[HN Gopher] Woman who had pioneering cancer treatment 18 years a...
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       Woman who had pioneering cancer treatment 18 years ago still in
       remission
        
       Author : ranit
       Score  : 179 points
       Date   : 2025-02-17 19:44 UTC (5 days ago)
        
 (HTM) web link (www.theguardian.com)
 (TXT) w3m dump (www.theguardian.com)
        
       | adamredwoods wrote:
       | Recruiting immune cells for cancer intervention is the future,
       | but it will still take a while to get there.
       | 
       | >> Over seven years that followed the therapy, 12 patients died
       | due to relapsed neuroblastoma. Among the seven that survived
       | beyond this point, five were cancer-free when given the CAR
       | T-cell therapy but had previously been treated for neuroblastoma
       | using other approaches and were at high risk of relapse. All five
       | were disease-free at their last follow-up, between 10 and 15
       | years after the CAR T-cell therapy, although the team note they
       | may already have been cured when the therapy was administered.
        
         | jandrese wrote:
         | The problem is that cancer is your own cells, so immunotherapy
         | solutions are always going to be balanced on a knife point. If
         | you make the tiniest mistake it is Lupus.
        
           | lr4444lr wrote:
           | Wouldn't that likely have a better prognosis than most
           | cancers?
        
             | meowfly wrote:
             | A family member of mine is going through keynote 522, which
             | is a clinical trial that combines 3 chemos and an
             | immunotherapy prior to surgery.
             | 
             | The five year survival rate for stage 3 triple negative
             | breast cancer is normally about ~60% but the clinical
             | trials show with immunotherapy it exceeds 80%. So the
             | survival rates you see online aren't capturing the progress
             | we are making with these drugs. Hashimotos seems worth the
             | risk.
             | 
             | An interesting aside is that the patients in the clinical
             | trials who had adverse reactions to immunotherapy and came
             | off the medication had higher survival rates than patients
             | who stayed on it. The hypothesis is that stimulating an
             | immune system overreaction also means it was also highly
             | effective against the cancer.
        
               | adamredwoods wrote:
               | Interesting theory, but not in my experience. My wife
               | died of MBC and she had lots of reactions. Anecdotally,
               | the pembro + chemo may have given her an extra year, she
               | did well on it.
        
             | jandrese wrote:
             | Lupus is not generally associated with "good prognosis".
        
           | mbil wrote:
           | I wonder if they could do two phases. Like first engineer T
           | cells that mark the target cell but don't kill it. And then,
           | if the marked cells are sufficiently scoped to cancer cells,
           | use the same targeting mechanism for cancer-destroying T
           | cells.
        
             | adamredwoods wrote:
             | Marking them is the challenge. Cells have expressions that
             | we can engineer chemicals to bind with, but sometimes the
             | cancer cells have no expression (Triple negative breast
             | cancer for one). It just mutates and divides faster. This
             | is why chemo works well, it is uptaken by cells that divide
             | faster, like cancer, and hair, mouth cells, etc.
             | 
             | But chemo is general, it doesn't specialize. So thus, the
             | new chemo called ADCs (anti-body drug conjugates), are
             | really nice. They target AREAS and release generally.
        
       | melling wrote:
       | A doctor in Australia has been cancer free for almost 2 years
       | after treating his brain cancer with Car-T therapy
       | 
       | https://www.bbc.com/news/world-australia-69006713
        
         | apwell23 wrote:
         | Every therapy works for someone spectacularly. This has been
         | the case forever. It doesn't really prove anything/ main
         | challenge is figuring out why it worked for this particular
         | person when it fails for most. Cancer treatment has always been
         | primitive throw shit at the wall and see what sticks. Still the
         | case today.
        
           | dennis_jeeves2 wrote:
           | You are partially correct. But here a broader picture - you
           | may have to get in touch with the person(s) who is claiming
           | the cure to draw a conclusion. Sometimes they may have done
           | multiple trials within their own circle, or if it's a
           | physician on his patients. They generally will have
           | documented their patients. They generally will not have the
           | means to do large scale trials. (I heard that it cost about
           | 10 million, and about 10 years to get an FDA approval). When
           | a unknown/non credentialed practitioners or a physician claim
           | something it is generally ignored - as far as I'm concerned
           | the cancer treatment cartel industry is real (As with almost
           | every other industry), if by the rare chance it does get some
           | publicity (as it happened with the Linus Pauling, Nicholas
           | Gonzales), the cartel indulges in accusations of quackery and
           | character assassination.
           | 
           | Now I'm not saying that the small time practitioners are
           | always correct, in fact they are mostly wrong. But they
           | deserve some investigation.
        
