"Kill" Wei Zexi immunotherapy is? You should know the truth about Wei Zexi, immunotherapy-IT information

Article from the shell mesh

These days, the synovial Sarcoma patient death of Wei Zexi maxed out. And like many people, I feel very sad about this news.

First of all, under the present medical condition, synovial sarcoma is, indeed, an "incurable disease", we like almost nothing; second, bad cheat weave false hope to patients and the public, greatly affects the quality of life for patients in the final stages. However, as a bio-pharmaceutical industry practitioners, what worries me more is that those brazen, a promising cancer treatment somehow a negative image into public view.

I said the immune therapies.

May be associated with Wei Zexi NET friend's death has, cancer immunotherapy in the post these days often played a "bogus treatments" role. In some articles, immunotherapy is not at all to play on the "so-called" Word. Other authors aware of therapy immunotherapy is not false, but it also does not make this clear, seems mainly CIK immune therapy and the like. Maybe even netizens believe that immunotherapy was "eliminated foreign technology."

These views are not accurate. Indeed, in China, you can see cancer immune therapy propaganda, most likely hung "immunotherapy" scam. But the real cancer immunotherapy, is indeed a promising (if not to give a clear answer) cancer treatment, if a bad reputation because of Li GUI, that is a very bad thing.

There are two main types of immunotherapy

Immunotherapy is what? As its name suggests, it is from the body's own immune system to treat disease category of methods. Tumor immunotherapy, nature is a kind of immunotherapy for the treatment of tumors.

Maybe you consider this question: why can resist many diseases of the immune system, but let the growth of tumors in the body? The answer is simple, in many cases, no tumor cells of the immune system as a threat. After all, most of the cells in the tumor from the body's own immune system won't see them as foreign bodies, so they will not take the initiative to attack. At other times, some tumor cells secrete molecules can be recognized by the immune system. This time, the immune system will find the tumor cells is not a good thing, you want to attack it. But tumor cells can secrete some "paralysis" small molecules of the immune system, the immune system attacks the results not good. And this is why we cannot successfully harnessed to counteract tumor destruction of the immune system.

New immune therapy is to change these situations exist. Some features of tumor tumor immunotherapy "tells" immune cells, allowing them to locate and causing destruction; other tumor immune therapy can protect the immune cells were paralyzed, allowing them to continue to have an attack on tumors.

Ideas need to "genetic modification"

T-cells before the modification is the use of an idea. Thought itself is simple, that is, extracting t cells from patients, and in vitro. In the process of training, we use genetic modification methods, these t cells express specific tumor Antigen receptor. This can be understood as telling t cell, what does cancer look like. After the in vitro proliferation, the engineered t cells will be injected back into the patient, which attack cancer cells expressing these antigens. In this direction, CAR-T is currently popular, or chimeric Antigen receptor-t cell therapy.

? CAR-T technologies: by gene editing, was expressed by t cells and protein-binding proteins on the surface of tumor cells, and to stimulate cellular immunity, tumor cell kill. Photo: the-scientist.com

Last November, the United Kingdom successfully use CAR-T therapy has cured a little girl named Richards, it also became one of the best known examples of this therapy. Richards was born shortly after diagnosed with acute lymphoblastic leukemia, in treatment, she is less than a year old, and CAR-T therapy helped her clear of cancer cells in the body.

In the United States, CAR-T therapy there are some success stories. MIT Technology Review (MIT Technology Review) wrote a piece of news: a 20-year-olds Milton Wright was suffering from leukemia. In leukemia after the third attack, desperate, he took part in the clinical trial of CAR-T therapy. Despite the transformed t cells when injected back into the body, Milton suffered serious reactions such as fever, but he beat the disease. After leaving the ICU doctors assessed the number of cancer cells in bone marrow that he, and the assessment of results is "0".

Needs to be emphasized is that while CAR-T therapy for patients with certain cancers showed some effect, but is still in the stage of clinical trials.

