The Big Story - Rage Patients Talking
The founding members of RAGE drew up the following aims and objectives, each of equal importance.
To campaign for national standards in Radiotherapy.
To raise awareness of the injuries and campaign for sympathetic medical care within the NHS.
To seek compensation commensurate with the injury.
To provide mutual support.
Each of these aims is strongly endorsed by the RAGE Committee on behalf of RAGE members.
The future of affordable cancer immunotherapy - 06 September 2023
Derived from: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1248867/full
Citation: The future of affordable cancer immunotherapy. Front. Immunol. 14:1248867. doi: 10.3389/fimmu.2023.1248867
Schaft N, Dörrie J, Schuler G, Schuler-Thurner B, Sallam H, Klein S, Eisenberg G, Frankenburg S, Lotem M and Khatib A (2023)
The treatment of cancer has been revolutionized within the last two decades by utilizing the mechanism of the immune system against malignant tissue in so-called cancer immunotherapy.
Two main developments have boosted cancer immunotherapy:
1) the use of checkpoint inhibitors, which are characterized by a relatively high response rate mainly in solid tumors; however, at the cost of serious side effects, and
2) the use of chimeric antigen receptor (CAR)-T cells, which were shown to be very efficient in the treatment of hematologic (blood) malignancies, but failed to show high clinical effectiveness in solid tumors until now.
Now active immunization against individual tumors is emerging, and the first products have reached clinical approval.
These new treatment options are very cost-intensive and are not financially compensated by health insurance in many countries.
Hence, strategies MUST be developed to make cancer immunotherapy affordable and to improve the cost-benefit ratio.
In this review below, the authors discuss the following strategies:
1) to leverage the antigenicity of “cold tumors” with affordable reagents,
2) to use microbiome-based products as markers or therapeutics,
3) to apply measures that make adoptive cell therapy (ACT) cheaper, e.g., the use of off-the-shelf products,
4) to use immunotherapies that offer cheaper platforms, such as RNA- or peptide-based vaccines and vaccines that use shared or common antigens instead of highly personal antigens,
5) to use a small set of predictive biomarkers instead of the “sequence everything” approach, and
6) to explore affordable immunohistochemistry markers that may direct individual therapies.
1 Introduction
Immunotherapy has changed the cancer treatment scenario and revolutionized tumor immunology. Immunotherapy treatments, such as adoptive T-cell therapy (ACT) or the use of immune checkpoint inhibitors (ICIs), are now well-established components of the toolbox of cancer treatments, significantly improving longevity in a substantial proportion of patients.
However, with the advancing success of cancer immunotherapy, it is becoming clear that a significant drawback of current immunotherapies is their high expense.
To enable the wider usage of immunotherapy:
efforts will eventually have to be centered on developing immunotherapy treatments that are significantly cheaper and affordable to larger populations worldwide.
Getting a cancer immunotherapy treatment costs more than a house in many cities in the US.......
The average cost of cancer drugs increased from $50,000 per patient in the mid-1990s to $250,000.
That is four times the median US household annual income.
Immunotherapies often cost more than $100,000 per patient.
For some of the newest immunotherapies, the price tag is even steeper:
When including the value of the medical support necessary to deliver these treatments, a price tag of $850,000 per patient is not unheard of (4).
For example, although the wholesale acquisition cost of CAR-T-cell therapies to treat B-cell lymphoma is $373,000,
a new study by Prime Therapeutics of real-world data found that the total cost averages more than $700,000 and can exceed $1 million in some cases (5).
Increasingly, approaches to treat solid tumors and hematological (blood) malignancies involve the concurrent administration of several products with distinct but complementary mechanisms of action in combination or in close sequence as part of a regimen
The use of combined immunotherapies means that costs can quickly double or triple.
Some recent examples include:
the addition of pertuzumab to trastuzumab for the treatment of human epidermal growth factor receptor-2 (HER-2)-positive breast cancer and
the use of programmed cell death protein (PD-1) and programmed cell death ligand (PD-L1) inhibitors in combination with anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) therapies in metastatic melanoma.
