[SunilNagpal]

HIV and Cancer are probably the deadliest diseases in the world! And, worst part, both the diseases start as silent killers! Whereas there is no possible treatment for the persons infected with HIV virus (a few drugs for only extending the life do exist), the persons infected with Cancer do retain a hope (though not guaranteed). But, if the cancer is diagnosed in terminal/final stages, wherein the uncontrolled proliferation has blown up beyond recovery, the death of the patient stands unavoidable in most cases. Recently, in a rarest of the rare feats, doctors from the University of Pennsylvania used genetically-modified (GM) strain of human immunodeficiency virus (HIV) to treat Leukemia (cancer of the blood cells) in a 6 year old girl who was under the full-blown terminal dying stage of the cancer. This article focuses on shedding light on this rare clinical trial that gave life to a Leukemia patient at the verge of death!

Dr. Grupp and team, at the Division of Hematology and Oncology, University of Pennsylvania Medical Center decided something unusual, as a part of a clinical trial, on a 6 year old patient, suffering from the terminal stage of Leukemia, who failed to get any sort of relief from any existing cancer therapy ranging from Chemotherapy-Radiotherapy; and was at the verge of immediate death. In the simplest of words, following is the summary of what the doctors did:

1. A part of Patients T-cells were removed from the blood.

2. The harvested T-cells were infected with GM HIV (unable to cause disease). The GM HIV carried genes for recognizing the particular type of cancer. As per the ability of HIV (which can invade T-cells), the genes were transferred to the harvested T-cells.

3. The modified T-cells thus expressed chimeric antigen receptors to recognize and clear various cancer cells.

4.The modified cells upon transfer into the patient's blood stream, proliferated inside the body of the patient, clearing off all the cancer cells.

5. The body of the patient rather acted as a bioreactor for the modified T-cells wherein they proliferated with time and cleared off the cancerous cells.

6. Remarkably, all the cancer cells were wiped off the body within 1 month of modified T-cells administration.

7. And, as per the status today, the 6 year old little girl patient then, is 7 year old now, and even after 1 year of the treatment, there's no sign of Leukemia in her body. Even the most sensitive tests couldn't detect the slightest of trace of Leukemia!

Following is the inspiring video of the entire story:

Technical Details:

Though in most of the cancers, tumor-specific antigens are not well defined for targeting, the B-cell neoplasms (Uncontrolled proliferated mass of B-lymphocytes) do express CD19 antigen. Thus development of autologous T cells expressing an anti-CD19 chimeric antigen receptor (CART19) was hypothesized. In order to test it, Autologous T cells from the patient were harvested and thawed, followed by transduction with HIV derived lentivirus having the genes to express the CD19-specific chimeric antigen receptor. The transduction lead to stable gene incorporation into the T-cells, making them modified/Chimeric T-cells. The T-cells were then infused into the patient. The patient suffered chills and low-grade fevers with grade 2 fatigue fourteen days after infusion. The chills intensified with high temperature upto 39.2°C (102.5°F), associated with rigors, anorexia, nausea, and diarrhea but no respiratory or cardiac symptoms, 5 days further. But on Day 22 tumor lysis syndrome was diagnosed! The remission continued even 6 months after infusion, which persists till date with no hints of Leukemia.

An informative News report:

Conclusion:

The finding is indeed radical and a brilliant use of something that was fearsome and a grave source of disease till date. Use of HIV to stably transduce the T-cells has in a way led to the emergence of a Vaccine like treatment to the Leukemia, as the modified T-cells proliferate inside the body and act against the cancer whenever it tends to develop. Thus the treatment is indeed a "cure" and not just a control.

But the study on long term side effects need to be conducted to make sure that the virus as deadly as HIV doesn't revive with time, leading to severe compromise of host immune system. But considering the fact that it's success rate is 80% till date (which is just too high and astonishing), and the truth that it gives hope to those who are at the verge of death, it's use is undoubtedly a boon for the leukemia patients and obviously it can be extended to other types of cancers as well!

So, the time should not be long when we may find a customized vaccine for almost every kind of cancer, derived from the HIV!

Thanks