However, the current situation, CAR-T therapy is very promising indeed. Acute lymphoblastic leukemia, for example, in the current treatment of patients, there is no relapse in patients with 90%. Just because it is a "miracle", clinical trial results, earlier developed CAR-T therapy of at least four companies have listed on the NASDAQ. In addition, more companies are used to CAR-T therapy in research and development. In data released in March this year, FDA announced that they received a total of 105 investigative new drug application based on transformation of t-cells. This means that there will be more clinical trials will be conducted, which will promote this therapy as soon as possible for approval.

Second release "inhibited"

Immunotherapy using the second way, killing t cells against tumor cells. This type of therapy drugs called immune inhibitors of checkpoint. In the human body, small molecules and immune receptors on t-cells, and inhibit their activity. This in the General case to avoid t-cells attack the body's normal cells, avoiding autoimmune disease, but unfortunately, cancer cells also use this, escape t cell attack. Some tumor cells secrete a ligand called PD-L1. When it PD-1 on the t-cell receptors, inhibits the activity of t-cells, allowing them to enter "sleep" State.

And now some of immune inhibitors of checkpoint blocking PD-1 and PD-L1 communication. They are humanized monoclonal antibodies can be combined with PD-1 or PD-L1. This allows PD-1 on the surface of t cells cannot be combined with PD-L1 of tumor cells, t-cells should not be paralyzed, and can be combined with the PD-L1 secreted by the tumor cells directly, so they are PD-1 close to the t-cell receptor. All in all, this class of drugs that block tumor cells to t cells "deceit", t cells able to remain active, killing of cancer cells.

It is worth mentioning that, Wei Zexi NET friend please friends back in Hong Kong, the efficacy of "targeted medicine" Keytruda, it is one of the earliest PD-1 antibody drug approved. This is a real tumor immunotherapy. In 2014, it is United States FDA approval, become the first FDA approval of PD-1 antibody drug. Prior to this, Japan has approved a PD-1 antibody drug Nivolumab. In addition to these two drugs, more drugs are being developed in connection with PD-1 and PD-L1.

Following is a listing of the drug when the news:

Of course, the PD-1 antibody drugs are not a panacea. It's biggest problem is that not everyone can get good results. This is because everyone's different levels of gene expression and tumor PD-1 fewer patients, the drug's efficacy may be limited. So some researchers called for ongoing before treatment, the patients in genetic testing, predict in advance whether there will be a response, be truly individualized care.

Far from "clinical treatment of cancer immunotherapy"

Related information

Writing so much, I just want to tell you from the perspective of persons working in the pharmaceutical industry, for now, cancer immunotherapy is a rapidly developing technology. Although it's just a new technology, but a lot of people believe that it will be an important aspect of cancer treatment in the future.

However, one thing needs to be emphasized is. As far as I know, at present, some research institutes are to submit to the medical Planning Commission applications for clinical trials of these treatments, there are also individual research agencies are allowed to conduct the relevant research, but there is no institution is allowed to put these methods into clinical therapy. In other words, if you find some of the information, claiming that several therapies in clinical treatment mentioned above, that most likely is the problem--please ensure that you, family and friends of patients to stay away from this kind of information.

Synovial Sarcoma

Synovial sarcoma is derived from the joint, the synovium and synovial tendon sheath of soft tissue cancer. With large joints of the limbs as predilection, can also occur in the forearm, thigh, back on the fascia and muscle membrane. Main symptoms are swelling, lumps, pain, limited mobility. Surgical treatment.