           | cjbgkagh wrote:
           | If the therapy had not worked would that be evidence that the
           | therapy is not effective? If so the fact that it did work
           | must be at least some evidence that the therapy is effective.
           | Simple Bayes factor, you can't have one without the other.
           | 
           | Additionally, if there is enough similar cancers we can know
           | the rate of spontaneous remission within a particular band of
           | time. This would be much lower than spontaneous remission at
           | any time so that a spontaneous remission at the specific time
           | of treatment could be a rather unlikely event and start to
           | look like decent evidence.
           | 
           | Not disagreeing that cancer treatment isn't a shit show but I
           | would suggest that such evidence cannot be easily dismissed
           | due to the lack of the gold standard large scale double blind
           | study.
        
       | ackbar03 wrote:
       | Problem with CAR-T is still too expensive to use...
       | 
       | people should be investing a lot more in early stage drug
       | discovery biotechs! A lot more!!! (I'm doing an early stage drug
       | discovery biotech)
        
         | Teever wrote:
         | Why is that a better course of action than investing resources
         | in making the existing and effective treatment more affordable?
         | 
         | From what I've heard the bottleneck for CAR-T is the lack of
         | technicians who can do the work and automation it make more
         | effective use of the technicians and their time.
         | 
         | It seems like there is a clear path to decreasing the cost of
         | this.
        
           | DennisP wrote:
           | Why not both? It's not like those are the only two things in
           | the world. Maybe they're both way more useful than a thousand
           | other ways we spend our money.
        
         | fredophile wrote:
         | There are companies pursuing CAR-T for veterinary treatments
         | that are driving the costs down. One example I'm aware of is
         | LEAH Labs (https://leahlabs.com) that is working on using CAR-T
         | to make affordable cancer treatments in dogs.
         | 
         | Full Disclosure: I am an investor in LEAH Labs.
        
         | iancmceachern wrote:
         | The problem is Erooms law. Yes we need to invest more, but we
         | also need to figure out why we're getting worse at doing it
         | year over year. My hypothesis, many others, is that the models
         | are flawed. We need better, more fluid models.
        
       | mattkrause wrote:
       | If you like stuff like this (i.e., beating cancer), badger your
       | reps to get the NIH back up and running!
       | 
       | This particular work came out of at least 3 NIH grants and
       | indirectly relies on a whole lot more.
        
         | n4r9 wrote:
         | Could be problematic; cancer research relies on a diverse
         | sample set.
        
           | mattkrause wrote:
           | Ha! I'm afraid to admit how much thought I've put into
           | avoiding words that overlap with the "naughty list", like
           | (statistical) bias and (electrical) polarization.
           | 
           | A dead comment says this is all a myth but from somebody in
           | the trenches...it's not. No access to the Federal Register
           | means no meetings to evaluate grants, which means no more
           | grants going out at all.
        
             | caycep wrote:
             | future of oncological meds might come from PRC
             | institutions, maybe EU; US pipeline will likely dry up
        
         | vkou wrote:
         | My reps can't do anything and the ones that can will laugh at
         | anyone who calls them with such a request.
        
           | johnmaguire wrote:
           | I agree that Democratic reps don't have a ton of power right
           | now, though some have voted to approve some poor Trump
           | cabinet picks.
           | 
           | I think it's still important to call both them, and your
           | Republican reps. They keep track of how many people call on
           | issues, and what side they take. I think a lot of reps are
           | worried about retaliation from the POTUS, and the only thing
           | that gives them ammunition is constituents on their side.
        
             | vkou wrote:
             | > I think a lot of reps are worried about retaliation from
             | the POTUS,
             | 
             | As they should be, everyone from the GOP who has ever
             | crossed the golden boy was destroyed by him. And now he has
             | the richest man in the world to finance a campaign to
             | destroy them.
             | 
             | The constituents matter far less to them than those two
             | things. They made a Faustian bargain, and they care about
             | keeping their jobs, which means doing what he tells them,
             | not what you tell them.
        
               | licebmi__at__ wrote:
               | They had the chance to boot him the last impeachment
               | trial, and they decided they wanted to keep being his
               | lackeys.
        
