a treatment with side effects that can be taken care of with something you can buy at Walgreen's.

Finally, there is the question of how this affects Follicular Lymphoma. Obviously,  Multiple Myeloma is not Follicular Lymphoma. But I think (in my hopeful, optimistic way) that the "proof of principle" is important for those if us with FL, too. Multiple Myeloma is, like lymphoma, a systemic cancer. In other words, while cells can gather in one place (the way FL cells gather in the lymph nodes), for the most part, the cells are flowing through the blood. This measles virus treatment is designed to go after systemic cancer.

Now, this particular virus was designed to seek out CD46 proteins, which are specific to Multiple Myeloma, so it wouldn't work as it is on Follicular Lymphoma patients. But the principle is there: in theory, a measles virus could be modified to respond to CD20 (or some other protein) and thus seek out Follicular Lymphoma cells. In theory.

As I said, there's a whole lot of work that will need to be done before we can say this is a successful treatment for Multiple Myeloma. And as much as I get excited by Dr. Russell's enthusiasm, it will be years, many years before we can say it is a cure for that blood cancer.

That means it would be even more years still before we could say the same about Follicular Lymphoma.

But it's certainly something to keep an eye on. And most certainly another reason for hope.

1 comment:

Anonymous said...

Measles, in its unmodified, natural state has cured follicular lymphoma in hundreds of African children with Aids with Herpes generated follicular lymphoma. Viruses such as measles and swine flu have successfully cured cancer patients without the scientists' permission and/or tinkering. You should never underestimate self-interest motives when science is involved.