Bringing back the Polio virus to cure brain cancer.
The paper to which this post refers is this one: Recurrent Glioblastoma Treated with Recombinant Poliovirus (Darell D. Bigner, M.D., Ph.D et al New England Journal of Medicine DOI: 10.1056/NEJMoa1716435 June 26, 2018)
My mother died from a brain tumor, and although decades have passed, it never really goes away.
There was no treatment. I'm not sure there'd be one now.
As it happens, my mother-in-law is one of the last Americans to have contracted Polio. She's still alive, and suffers from what is happily becoming increasingly unknown, Post Polio syndrome, a syndrome involving intense pain.
The anti-science crowd of course, opposes vaccination, and from what I understand, some of the ignorance spread by a scientifically illiterate freak who is famous for taking off her clothes for a stupid magazine for puerile pubescent males and males who never grew up, and not famous for having ever made an intelligent remark in her useless life, has oozed out into the rare parts of the world where Polio is still known, preventing the elimination of this disease.
One plane trip by an infected person can bring it all back. Congratulations, naked asshole.
Another anti-science crowd opposes genetic engineering and this paper reports on genetic engineering.
The polio virus attacks nerve cells. Brain cancer is rogue nerve cells, and as many people know, cancer cells - most often genetic mutants in their own right - do display many of the proteins that normal cells do.
The target protein for the polio virus is a protein known as CD155. Apparently in brain cancer cells this particular protein is greatly upregulated.
The virus has been re-engineered to attach to this protein, and thus to stimulate an immune response to cells displaying an excess of CD155.
This graphic, written in the somewhat depressing format of mean survival years, says something.
Some text from the paper:
Overall Survival among Patients Who Received PVSRIPO and Historical Controls.
However, overall survival among the patients who received PVSRIPO reached a plateau beginning at 24 months, with the overall survival rate being 21% (95% CI, 11 to 33) at 24 months and 36 months, whereas overall survival in the historical control group continued to decline, with overall survival rates of 14% (95% CI, 8 to 21) at 24 months and 4% (95% CI, 1 to 9) at 36 months (Figure 1). A sensitivity analysis evaluating the effect of including patients in the historical control group who only underwent biopsy revealed that their inclusion had no effect on survival estimates (Table 1, and Fig. S3 in the Supplementary Appendix). In comparison, the use of NovoTTF-100A in patients with recurrent glioblastoma led to an overall survival rate of 8% at 24 months and of 3% at 36 months. It is too early to evaluate our statistical hypothesis of survival at 24 months, because only 20 of the 31 patients at dose level ?1 were treated with PVSRIPO more than 24 months before the data-cutoff date of March 20, 2018.
Because patients who have tumors with the IDH1 R132 mutation are thought to have a survival advantage, we examined whether long-term survivors who have tumors with the IDH1 R132 mutation disproportionately contributed to the overall survival in the entire group. Survival analyses involving only the patients who received PVSRIPO whose tumors were confirmed to have nonmutant IDH1 R132 (Table 1) revealed a median overall survival of 12.5 months among the 45 patients with nonmutant IDH1 R132 and 12.5 months among all 61 patients who received PVSRIPO. Moreover, the overall survival rate at 24 months and 36 months was 21% among the 45 patients with nonmutant IDH1 R132 and among all 61 patients who received PVSRIPO. These findings are consistent with reports that IDH1 R132 status has no bearing on survival among patients with recurrent glioblastoma.20
...
In this clinical trial, we identified a safe dose of PVSRIPO when it was delivered directly into intracranial tumors. Of the 35 patients with recurrent WHO grade IV malignant glioma who were treated more than 24 months before March 20, 2018, a total of 8 patients remained alive as of that cutoff date. Two patients were alive more than 69 months after the PVSRIPO infusion. Further investigations are warranted.
This is not a comprehensive "one size fits all" cure, but it's something.
It's cool that a virus that caused so much pain in my family can be reengineered to address a disease that also caused me and my family so much pain.
I thought it interesting, and decided to point out this promising advance in medical science.
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