Thanks for reviewing the paper, Mark, and sharing what you found. That was helpful.
I've not read the paper myself, so my impressions of the therapy are based on what's been in the general press. From what I have seen, it seems that this treatment can only be given once. Is that also your impression based on what you've read?
It would make sense, since the first dose would be similar to a measles vaccine, and the body's own defenses would diminish the effectiveness of the viral therapy whenever it was attempted again.
But I'm curious if that point is addressed directly in the journal article or not.
Forums
Re: Mayo Clinic measles vaccine study
Interesting video:
Dr. Stephen Russell, the Richard O. Jacobson Professor of Molecular Medicine and a Consultant in Hematology from Mayo Clinic in Rochester, MN
"Remission of Disseminated Cancer After Systemic Oncolytic Virotherapy"
Dr. Stephen Russell, the Richard O. Jacobson Professor of Molecular Medicine and a Consultant in Hematology from Mayo Clinic in Rochester, MN
"Remission of Disseminated Cancer After Systemic Oncolytic Virotherapy"
Re: Mayo Clinic measles vaccine study
So, after reading most of the posts concerning the measles vaccine study, I am still confused about it only applying to people that have not had, been exposed to, or have not previously received a measles vaccination.
Here's my question. Would a BMT remove the protection obtained from having childhood measles and/or receiving a childhood measles vaccine? Probably not, but if so, and if this research proves to be effective, then a BMT prior to receiving the super-measles vaccine would seem to be part of the treatment plan.
Thank you.
Here's my question. Would a BMT remove the protection obtained from having childhood measles and/or receiving a childhood measles vaccine? Probably not, but if so, and if this research proves to be effective, then a BMT prior to receiving the super-measles vaccine would seem to be part of the treatment plan.
Thank you.
Re: Mayo Clinic measles vaccine study
Hi Juliofrippo,
Probably having the BMT (ASCT) could remove the immunities that include the protection against measles, if one did have childhood vaccines against measles. It is assumed that one has lost one's immunities, and one can get one's childhood and other vaccines again after a set period of time, determined by one's cancer centre.
However, I think that the only real way to know if one has immunity against a disease is to have a 'titre' done. That might be how the Mayo Clinic determined that the patients in the study had no immunity to measles, but there may have been other ways to do that also!
Probably having the BMT (ASCT) could remove the immunities that include the protection against measles, if one did have childhood vaccines against measles. It is assumed that one has lost one's immunities, and one can get one's childhood and other vaccines again after a set period of time, determined by one's cancer centre.
However, I think that the only real way to know if one has immunity against a disease is to have a 'titre' done. That might be how the Mayo Clinic determined that the patients in the study had no immunity to measles, but there may have been other ways to do that also!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Mayo Clinic measles vaccine study
The response that was seen to measles virus administration in the single patient (highlighted in the worldwide media blitz) was remarkable.
However, critical information was missing from the news release. Some of this missing information - essential to gain proper perspective - has been shown below:
One of my patients received the following email from Mayo Clinic when the news was released:
However, critical information was missing from the news release. Some of this missing information - essential to gain proper perspective - has been shown below:
- 26 patients were treated at doses under 100 billion without response
- 6 patients were treated at the 100 billion level
- 2 responded; 1 complete response and 1 minor response
- The single CR patient relapsed 9 months later - localized relapse that responded to radiation - but a relapse nonetheless
One of my patients received the following email from Mayo Clinic when the news was released:
As part of the Mayo Clinic community, I wanted to tell you about a big breakthrough at Mayo Clinic.
A new study, which we just released last week, showed a very high dose of the measles virus can be effective against multiple myeloma, a particularly deadly blood cancer. Mayo Clinic scientists discovered a way to concentrate and administer a dose of the virus that was enough to vaccinate 10 million people. Dr. Angela Dispenzieri says: "The measles virus essentially makes cancer cells join together and essentially explode" and this results in the death of the cancer cells. This is the first time ever that this treatment of using viruses to attack cancer cells (known as virotherapy) has been shown effective against a spreading cancer like myeloma.
The implications are huge.
Virotherapy is opening the door to cancer treatments that are more effective, faster, and carry fewer side effects than traditional therapies, offering hope when previously there wasn't any. Dr. Stephen Russell, who co-developed the treatment, says "we've begun to think about the idea of a single shot cure for cancer. That's our goal."