“害死”魏则西的免疫疗法是什么？你应该知道的真相 - 魏则西,免疫疗法 - IT资讯

文章来自果壳网

这几天，滑膜肉瘤患者魏则西去世的消息刷爆了各种圈。和许多人一样，我对这个消息感到很痛心。

首先，在目前的医疗条件下，滑膜肉瘤确实是一种“绝症”，我们对许多类似疾病几乎束手无策；其次，恶劣的欺骗行为为患者和公众编织虚假的希望，极大影响了患者在最后阶段的生活质量。然而，作为一名生物医药行业的从业者，我更担心的是因为那些无耻行为，一种极有前途的癌症治疗方法莫名其妙以负面的形象进入公众视野。

我说的是免疫疗法。

或许是与魏则西网友的死亡有着关联，癌症免疫疗法在这几天的帖子里往往扮演了一种“虚假疗法”的角色。在一些文章中，免疫疗法被不客气地打上了“所谓”二字。另一些作者意识到了免疫疗法不是虚假的疗法，但也没有把这种疗法说清楚，好像免疫疗法主要就是CIK之类一样。或许，甚至还有网友认为，免疫疗法是“国外淘汰下来的技术”。

这些观点是不准确的。确实，在中国，你所看到的癌症免疫临床治疗宣传，极有可能是挂“免疫疗法”之名的骗局。但真正的癌症免疫疗法，也确实是一个颇有前途（哪怕还不能给出明确答案）的癌症治疗方向，如果因为李鬼而坏了名声，那是件极为可惜的事情。

免疫疗法主要有两种思路

那么免疫疗法究竟是什么呢？顾名思义，它是用人体自身的免疫系统去治疗疾病的一类方法。而肿瘤免疫疗法，自然就是一类用于治疗肿瘤的免疫疗法。

也许你考虑过这样的问题：为什么免疫系统能抵御很多疾病，却任凭肿瘤在体内生长？答案很简单，很多时候，免疫系统没有把肿瘤细胞视作是威胁。毕竟，肿瘤中的细胞大多来源于人体自身，免疫系统不会轻易把它们视为异物，因此不会主动对它们展开攻击。而在另一些时候，肿瘤细胞表面会分泌一些能够被免疫系统识别的分子。这个时候，免疫系统会发现肿瘤细胞不是好东西，要对它进行攻击。但由于肿瘤细胞本身能分泌另一些“麻痹”免疫系统的小分子，免疫系统的攻击效果往往不是很好。这也就是为什么我们在之前无法成功地驾驭免疫系统来对肿瘤造成杀伤。

而最新的免疫疗法就是为了改变这些情况而存在的。一些肿瘤免疫疗法能够把肿瘤的特征“告诉”免疫细胞，让它们去定位，并造成杀伤；另一些肿瘤免疫疗法能够保护免疫细胞不被麻痹，让它们继续得以对肿瘤产生攻击。

思路一 需要用到“转基因”

T细胞改造就是使用的前一种思路。思路本身很简单，即先从患者体内抽取出T细胞，然后在体外培养。在培养过程中，我们用基因改造的方法，让这些T细胞表达一些特异的肿瘤抗原受体。这可以理解为告诉T细胞，肿瘤长什么样子。在体外大量增殖后，这些经过改造的T细胞就会被注射回患者体内，进而对表达这些抗原的癌细胞进行攻击。在这个方向上，CAR-T是目前的热门，也就是嵌合抗原受体-T细胞疗法。

▲CAR-T技术：通过基因编辑，让T细胞表达可与肿瘤细胞表面蛋白结合的蛋白质，并激发细胞免疫，将肿瘤细胞杀死。图片来自：the-scientist.com

去年11月，英国成功地使用CAR-T疗法治愈了一名名为理查德兹的小女孩，这也成了这种疗法最为人知的例子之一。理查德兹出生后不久经诊断患有急性淋巴性白血病，在接受治疗时，她还不满一岁，而CAR-T疗法帮她清除了体内的癌细胞。

在美国，CAR-T疗法也有一些成功案例。MIT科技评论（MIT Technology Review）曾报道过这样一则新闻：一名20岁的青年Milton Wright自小就患有白血病。在白血病第三次发作后，走投无路的他参加了CAR-T疗法的临床试验。尽管在将改造后的T细胞注射回体内后，Milton一度出现了高烧等严重反应，但他最终还是战胜了病魔。在离开重症监护病房后，医生对他的骨髓癌细胞数进行了评估，而评估的结果是“0”。

