Woman's cancer wiped out by massive dose of measles vaccine

[mountaineer]

Woman's cancer wiped out by massive dose of measles vaccine
By Rob Quinn, FOX News
·Published May 15, 2014


In a breakthrough that could offer new hope to people with some kinds of cancer, Mayo Clinic researchers say they managed to wipe out a woman's cancer with a blast of measles vaccine strong enough to inoculate 10 million people.

The 50-year-old woman's blood cancer, which had spread through her body, went into complete remission after the vaccine dose and Stacy Erholtz has been clear of the disease for more than six months.

"It's a landmark," lead researcher Dr. Stephen Russell tells the Minneapolis Star Tribune. "We've known for a long time that we can give a virus intravenously and destroy metastatic cancer in mice. Nobody's shown that you can do that in people before." And Erholtz's take on the approach is more than positive: "It was the easiest treatment by far with very few side effects. I hope it's the future of treating cancer infusion." The trial involved two patients with multiple myeloma, and the second failed to go into complete remission, with the cancer returning after nine months.

KARE-11 reports the trial involved patients with multiple myeloma because their immune systems are so compromised they lack the ability to immediately fight off the measles, giving the virus time to attack the cancer; they also had no conventional treatment options left.

Russell explains how the process works in layman's terms: "It puts the virus into bloodstream, it infects and destroys the cancer, debulks it, and then the immune system can come and mop up the residue." Up next: larger-scale studies, and tests of the vaccine's effectiveness against ovarian, brain, head, and neck cancers, as well as mesothelioma.

They also plan to test vaccines for viruses other than measles, with the goal being to find a "single-shot" cure for many cancers.

[mountaineer]

Kent Sepkowitz, Daily Beast

Are Viruses the Next Cure for Cancer?

Giant doses of a genetically modified measles vaccine cured two of blood cancer at the Mayo Clinic this week. Why the magic remedy must be met with caution.

The unlikely strategy of using a live virus to treat cancer took yet another step forward this week with the news that scientists at the Mayo Clinic had treated two adults with the blood cancer, multiple myeloma, by injecting them with mega-doses of genetically modified measles virus.

Both patients had failed all other available therapies; with the new “oncolytic virus” treatment, each responded and one remains in remission nine months later.

In this study, the patients—neither with existing antibody to measles virus—received enormous doses of live measles virus infused directly into their vein—not given as a shot like a vaccine. Both became feverish and ill with the infusion, as expected, and both recovered. The measles virus was derived from the strain used in routine measles vaccine but had been carefully altered by scientists to enhance its tumor killing effects. It was still, however, a measles virus, capable of giving a person a measles-like illness. The choice of measles for the cancer was quite deliberate—this virus is known to seek out and attack a type of white blood cell that myeloma arises from. The investigators simply harnessed measles virus’ natural born killer tendency.

As the investigators noted, the patients’ lack of immunity was critical to the success of this study. Most people—at least 95 percent of adults—have pre-existing antibody to measles. This is a good thing to assure they will not develop measles but would be extremely problematic for measles oncolytic therapy—the patient’s own antibody would kill off the killer measles before it could reach the cancer cell. Thus a major problem with all oncolytic virus treatment—the patient’s immune system, which has its own seek and destroy mission—was circumvented in the Mayo trial.

For these patients, it is unclear how long the treatment benefit will last. With a disease like myeloma, cure is unusual. A very long remission and stability is considered a substantial success. But using the muscle power of viruses and other infections is an exciting new frontier, albeit one based on rather old observations.

Scientists have been fascinated by the approach for years. One of the first possible demonstrations of effect was with the use, more than 100 years ago, of something called Coley’s toxin, a mish-mosh of killed bacteria and other proteins that was injected near and directly into solid tumors.

The news that measles virus might have benefit and that a patient is doing well, for now, is credible and exciting—but we are still miles and miles away from this sort of approach becoming routine for cancer.

Although the approach engendered substantial excitement, Coley’s toxins were never proven to be beneficial. Many small trials were performed—some showed effectiveness, others did not. In 1963, more than 70 years after it was introduced, the FDA determined that the product could only be given in the context of clinical trials. The strategy, though, captured the imagination of scientists worldwide and gave birth to the field of immunotherapy, which is extremely hot today.

The next well-publicized study using infection to kill cancer took place in the 1950s. West Nile virus, then considered a harmless infection, was given to more than 100 patients at what is now Memorial Sloan Kettering Cancer Center. A scientist, Dr. Chester Southam, had noticed that West Nile, discovered in the late 1930s, had tumor-shrinking properties in various experiments and so offered the treatment to patients without other cancer-treatment options as part of a clinical trial.

A few patients responded, particularly those with lymphoma and one newspaper ran an excited headline, Deep Cancers Temporarily Shrunk by Rare Nerve Virus From Africa, trumpeting the breakthrough.

The problem though was a spate of unexpected side effects—about 10 percent of the patients got drowsy and confused—presumably developing the disease we now recognize as West Nile encephalitis. This unexpected finding, as well as the mediocre antitumor effect, led to the end of the trial.

But once again, the science of the approach was compelling. A generation later, a better understanding of viruses and their ability to enter and destroy certain cells made “oncolytic virus” treatment again of interest to scientists. Herpes virus, adenovirus and many others have been studied against a wide variety of cancers; many trials are ongoing. The enthusiasm is such that even the oldest of all vaccines—vaccinia, the ur-shot used to prevent small pox—has been called into action with interesting preliminary results.

Though an area of very active investigation, no one is certain why this approach works. Some think that the virus has the ability to goose up a person’s immune system in a non-specific way, and that with a heightened and more sharply tuned immune repertoire, cancer cells are attacked and killed more or less accidentally.