Today I'm inviting you to be a part of that goal. This recent breakthrough only happened because of donations from generous benefactors. In fact, as a not-for-profit organization, much of our most cutting-edge research here at Mayo Clinic is made possible by individuals like you. If you'd like to be a part of the next advancement in virotherapy, please make a donation today.
I hope you'll watch the video and read the article below to learn more about the study and our patient, Stacy, whose myeloma had reoccurred several times over 10 years of treatment including two bone marrow transplants before this new therapy put her cancer into complete remission.
News like this makes me proud to be a part of Mayo Clinic. Thank you for being part of it, too.
Michael Camilleri, M.D.
Executive Dean for Development
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Mayo Clinic First to Show Virotherapy is Promising Against Multiple Myeloma
ROCHESTER, Minn. - May 14, 2014 - In a proof of principle clinical trial, Mayo Clinic researchers have demonstrated that virotherapy - destroying cancer with a virus that infects and kills cancer cells but spares normal tissues - can be effective against the deadly cancer multiple myeloma. The findings appear in the journal Mayo Clinic Proceedings.
Two patients in the study received a single intravenous dose of an engineered measles virus (MV-NIS) that is selectively toxic to myeloma plasma cells. Plasma cells are normally produced in the bone marrow, but in multiple myeloma, they turn into leukemia-like cells and spread through many different tissues and organs in the body causing skeletal or soft tissue tumors. This cancer usually responds to immune system-stimulating drugs, but eventually overcomes them and is rarely cured. Both patients responded, showing reduction of both bone marrow cancer and myeloma protein. One patient, a 49-year-old woman, experienced complete remission of myeloma and has been clear of the disease for over six months.
"This is the first study to establish the feasibility of systemic oncolytic virotherapy for disseminated cancer," says Stephen Russell, M.D., Ph.D., Mayo Clinic hematologist, first author of the paper and co-developer of the therapy. "These patients were not responsive to other therapies and had experienced several recurrences of their disease."
n their article, the researchers explain they were reporting on these two patients because they were the first two studied at the highest possible dose, had limited previous exposure to measles, and therefore fewer antibodies to the virus (which would have neutralized the treatment provided), and essentially had no remaining treatment options. Oncolytic virotherapy - using re-engineered viruses to fight cancer - has a history dating back to the 1950s. Thousands of cancer patients have been treated with oncolytic viruses from many different virus families (herpesviruses, poxviruses, common cold viruses, etc.). However, this study provides the first well-documented case of a patient with disseminated cancer having a complete remission at all disease sites after virus administration.
The second patient reported in the publication, whose cancer did not respond as well to the virus treatment, was equally remarkable because her imaging studies provided a clear proof that the intravenously administered virus specifically targeted the sites of tumor growth. This was done using high-tech imaging studies, which were possible only because the virus had been engineered with a 'snitch gene' - an easily identifiable marker - so researchers could accurately determine its location in the body.
More of the MV-NIS therapy is being manufactured for a larger, phase 2 clinical trial. The researchers also want to test the effectiveness of the virotherapy in combination with radioactive therapy (iodine-131) in a future study.
Other authors include Mark Federspiel, Ph.D., Kah-Whye Peng, Ph.D., M.Med., Caili Tong, David Dingli, M.D., Ph.D., William Morice, M.D., Ph.D., Val Lowe, M.D., Michael O'Connor, Ph.D., Robert Kyle, M.D., Nelson Leung, M.D., Francis Buadi, M.D., S. Vincent Rajkumar, M.D., Morie Gertz, M.D., Martha Lacy, M.D., and senior and corresponding author Angela Dispenzieri, M.D., all of Mayo Clinic. The research was supported by the National Institutes of Health-National Cancer Institute, Al and Mary Agnes McQuinn, The Harold W. Siebens Foundation; and The Richard M. Schulze Family Foundation.
Drs. Russell, Federspiel and Peng and Mayo Clinic have a financial interest in the technology used in the study.
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jmehta - Name: Jayesh Mehta MD
Re: Mayo Clinic measles vaccine study
I was just wondering if anyone had any updated news information on Stacey (the patient who went into complete remission after the measles virus)?
Several articles stated that she was going for tests in June to see if she is still in remission?
Thanks.
Several articles stated that she was going for tests in June to see if she is still in remission?
Thanks.
