BIO Convention – Winning the War on Cancer, One Personal Pitched Battle at a Time
Forty years ago, President Richard Nixon effectively declared war on cancer in his 1971 State of the Union message. In 1970, the cancer death rate for men was 249.3 per 100,000, rising to 279.8 in 1990 and dropping to 221.1 in 2006. For women, the rate in 1970 was 163 per 100,000, peaking at 175.3 in 1991, and falling to 153.7 in 2006. This year, the American Cancer Society reported [PDF] that the 5-year cancer survival rate is now 68 percent, up from 50 percent in the 1970s.
As we all well know, the fight against cancer is far from won. The American Cancer Society estimates that nearly 1.6 million Americans will get some form of the disease this year. But that's just the problem; cancer is not just one disease. In many ways each cancer patient's disease is unique to herself which makes treating her malady very complicated. In addition, cancer cells are unstable and mutate a lot, enabling them to evolve resistance to our medicines.
A session at the Biotechnology Industry Convention on Tuesday discussed the advent of personalized oncology. William Dalton, CEO and president of Moffit Cancer Center, has launched the Total Cancer Care program in which the Center's physicians and researchers partner with patients. While undergoing treatment, patients enrolled in Total Cancer Care programs at treatment centers around the country agree to allow researchers to biopsy and study their tumors using modern molecular techniques. If the Moffit Center researchers identify a relevant clinical trial based on what they discover about a patient's tumor they contact her and suggest that she consider enrolling. This way they can bring the most up-to-date therapies to their patients. In the meantime, the Moffit Center is creating a massive cancer database which can be mined by other researchers for insights about molecular pathways that might provide suitable targets for novel cancer medicines. In addition, the Center is creating a clinical portal that will enable other physicians to compare the efficacy of various treatments for their patients who are clinically and molecularly similar to Moffit cancer patients. In the future, molecular diagnostic techniques could identify populations who are at higher risk of various cancers and tab ways to intervene before disease manifests. "The real firepower will be in prevention," declared Dalton.
Carlos Santos, the chief scientific officer of Biovest International, a subsidiary of Accentia Biopharmaceuticals, talked about his company's progress in developing personalized vaccines for B-cell non-hodgkins lymphoma. Cancer cells in each patient express specific surface proteins that identify them as cancerous but which are not seen by the patient's immune system. The company's BiovaxID vaccine is made for each individual patient by combining their specific cancer cell surface protein with a foreign protein. Once injected, a patient's immune system can now identify cancer cells as foreign and destroy them.
Currently in a Phase III trial, the vaccine is administered once standard chemotherapy has forced the disease into remission. The problem is that chemotherapy doesn't get rid of all the cancer cells that are lurking in a patient's body. Consequently, patients who undergo the standard treatment tend to relapse after two to three years. With the BiovaxID vaccine, patients average an extra 14 months of disease free survival. Clearly BiovaxID is no anti-cancer silver bullet, but it compares favorably with the new prostate cancer vaccine Provenge which boosted patient survival from 22 months to 26 months. Even when the lymphoma returns after vaccination, it behaves in a more indolent way. If the vaccine is approved by the Food and Drug Administration, patients could be treated periodically with it perhaps driving it back into remission many times. Santos told me that six of the first people treated in Phase 2 are still disease free since 1995. But war is not cheap. Each individualized treatment will cost somewhere around $100,000.
Next up: How diagnostics are redefining cancer and revolutionizing treatment.