       | Workaccount2 wrote:
       | Can someone explain "remission" to me?
       | 
       | Perhaps I am missing something because to me, going 18 years
       | without cancer after having cancer and going through treatment
       | is...expected? Does canceer treatment not actually get rid of the
       | cancer or something like that?
        
         | teddyh wrote:
         | Relevant xkcd: <https://xkcd.com/931/>
        
           | DennisP wrote:
           | I know that's generally true, but apparently sometimes the
           | odds of recurrence are so low they stop worrying about it. I
           | have a relative who was diagnosed with stage 4 melanoma a
           | decade ago. She got three doses of immunotherapy and her
           | tumors immediately shrank by 2/3, and eventually disappeared
           | entirely. For a while they kept scanning her twice a year,
           | but several years ago they told her it was gone and stopped
           | the scans.
        
             | Out_of_Characte wrote:
             | That's great to hear but, your risk of cancer before
             | diagnosis and after you're cured is, at best, the same.
        
               | DennisP wrote:
               | Yes of course, even if all her cancer cells have been
               | destroyed, she could still get an entirely new cancer,
               | just like anyone else. She hasn't attained some kind of
               | immunity.
        
         | apwell23 wrote:
         | you really have no way to know if cancer has been "gotten rid
         | of". Presumably thing that went wrong in your body and gave you
         | cancer is still wrong. remission = we can't see anything in
         | this scan. you cannot assume scan can 'see' all cancer, there
         | is no such scan.
         | 
         | Its no different than taking a pill for high cholesterol you
         | are not cured of the disease .
        
           | spondylosaurus wrote:
           | Yeah, "remission" comes from the Latin "remit," which liter
           | means "to return or restore."
           | 
           | When illness originates outside the body, it's usually
           | possible to completely kill/eradicate it, at which point
           | you're "cured." But some things either linger forever
           | (certain viruses, like how chicken pox can come back as
           | shingles) or originate inside your own body (cancer, lupus,
           | rheumatoid arthritis). In the latter case, treatment makes it
           | possible to return to a baseline normal, but there's no
           | guarantee it's all the way gone or won't ever return, so we
           | say it's in remission rather than cured. Cancer lurks;
           | autoimmune diseases go dormant but don't die.
           | 
           | (One autoimmune exception: if you have ulcerative colitis,
           | completely removing your colon cures most people, since the
           | problem lies in that specific organ. But that goes to show
           | how drastic a true cure is!)
           | 
           | There are also some conditions, notably MS, that are
           | described as "relapsing/remitting" because they alternate
           | between periods of relapse and remission. So you'll feel fine
           | for a while, then the symptoms come back, then they go away
           | again, etc.
        
       | lancercane wrote:
       | I've been exposing myself to similar, vaccine induced T cell
       | production to fight cancer, research recently due to a family
       | member recently going through it with pancreatic cancer.
       | 
       | https://www.mskcc.org/news/can-mrna-vaccines-fight-pancreati...
       | 
       | My family member was ineligible for the trial due to requiring
       | chemo before surgery due to ca19-9 markers being above the limit
       | for surgery eligibility.
       | 
       | Here are some of my observations as someone forced to the
       | outside:
       | 
       | I read the 2017 and phase i papers.
       | 
       | They are both very mathy and talk more about the life spans of
       | their induced T cells than their patients.
       | 
       | Looks like phase i was 19 patients (16 given the vaccine), 2
       | recurred, one died, they seem to want to blame the patients'
       | immune system.
       | 
       | The study is: surgery, vaccine, then 12 cycles of chemo regiment,
       | then vaccine booster.
       | 
       | I was frustrated to see a lack of any search results for "diet",
       | "nutrition", "sugar", "glutamine", in either paper.
       | 
       | I think the mathy science is cool, and a necessary component, but
       | focusing on pharmaceutical solutions and calculating their
       | efficacy based on if their intended biological reaction occurred,
       | seemingly oblivious of, or defiantly ignoring, lifestyle change
       | appears misguided.
       | 
       | Diet and exercise is insufficient on its own, but due to the vast
       | differences in individual diets, studies like these should
       | include lifestyle requirements as a control.
       | 
       | Especially if they are going to point at a patients immune
       | system.
       | 
       | Diet effects on both immune system function and specifically
       | targeting cancers is uncontroversial and scientifically
       | supported.
       | 
       | Why are these two research efforts so siloed from each other?!
        