Re: Mayo Clinic measles vaccine study
My understanding from people in contact with the Mayo Clinic researchers is that Stacy Erholtz has NOT yet relapsed. I hope this bodes well for the use of virotherapy against myeloma in the future.
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gcwn56
Mayo Clinic measles vaccine study
Here is what one of the Mayo investigators emailed me:
"She had an extramedullary relapse at the skull at 9-10 months. Nothing in the bone marrow, so skull that had shrunk with MV-NIS at 9-10 months was irradiated and she is doing well again."
I'd go with relapse! Relapse does not mean virotherapy is not useful or is not promising. The point was that any news release must be complete and accurate to be useful - and to avoid misguiding people.
"She had an extramedullary relapse at the skull at 9-10 months. Nothing in the bone marrow, so skull that had shrunk with MV-NIS at 9-10 months was irradiated and she is doing well again."
I'd go with relapse! Relapse does not mean virotherapy is not useful or is not promising. The point was that any news release must be complete and accurate to be useful - and to avoid misguiding people.
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jmehta - Name: Jayesh Mehta MD
Re: Mayo Clinic measles vaccine study
Mark posted earlier in this discussion the information about the "relapse" experienced by the patient you mentioned who achieved a complete response to the measles virus therapy.
Mark quoted from the original journal article about the Mayo Clinic study, which said the following:
"The scan in patient 1 showed substantial improvement in all 5 previously noted lesions. There was almost complete resolution of the FDG-avid soft tissue mass occupying the lytic lesion in the left frontal bone. Further, there was a considerable reduction of maximum standard uptake value in the lytic lesions in the right frontal bone, medial right clavicle, and sternum and resolution of the focus in vertebra T11. A repeated scan 6 months after therapy revealed minimal FDG uptake in the right frontal lesion and no discernible uptake in the remaining lesions. By 9 months after therapy, there was increasing FDG uptake in the right frontal lesion. Local radiotherapy was administered because the remainder of the skeletal lesions were FDG negative and on repeated bone marrow biopsy, results remained morphologically and immunophenotypically negative by flow cytometry."
I'm not a physician, so I can't say whether the patient's imaging results and need for radiation therapy qualify as a "relapse". Maybe it doesn't, which would explain what you were told by the IMF.
But, at least qualitatively, it certainly seems to me that the patient experienced a relapse.
Mark quoted from the original journal article about the Mayo Clinic study, which said the following:
"The scan in patient 1 showed substantial improvement in all 5 previously noted lesions. There was almost complete resolution of the FDG-avid soft tissue mass occupying the lytic lesion in the left frontal bone. Further, there was a considerable reduction of maximum standard uptake value in the lytic lesions in the right frontal bone, medial right clavicle, and sternum and resolution of the focus in vertebra T11. A repeated scan 6 months after therapy revealed minimal FDG uptake in the right frontal lesion and no discernible uptake in the remaining lesions. By 9 months after therapy, there was increasing FDG uptake in the right frontal lesion. Local radiotherapy was administered because the remainder of the skeletal lesions were FDG negative and on repeated bone marrow biopsy, results remained morphologically and immunophenotypically negative by flow cytometry."
I'm not a physician, so I can't say whether the patient's imaging results and need for radiation therapy qualify as a "relapse". Maybe it doesn't, which would explain what you were told by the IMF.
But, at least qualitatively, it certainly seems to me that the patient experienced a relapse.
Re: Mayo Clinic measles vaccine study
Thanks everyone. I know that the plasmacytoma on the forehead returned after virotherapy and that it was treated with radiation. HOWEVER, since then she has not relapsed (to-date). I should have qualified my remark. Here are the very words that I received:
"Stacy has not relapsed since they radiated the recurrent plasmacytoma on her forehead. Mayo is awaiting production of more measles virus and will likely have a lottery for their phase II trial in September. "
In any case, I agree that it is best to contact the organizations directly in the know about treatments. The only reason I posted a comment in the first place was in response to a previous post in which someone was speculating about the condition of Stacy Erholz.
"Stacy has not relapsed since they radiated the recurrent plasmacytoma on her forehead. Mayo is awaiting production of more measles virus and will likely have a lottery for their phase II trial in September. "
In any case, I agree that it is best to contact the organizations directly in the know about treatments. The only reason I posted a comment in the first place was in response to a previous post in which someone was speculating about the condition of Stacy Erholz.
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gwn56
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