This trend presents serious challenges for Health Technology Assessment (HTA) bodies and payers.
Combination regimens are expected to increase over the next few years (7, 9).
Almost all information regarding the costs of immunotherapy is based on data from OECD countries; however, access to oncology medicines remains unequal across OECD/EU countries.
The charges in non-OECD countries will probably be higher and may enjoy less support from health or insurance institutions or drug companies.
Additionally, there is little doubt that the population of third-world countries will mostly be unable to cope with such expenses.
The future of cancer immunotherapy will largely depend on the ability of researchers to make it affordable to larger populations.
This review summarizes some scientific suggestions for making this happen........
https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1248867/full
Citation: Schaft N, Dörrie J, Schuler G, Schuler-Thurner B, Sallam H, Klein S, Eisenberg G, Frankenburg S, Lotem M and Khatib A (2023) The future of affordable cancer immunotherapy. Front. Immunol. 14:1248867. doi: 10.3389/fimmu.2023.1248867
Received: 27 June 2023; Accepted: 11 August 2023;
Published: 06 September 2023.
04 June 2018 - Immune cells from the woman’s own body used to wipe out tumours
A leading cancer researcher said the experiment was proof that we are on the ‘cusp of a major revolution’ in being able to target cancer with immunotherapy.
It is the first time that a patient with late-stage breast cancer has been successfully treated by a form of immunotherapy that uses the patient’s own immune cells to find and destroy cancer cells that have formed in the body.
The doctors treated Perkins by injecting 80 billion carefully-selected immune cells into her body.
The therapy was given alongside pembrolizumab, a standard drug that can help the immune system to attack cancers.
Tests after 42 weeks showed Perkins was completely cancer free. She has remained so ever since.
The success, reported in the journal Nature Medicine, is all the more remarkable because breast cancers, like prostate and ovarian cancer, have relatively few mutations, which makes them harder for the immune system to spot amid the body’s healthy tissues.
“Metastatic breast cancer remains incurable, and if we are to finally stop women dying we urgently need to find new ways to target and stop the spread of the disease. We are thrilled by this early finding, but we must remember that this type of immunotherapy remains an experimental approach that has a long way to go before it might be routinely available to patients.”
Jun 4, 2024,11:12am EDT https://www.forbes.com
Cancer vaccines are finally showing promise as Moderna and Merck produced promising data on an experimental skin cancer vaccine this week.
NHS England has announced plans for a “landmark” scheme to test the mRNA technology across the United Kingdom, after decades of research that could bring a new era of personalized medicine.
Merck and Moderna released “extremely impressive” positive data from a mid-stage trial of the world’s first personalized mRNA cancer vaccine for melanoma, the deadliest form of skin cancer, which when used alongside Merck’s blockbuster immunotherapy, Keytruda, halved the risk of patients dying or the cancer returning.
The trial, the longest study into the new technology so far, is one of a growing number of collaborations testing how mRNA vaccines — the technology underpinning COVID-19 in shots from Pfizer, BioNTech and Moderna — can be turned against different types of cancer.
mRNA, short for messenger ribonucleic acid, is a kind of informational molecule that carries instructions for cells on how to make proteins, including antigens that can stimulate the immune system.
While mRNA shots for viruses like COVID-19 are designed to prevent disease by instructing cells to produce a harmless viral protein that trains the immune system to recognize and defend against the virus in the future, mRNA cancer vaccines are therapeutic and are for people who already have cancer.
Each vaccine is developed using samples of their cancer and personalized to an individual patient using genetic sequencing and artificial intelligence, priming the immune system to recognize unique mutations or features of the cancer cells and attack them if any are remaining or resurface after treatments like surgery, boosting chances of recovery and remaining cancer free in the future.
In addition to melanoma, trials of the personalized vaccines are already planned or underway for a wide range of cancers, including other skin cancers, neck and head, lung, pancreatic, bladder and kidney cancers, and experts have hailed the shots as “gamechangers” that offer a real hope of curing cancer.