         | goda90 wrote:
         | I think some people try to distance themselves from the diet
         | and exercise parts because of how easy it is to sell quackery
         | in that area. "Take this supplement to cure cancer", "Read my
         | book about the exact diet to cure your cancer!", etc.
         | 
         | We'll probably start seeing more and more mixing of traditional
         | or cutting edge treatments like chemo, radiation, and
         | immunotherapy with having the right lifestyle choices to have a
         | stronger immune system. There is research being done, even if
         | limited.
         | 
         | Another interesting thing I'd like to see more research done on
         | is metabolic therapy. Not just having a diet to boost the
         | immune system, but targeting the metabolism of cancer cells.
         | The Warburg effect[0] means a lot of cancer depends on glucose
         | and glutamine for energy. Some researchers have tried using a
         | ketogenic diet to reduce glucose, since normal cells can
         | survive without it, plus using drugs to temporarily drop
         | glutamine levels with the hope that the cancer cells starve
         | first.
         | 
         | [0]https://en.wikipedia.org/wiki/Warburg_effect_(oncology)
        
           | lancercane wrote:
           | I appreciate your reply, but I think calling diet and
           | exercise "traditional" and saying the research is "limited"
           | plays into the downvoters' prejudice.
           | 
           | I see this sort of sentiment a lot on this forum: it's only
           | "science" if it's pharmaceutical, (see: any thread about
           | semaglutides) when in reality cancer response to diet
           | research is well trodden, and I would argue the better
           | science.
           | 
           | Better science because it has stronger controls on variables.
           | 
           | When you read about diet research the patients are all given
           | the same pharmaceutical regiment and the variable is the
           | diet, whereas on the flip side the diets of the patients are
           | completely ignored.
           | 
           | That's bad science. It may be great research, but it's still
           | bad science.
           | 
           | It'd be like the diet researchers allowing the patients to
           | choose their own doses for the pharmaceutical side of their
           | treatment, which would be an absurd confounding variable.
           | 
           | Cancer cell metabolism is thoroughly researched.
           | 
           | The leading cause of death is heart disease, and the leading
           | cause of heart disease is build up of fatty deposits, ie
           | diet.
           | 
           | I'm unsure why people act surprised that the same factors
           | play into the body's ability to respond to cancer.
           | 
           | Read a study on chemo from the 90s and tell me what's more
           | "quackery": the pharmaceuticals they tried back then that now
           | would result in a malpractice suit if given to a patient
           | today, or the diet guidelines that have remained consistent
           | over the same time period?
           | 
           | I made it clear in my op that both are necessary, I just want
           | the pharmaceutical side to acknowledge that reality too.
        
       | m3kw9 wrote:
       | Must be way way more complicated than just find the cancer
       | protein, make a special cell and inject
        
         | chromatin wrote:
         | "Cancer protein"s are rarely restricted to the neoplastic clone
        
       | bufferoverflow wrote:
       | People go into cancer remission without any treatment. Single
       | point isn't data, not proof of anything.
        
         | melling wrote:
         | What percentage of people go into remission without treatment?
        
           | bluGill wrote:
           | Something > 0, which is all we need to know about single
           | point data sources.
        
         | rozap wrote:
         | Yes, clean food diets and meditation are famously very
         | effective against cancer. I've heard eliminating seed oils is a
         | magic bullet.
        
       | vonneumannstan wrote:
       | Bro didn't you know you can inject Ivermectin directly into your
       | balls and it cures your cancer? Duh.
        
       | wonderwonder wrote:
       | I have zero medical experience so take this question as it is in
       | good faith. Assuming the process to do this was known, how
       | difficult would it be for a reasonably intelligent person to
       | implement this procedure on their own
        
         | throwaway_acgt wrote:
         | Basically impossible. There's too much specialized knowledge
         | and equipment that go into it.
        
       | cbracketdash wrote:
       | > "All five were disease-free at their last follow-up, between 10
       | and 15 years after the CAR T-cell therapy, although the team note
       | they may already have been cured when the therapy was
       | administered."
       | 
       | > "The other two surviving patients had cancer that was actively
       | growing or spreading when they received CAR T-cell therapy, but
       | subsequently went into complete remission. One of these patients
       | stopped participating in follow-up sessions eight years after
       | treatment, but the other continued and has remained cancer-free
       | more than 18 years."
       | 
       | Based on these statements, the evidence for this treatment is
       | anecdotal at best. Only 2/27 patients lived longer than 7 years.
       | 
       | (There are probably more advancements in the last 10-15 years
       | that have increased efficacy)
        
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