Discovery ‘may treat all cancer’

A NEWLY-discovered part of our immune system could be harnessed to treat all cancers, say scientists.
The Cardiff University team discovered a method of killing prostate, breast, lung and other cancers in lab tests.
The findings, published in Nature Immunology, have not been tested in patients, but the researchers say they have “enormous potential”.
Experts said that although the work was still at an early stage, it was very exciting.

What have they found?
Our immune system is our body’s natural defence against infection, but it also attacks cancerous cells.
The scientists were looking for “unconventional” and previously undiscovered ways the immune system naturally attacks tumours.
What they found was a T-cell inside people’s blood. This is an immune cell that can scan the body to assess whether there is a threat that needs to be eliminated.
The difference is this one could attack a wide range of cancers.
“There’s a chance here to treat every patient,” researcher Prof Andrew Sewell told the BBC.
He added: “Previously nobody believed this could be possible.
“It raises the prospect of a ‘one-size-fits-all’ cancer treatment, a single type of T-cell that could be capable of destroying many different types of cancers across the population.”

How does it work?
T-cells have “receptors” on their surface that allow them to “see” at a chemical level.
The Cardiff team discovered a T-cell and its receptor that could find and kill a wide range of cancerous cells in the lab including lung, skin, blood, colon, breast, bone, prostate, ovarian, kidney and cervical cancer cells.
Crucially, it left normal tissues untouched.
Exactly how it does this is still being explored.
This particular T-cell receptor interacts with a molecule called MR1, which is on the surface of every cell in the human body.
It is thought MR1 is flagging the distorted metabolism going on inside a cancerous cell to the immune system.
“We are the first to describe a T-cell that finds MR1 in cancer cells – that hasn’t been done before, this is the first of its kind,” research fellow Garry Dolton told the BBC.

Why is this significant?
T-cell cancer therapies already exist and the development of cancer immunotherapy has been one of the most exciting advances in the field.
The most famous example is CAR-T – a living drug made by genetically engineering a patient’s T-cells to seek out and destroy cancer.
CAR-T can have dramatic results that transform some patients from being terminally ill to being in complete remission.
However, the approach is highly specific and works in only a limited number of cancers where there is a clear target to train the T-cells to spot.
And it has struggled to have any success in “solid cancers” – those that form tumours rather than blood cancers such as leukaemia.
The researchers say their T-cell receptor could lead to a “universal” cancer treatment.
So how would it work in practice?
The idea is that a blood sample would be taken from a cancer patient.
Their T-cells would be extracted and then genetically modified so they were reprogrammed to make the cancer-finding receptor.
The upgraded cells would be grown in vast quantities in the laboratory and then put back into the patient. It is the same process used to make CAR-T therapies.
However, the research has been tested only in animals and on cells in the laboratory, and more safety checks would be needed before human trials could start.
What do the experts say?
Lucia Mori and Gennaro De Libero, from University of Basel in Switzerland, said the research had “great potential” but was at too early a stage to say it would work in all cancers.
“We are very excited about the immunological functions of this new T-cell population and the potential use of their TCRs in tumour cell therapy,” they said.
Daniel Davis, a professor of immunology at the University of Manchester, said: “At the moment, this is very basic research and not close to actual medicines for patients.
“There is no question that it’s a very exciting discovery, both for advancing our basic knowledge about the immune system and for the possibility of future new medicines.” –BBC

Fake drugs a public health crisis

THE proliferation of fake medicines in Africa is a public health crisis that can no longer be ignored, according to a UK charity.
There’s a meeting of seven African countries, in Togo, this week, to combat the problem.
Congo, Niger, Senegal, Togo, Uganda, Ghana and The Gambia will discuss measures to clamp down on trafficking in fake medicines, says the Brazzaville Foundation.
But how big a problem is counterfeit medicine in Africa, and what impact does it have?

How many counterfeit drugs are there?
Globally, the trade in counterfeit pharmaceuticals is worth up to $200bn annually, with Africa among the regions most affected, according to industry estimates.
The World Health Organisation (WHO) says 42 per cent of all fake medicines reported to them between 2013 and 2017 were from Africa.
The European region and the Americas (North and South) accounted for 21 per cent each.
But how reliable are these figures?
The WHO has a reporting mechanism that relies on national or regional regulatory authorities around the world to notify it of seizures. So the data for 2013-17 is only as good as the surveillance and reporting systems in the countries or regions concerned.
The WHO has itself noted that as more officers were trained and national regulators became more aware, the numbers of drug seizure reports went up. So it’s possible areas with weak regulation and enforcement may be under-reporting the extent of the problem.
Bright Simons, who set up a mobile system to verify drugs in Ghana, says it’s not possible to produce a precise estimate, as the trade is underground.
But there’ve been several seizures in recent years, which give an indication of the size of the problem in West Africa:

  • Ivory Coast, Guinea-Bissau, Liberia and Sierra Leone seized 19 tonnes of counterfeit medicines in 2018
  • Smugglers in Ivory Coast were intercepted trying to bring in 12 tonnes of counterfeit pharmaceuticals from Ghana in 2019
  • An Interpol-led operation in seven West African countries seized more than 420 tonnes of illicit pharmaceutical products in 2017
  • Nearly 19.88 tonnes of fake medicines were seized in Mali between 2015-18

The accounting firm PwC says the proportion of fake pharmaceuticals in some countries can be as high as 70 per cent, in developing regions such as Africa.
The WHO estimates one out of every 10 medical products in low- and middle-income countries, which includes most of Africa, is sub-standard or fake.

What harm do fake drugs do?
Analysis by the London School of Hygiene and Tropical Medicine for the WHO estimates substandard and fake anti-malarial drugs could be causing 116,000 extra deaths from the disease every year in sub-Saharan Africa at a cost to patients and health systems of on average $38.5m a year.
And in 2015, a study published in the American Society of Tropical Medicine and Hygiene estimated more than 122,000 children under the age of five died each year because of sub-standard anti-malarial drugs in sub-Saharan Africa.
Although these results are only estimates, the scientists say they suggest poor quality drugs are important contributors to under-five mortality rates.

Why is it hard to fight fake medicines?
Fake medicine can often be indistinguishable from the real products, with the packaging as good if not better than the original.
And weak or inconsistent legal frameworks and the lack of regulations to address sales, often carried out online or in informal locations, add to the problem, the UN says.
There’s also an issue with the cost of drugs in poorer countries.
“If a good quality medicine from a known supplier is too expensive, people may try a cheaper one from an unlicensed supplier,” the WHO says.
Cutting prices for licensed drugs, however, does not guarantee a solution.
Even low priced medicines can make money for criminals, as long as the sales volume is high enough.
But there are some technological solutions being tried out to tackle the problem, including mobile apps to help users verify medicines, using scratch stickers, barcodes and other means of identification printed on packaging. –BBC

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