需要特别强调的是，虽然CAR-T疗法对一些特定的癌症患者展示出了一定的效果，但目前还处于临床试验的阶段。

不过，就目前的情况来看，CAR-T疗法确实很有前景。以急性淋巴性白血病为例，在目前的经治患者中，有90%的患者没有出现复发。正因为它堪称“奇迹”的临床试验结果，至少四家较早研发CAR-T疗法的公司已在纳斯达克上市。此外，更多的公司正投入到CAR-T疗法的研发中。在今年3月公布的数据中，FDA宣布他们一共收到了105份基于改造T细胞的调查性新药申请。这意味着未来将有更多的临床试验将得以进行，这也会推动这项疗法的尽快获得审批。

思路二 解除“抑制”

免疫疗法使用的是第二种思路，让T细胞恢复对肿瘤细胞的杀伤。这类疗法中的药物被称为免疫检查点抑制剂。在人体内，一些小分子往往能与免疫T细胞上的受体结合，抑制它们的活性。这在一般的情况下能够避免T细胞攻击人体的正常细胞，避免自身免疫疾病，但不幸的是，肿瘤细胞也会利用这一点，逃过T细胞的攻击。一些肿瘤细胞会分泌一种叫做PD-L1的配体。当它与T细胞上的PD-1受体结合后，会抑制T细胞的活性，让它们进入“沉睡”状态。

而现在的一些免疫检查点抑制剂能够阻断PD-1与PD-L1之间的交流。它们都是人源化的单克隆抗体，能够与PD-1或者PD-L1结合。这可以让T细胞表面的PD-1无法与肿瘤细胞的PD-L1结合，让T细胞不至于被麻痹，也可以直接与肿瘤细胞分泌的PD-L1结合，不让它们靠近T细胞的PD-1受体。总之，这类药物阻断了肿瘤细胞对T细胞的“欺骗”，让T细胞能够得以保持活性，对肿瘤细胞产生杀伤。

值得一提的是，魏则西网友拜托香港朋友带回来，产生疗效的“靶向药”Keytruda，正是最早被批准的PD-1抗体药物之一。这是一种货真价实的肿瘤免疫疗法。它在2014年被美国FDA批准，成为FDA批准的首个PD-1抗体药物。而在此之前，日本也批准了一种PD-1抗体药物Nivolumab。除了这两种药物外，更多与PD-1和PD-L1有关的药物也正在开发之中。

以下为该药上市时的新闻报道：

当然，PD-1抗体药物也不是万能药。它的最大问题是并非人人都能获得良好的疗效。这是由于每个人的基因表达水平不同，对于肿瘤表达PD-1较少的患者来说，这种药物的疗效就可能很有限。所以现在也有一些研究人员呼吁在进行治疗前，先对患者进行基因检测，提前预判药物是否会有响应，做到真正的个体化治疗。

远离“癌症免疫疗法临床治疗”

相关信息

写了那么多，我无非是想从一个医药行业工作人士的角度告诉大家，在目前看来，肿瘤免疫疗法是一项正在迅猛发展的技术。虽然目前它只是一项新生的技术，但很多人相信，未来它会是癌症治疗的一个重要方向。

然而，需要特别强调的一点是。就我所知道的，目前国内有些研究机构正在向卫计委提交以上几种疗法的临床试验申请，也有个别研究机构获准开展了相关的研究，但并没有机构获准将这些方法投入临床治疗。也就是说，如果你找到了某些信息，声称将上述几种疗法投入临床收费性治疗，那极有可能是有问题的——请保证你自己、家人以及患者朋友远离这样的信息。

关于滑膜肉瘤

滑膜肉瘤是源于关节、滑膜及腱鞘滑膜的软组织的恶性肿瘤。以四肢的大关节为好发部位，也可发生于前臂、大腿、腰背部的肌膜和筋膜上。主要临床症状为局部肿胀、肿块、疼痛，活动受限为主。以手术治疗为主。