Others point to the unique properties of viruses to enter cells and kill them; they posit that the task is only to find the right virus for each tumor, as was done with the current measles versus myeloma study. They envision a group of stealth killers each with a seek-and-destroy mission killing cancer “naturally.” And bonus—with some viruses, such as herpes, once the task is done, the virus itself can be killed off using routinely available anti-herpes antivirals.

The news that measles virus might have benefit and that a patient is doing well, for now, is credible and exciting—but we are still miles and miles away from this sort of approach becoming routine for cancer. Once again we should walk the fine line between soaring hope and miserly caution and give scientists the time (and funding) to complete thoughtful, well-designed studies.

[mountaineer]

CNN:

Measles virus used to put woman's cancer into remission
By Jacque Wilson and William Hudson, CNN
May 15, 2014 -- Updated 1721 GMT (0121 HKT)

 


STORY HIGHLIGHTS
 Researchers inject highly concentrated dose of measles virus into cancer patients
Woman's cancer went into remission; a second patient responded but not as well
This experimental treatment is a long way from being commonly used to fight cancer
 

 
(CNN) -- A woman with an incurable cancer is now in remission, thanks, doctors say, to a highly concentrated dose of the measles virus.

For 10 years, Stacy Erholtz, 49, battled multiple myeloma, a deadly cancer of the blood. Doctors at the Mayo Clinic say she had received every type of chemotherapy drug available for her cancer and had undergone two stem cell transplants, only to relapse time and again.

Then researchers gave her and five other multiple myeloma patients a dose of a highly concentrated, lab-engineered measles virus similar to the measles vaccine. In fact, the dose Erholtz received contained enough of the virus to vaccinate approximately 100 million people.

"The idea here is that a virus can be trained to specifically damage a cancer and to leave other tissues in the body unharmed," said the lead study author, Dr. Stephen Russell.

It's a concept known as virotherapy, and it's been done before. Mayo Clinic scientists say thousands of cancer patients have been treated with viruses, but this is the first case of a patient with a cancer that had spread throughout the body going into remission.

Erholtz was cancer-free for nine months.

"I think we succeeded because we pushed the dose higher than others have pushed it," Russell said. "And I think that is critical. The amount of virus that's in the bloodstream really is the driver of how much gets into the tumors."

In simple terms, the measles virus makes cancer cells join together and explode, Mayo Clinic researcher Dr. Angela Dispenzieri explains. There's also some evidence to suggest, she says, that the virus is stimulating the patient's immune system, helping it recognize any recurring cancer cells and "mop that up."

This treatment is still in the early testing stages, though. Doctors recently used radiation therapy to treat a small, localized tumor in Erholtz's body.

And the other patients in the trial did not go into remission. Tests showed the virus helped shrink one woman's tumors, but they started growing again soon after. The other patients' cancers did not respond to the treatment.

Researchers also don't know whether this virotherapy will help other patients or whether it can be applied to other types of cancer. The measles virus worked with these multiple myeloma patients because they are already immune-deficient, meaning their bodies can't fight off the virus before it has a chance to attack the cancer cells.

More of the highly concentrated measles virus is being created now to be used in a larger clinical trial, Mayo Clinic researchers say. They've developed a manufacturing process that can produce large amounts of the virus, Russell says.

"We recently have begun to think about the idea of a single shot cure for cancer -- and that's our goal with this therapy," he said.

[mountaineer]

In what they describe as a proof of principle study, doctors in the US were able to keep a woman with deadly multiple myeloma - an incurable bone marrow cancer - free of all signs of living cancer cells for over 6 months by giving her just one high dose of measles virus.

Two patients received a single intravenous dose of measles virus that was engineered to kill myeloma plasma cells and not harm other cells.

The team, from the Mayo Clinic in Rochester, MN, says both patients responded to the treatment, showing reduced bone marrow cancer and levels of myeloma protein.

But one patient, a 49-year-old woman, experienced complete remission and remained disease-free for over 6 months.

A report on this first study to establish the feasibility of the treatment appears in the journal Mayo Clinic Proceedings.

Proof virotherapy works for disseminated cancer

First author Dr. Stephen Russell, hematologist and co-developer of the therapy, says:


"This is the first study to establish the feasibility of systemic oncolytic virotherapy for disseminated cancer. These patients were not responsive to other therapies and had experienced several recurrences of their disease."

The treatment is an example of oncolytic virotherapy - using engineered viruses to fight cancer - an approach that dates back to the 1950s. Thousands of patients have received this type of therapy, using oncolytic viruses from various families, including common cold viruses, herpes viruses and pox viruses.

But the authors say this is the first well-documented case of a patient with cancer that has spread experiencing complete remission at all disease sites after receiving oncolytic virus therapy. ...More at Medical News Today

[Oceander]

some more:

Dr. Russell and colleagues explain in their article that they chose to report these two cases in particular because they were the first patients they had studied who had received the highest possible dose, and with limited previous exposure to measles, so their immune systems did not have many antibodies to the virus. They had also exhausted other treatment options.

Senior author Dr. Angela Dispenzieri, an expert in multiple myeloma, says in very simple terms, the measles virus makes the cancer cells join together and explode. The treatment also appears to trigger another lasting benefit:

"There's some suggestion that it may be stimulating the patient's immune system to further recognize the cancer cells or the myeloma cells and help mop that up more effectively than otherwise."

Having effectively completed a phase I clinical trial - to prove the concept that the measles virus can fight cancer - the team is now moving quickly into a phase II trial involving more patients.

They also intend to test the virus's effectiveness as a tool to fight other cancers, such as head and neck, brain and ovarian cancers and mesothelioma. And they are engineering other viruses that may be able to kill cancer cells.