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初步试验表明疫苗有望清扫干净慢粒癌细胞

(2010-01-18 18:52:48)
标签:

白血病

慢粒

格列卫

疫苗

分类: 资讯搜集

最近看到两篇关于白血病疫苗的消息。不一定立竿见影马上看到实效解决一切问题,但感觉步子又往前迈了一步。

 

这一篇是在用Google搜上一篇的时候偶然发现的,有种眼前一亮的感觉,不过这确实是个很初级的试验,样本数太少,希望能有进一步的可靠研究结果。

 

发布这一实验结果的是约翰·霍普金斯大学(The Johns Hopkins University),有所耳闻,一查才知道,有33名诺贝尔奖获得者来自这所在美国马里兰州巴尔的摩的大学,其科研经费连续29年成为全美国年科研经费最高的大学,科研实力可想而知。

 

下面是霍普金斯大学医学院官方网站上发布的消息。

http://www.hopkinskimmelcancercenter.org/index.cfm/cID/1684/mpage/item.cfm/itemID/1170

Early Tests Show Vaccine Appears to "Mop Up" Leukemia Cells

January 5, 2010

JOHNS HOPKINS RESEARCHERS SAY VACCINE APPEARS TO “MOP UP” LEUKEMIA CELLS GLEEVEC LEAVES BEHIND

霍普金斯大学的研究者说,初步试验表明疫苗有望“清扫干净”格列卫所不能清除的慢粒癌细胞


--Team cautions that results are very preliminary and they cannot yet rule out other reasons for success

研究团队提醒:目前的结果是非常初级的,还不能排除因为其他原因而不能取得最终的成功。


Johns Hopkins Kimmel Cancer Center researchers say preliminary studies show that a vaccine made with leukemia cells may be able to reduce or eliminate the last remaining cancer cells in some chronic myeloid leukemia (CML) patients taking the drug Imatinib mesylate (Gleevec).

 

大意:霍普金斯大学医学院的Kimmel癌症综合中心研究者说,初步研究显示,一种提取自癌细胞的疫苗可能能够降低或者根除慢粒患者服用格列卫所残留的癌细胞。

 

Gleevec, one of the first targeted cancer therapies with wide success in CML patients, destroys most leukemic cells in the body, but in most patients, some cancerous cells remain and are measurable with sensitive molecular tests.  These remaining cells are a source of relapse, according to the investigators, especially if Gleevec therapy is stopped.

大意:格列卫是最早的靶向治疗药物,清除了慢粒患者体内绝大部分的白血病细胞,但如果用更加灵敏精细的分子学测试,不少患者的残留癌细胞数量还是很可观的,而这些残留癌细胞就是复发源,尤其是当患者停止服用格列卫之后。

 

In a pilot study published in Clinical Cancer Research, the Johns Hopkins investigators used a vaccine made from CML cells irradiated to halt their cancerous potential and genetically altered to produce an immune system stimulator called GM-CSF.  The treated cells also carry molecules, called antigens, specific to CML cells, which prime the immune system to recognize and kill circulating CML cells.

大意:这项小规模实验发表在《Clinical Cancer Research》杂志上,研究学者用一种疫苗来终止慢粒癌细胞的致癌潜能,同时改变其基因从而生成一种免疫系统刺激剂,也就是GM-CSF(granulocyte macrophage-colony stimulating factor,巨噬细胞-粒细胞集落刺激因子)。这些被疫苗治疗过的癌细胞同时携带有一种针对慢粒癌细胞的抗原分子,它能使得免疫系统能辨认出活动中的慢粒癌细胞,并将其歼灭。

(杂志网站上的论文地址:http://clincancerres.aacrjournals.org/content/16/1/338.abstract

 

The study vaccine was given to 19 CML patients with measurable cancer cells, despite taking Gleevec for at least one year.  A series of 10 skin injections were given every three weeks for a total of four times.  After a median of 72 months of follow-up, the number of remaining cancer cells declined in 13 patients, 12 of whom reached their lowest levels of residual cancer cells.  In seven patients, CML became completely undetectable.

大意:在这项研究中,19名慢粒患者被施以这种疫苗,这些患者虽然服用格列卫一年以上,但体内仍带有大量的癌细胞。他们每3周接受一回皮下注射, 每回注射有10针,总共有4回。72个月的跟踪随访后,13人的残留癌细胞数量下降,12人达到最低水平,其中7人完全检测不到癌细胞。

 

Because the study was conducted in a limited number of patients and not compared with other therapies, the researchers warn they cannot be sure that the responses were a result of the vaccine.

由于这项研究参与的患者有限,而且没有其他治疗可比较,研究者们还不敢肯定上述结果的取得就是来自疫苗的效果。

 

“We want to get rid of every last cancer cell in the body, and using cancer vaccines may be a good way to mop up residual disease,” says Hyam Levitsky, M.D., professor of oncology, medicine and urology at the Johns Hopkins Kimmel Cancer Center.  More research to confirm and expand the results is needed, Levitsky said.

该研究中心的Levitsky 教授说,还需要更多的研究去证实以上结果。

 

The investigators will be testing blood samples taken from the study patients to identify the precise antigens that the immune system is recognizing.  With this information, they will tailor their vaccine for additional studies that monitor immune response more precisely.

 

Patients receiving the trial vaccine experienced relatively few side effects that included injection site pain and swelling, occasional muscle aches and mild fevers.

 

According to the investigators, most patients with CML will need to remain on Gleevec therapy for the rest of their lives.  More than 90 percent of them will achieve remission, but about 10 to 15 percent of patients cannot tolerate the drug long term.  “Often patients have low blood cell counts, fluid retention, significant nausea and other gastrointestinal problems,” says B. Douglas Smith, M.D., associate professor of oncology at the Johns Hopkins Kimmel Cancer Center.  Secondary therapies, including dasatinib and nilotinib, also have many side effects.

 

Another common side effect of Gleevec, says Smith, is fatigue.  “Patients often tell me that they feel about 80 to 90 percent of what they should, and over time, this may have a big impact on their quality of life,” he says.

 

Gleevec also cannot be taken during pregnancy, and since one-third of CML patients are in their 20s and 30s, many patients hoping to start families would like to discontinue taking it.

 

“Ultimately, should this vaccine approach prove to be successful, the ability to get patients off lifelong Gleevec therapy would be a significant advance,” says Levitsky.

Levitsky说,“最终如果该疫苗被证明是有效的、成功的,慢粒患者就很有希望不用再终身服用格列卫”

 

The research was funded by the National Institutes of Health.

 

Study contributors include Yvette Kasamon, Jeanne Kowalski, Christopher Gocke, Kathleen Murphy, Hua-Ling Tsai, Lu Qin, Christina Chia, Barbara Biedrzycki, and Richard Jones from Johns Hopkins; Carole Miller from St. Agnes Hospital; Elizabeth Garrett-Mayer from the Medical University of South Carolina; and Thomas Harding and Guang Haun Tu from Cell Genesys, Inc.

 

Under a licensing agreement between BioSante Pharmaceuticals Inc. and the Johns Hopkins University, Dr. Levitsky is entitled to a share of milestone payments and a share of royalty received by the University on sales of GVAX. Dr. Levitsky previously served as a paid consultant to Cell Genesys, which has since been acquired by BioSante Pharmaceuticals Inc.  The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict-of-interest policies.

 

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