Trials of these mRNA personalized vaccines are planned or underway for:
skin cancers - https://trials.modernatx.com/study/?id=mRNA-4359-P101
neck and head - https://www.cancer.ox.ac.uk/news/oxford-university-hospitals-launches-new-mrna-cancer-vaccine-trial-for-patients-with-head-and-neck-cancers
lung - https://www.nihr.ac.uk/news/first-uk-patients-receive-experimental-mrna-therapy-for-cancer/35567
pancreatic - https://sites.google.com/d/1sAXgaYrNxlOq2mbz1q90rHEa7ZKoqeiC/p/1gBIeGlMo04zMyu6WdBkc5IdGDUDK62S1/edit
melanoma, bladder and kidney - https://www.independent.co.uk/news/health/mrna-cancer-jab-melanoma-trial-treatment-b2534935.html
Experts have hailed the shots as “gamechangers” that offer a real hope of curing cancer.
NEWS PEG
While mRNA cancer vaccines are starting to show promise and experts hint a paradigm shift for cancer treatment is on the horizon, it is still early days for the therapy.
The treatments have a long way to go until entering mainstream clinical practice.
Until approval, the vaccine treatments are considered experimental and will primarily be available as part of clinical trials, for which patients around the world, including the U.S., are already being recruited.
In late May, England announced a first-of-its kind scheme aimed at streamlining the often difficult recruitment process for trials.
The country’s National Health Service will act as a matchmaker setting up thousands of patients with different clinical trials for specific cancer shots as part of the scheme, which is called the Cancer Vaccine Launch Pad.
Victoria Kunene, a clinician leading the trial at Queen Elizabeth Hospital Birmingham, told the BBC she believes the vaccines mark a “new era,” adding that she hopes they become “the standard of care” one day.
Merck and Moderna said they started late stage clinical trials for both their melanoma vaccine and a lung cancer vaccine, both of which are “actively enrolling” participants.
The firms have also started mid-to-late stage trials of squamous cell carcinoma, another type of skin cancer, as well as a type of kidney cancer and urothelial carcinoma, which makes up most bladder cancers.
Late last year, Moderna CEO Stéphane Bancel told AFP of the melanoma vaccine: “We think that in some countries the product could be launched under accelerated approval by 2025,” describing the vaccines as “immunotherapy 2.0.”
The early successes of Moderna’s cancer vaccine has helped shore up confidence in the company and its future.
While Moderna flourished during the pandemic, its coronavirus shots remain its only product on the market.
This will soon change following the recent approval of its RSV shot, its second ever, but Moderna has struggled to maintain its profile amid an influx of mRNA competitors and dwindling demand for Covid jabs.
Though it maintains a robust pipeline of traditional vaccines in development that use its mRNA technology — such as for Lyme disease, flu and norovirus — the company has bet big on its personalized cancer treatments and is clear it plans to be at the forefront of this new frontier of medicine.
Volume 55 - Issue 1 - January, 2009
Radiation-induced tissue injury and wounds with radiation-impaired healing are traumatic for patients and challenging for their caregivers. Standardized management approaches do not exist. The effect of Leptospermum honey as a primary dressing for managing these wounds was assessed in four patients (age range 63 to 93 years) who had previously undergone radiotherapy that left them with fragile friable areas of damaged skin that did not respond to conventional treatment.
No adverse events were reported. Honey as an adjunct to conventional wound/skin care post radiation therapy shows promise for less painful healing in these chronic wounds. Prospective, randomized, controlled clinical studies are needed to confirm these observations.
The European Cancer Patient Coalition have asked for our support with their survey on COVID-19 and cancer which they launched recently.
With their survey 'Mapping EU Member State's response to the COVID-19 pandemic and cancer' they are gathering information to understand the effect that COVID-19 has had on cancer patients and their treatment across Europe.
Further details can be found on RAGE here: More Info Or go directly to the ECPC page here: ECPC Survey
To apply to become a member, or to contact R.A.G.E.
Email - info@rageuk.org
Telephone - 01892 557804