For a deadly type of childhood cancer, science has evaded the best tools. Now doctors have made progress with an unusual treatment: to drip millions of copies of a virus directly into the children’s brains to infect their tumors and trigger an immune system attack.
A dozen children treated this way have lived more than twice as long as similar patients have done in the past, doctors reported Saturday at an American Association for Cancer Research Conference and in the New England Journal of Medicine.
This 2016 photo provided by the family shows Jake Kestler, middle, with his parents, Gallite and Josh, and his sister, Lily, a month before he was diagnosed with brain cancer.
(Family photo via AP)
Although most of them eventually died of their disease, there are a few that are alive, a few years after treatment. It is virtually unheard of in this situation.
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“This is the first step, a critical step,” said study leader Dr. Gregory Friedman, a pediatric cancer specialist at the University of Alabama in Birmingham.
“Our goal is to improve it,” possibly by trying it once patients are diagnosed, or by combining it with other therapies to boost the immune system, he said. The patients in the study took the experimental approach after failing other treatments.
The study covers gliomas, which are responsible for 8% to 10% of brain tumors in children. They are usually treated with surgery, chemotherapy or radiation, but they occur frequently. Once that happens, the average survival is just under six months.
In such cases, the immune system loses the ability to recognize and attack cancer, so scientists have been looking for ways to make the tumor a fresh target. They turned to the herpes virus, which causes feverfew and a strong immune system response. A suburban company in Philadelphia called Treovir has developed a treatment by genetically modifying the virus so that it would infect only cancer cells.
Through small tubes inserted into the tumors, doctors gave the altered virus to 12 patients aged 7 to 18 years whose cancer worsened after regular treatments. Half also received one dose of radiation, which is thought to help spread the virus.
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Eleven have shown in image tests or tissue samples evidence that the treatment works. The median survival was just over a year, more than double that seen in the past. As of June last year – the cut-off for the analysis of these results – four still lived at least 18 months after treatment.
Tests also showed high levels of specialized immune system cells in their tumors, suggesting that the treatment enlisted the necessary help from the body to attack the disease.
No serious safety issues were seen, although there were several procedure-related complications and mild side effects including nausea, vomiting, diarrhea and fatigue.
Jake Kestler had the treatment when he was 12 years old.
“It went very well. He lived a year and four months after that,” long enough to celebrate his bar mitzvah, go to Hawaii with his family and see a brother born, his father, Josh Kestler, a financial executive, said. of Livingston, New Jersey.
This combination of MRI images provided by the University of Alabama in April 2021 shows scans of a child with a brain tumor, before and after treatment using viruses to stimulate an immune system response to the cancer cells . Lighter color areas within the red circles indicate the size of the crop.
(UAB via AP)
Jake passed away on April 11, 2019, but “we have no regrets at all” about the treatment, Kestler, who, along with his wife, founded a foundation, Trail Blazers for Kids, to investigate further.
“It is a devastating disease for these patients and their families,” and the early results suggest that virus treatment helps, but this needs to be confirmed in a larger study that doctors are planning, said Dr Antoni Ribas, a cancer specialist at the University of California, Los Angeles, and president of the group hosting the conference.
Friedman said that studies are also being continued in adults, and that plans for other types of brain tumors are being planned in childhood. U.S. government grants and several foundations were paid for the study, and several doctors have financial ties to Treovir.
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Only one similar virus therapy is currently approved in the United States – Imlygic, also a modified herpes virus, for the treatment of melanoma, the most serious form of skin cancer.