Just after a new immunotherapy clinical trial was announced, another new weapon in the fight against cancer got its first FDA approval. While immunotherapy uses the cancer patient’s immune cells to recognize and attack their tumors, a new drug uses a virus to kill skin cancer cells. It’s the first virus-based cancer treatment that’s gotten FDA approval and dozens more are in line behind it.
Imlygic, the new treatment made by the biotechnology company Amgen, was created when researchers modified a herpes virus so that it wouldn’t cause cold sores but help destroy cancer cells. To treat skin cancer, which is the current focus of the drug, doctors will inject a massive dose of millions of viruses directly into the tumors, where the modified herpes viruses will infect cancer cells. Thus far the viruses tend to leave healthy cells alone, though according to researchers it’s unclear why they show this preference. The influx of viruses will then cause skin cancer cells to burst, and the immune system to activate and take care of the remains of the tumor. Injections are administered every few weeks until the cancer is gone which in the final Phase III clinical trial took an average of about four months for the patients that responded to the treatment.
Oncology researchers excited about future possibilities
While the initial results of Imlygic aren’t a gamer changer for most skin cancer patients (a $65,000 course of treatment extends melanoma patients’ lives by less than four and a half months, on average), its the approval of a virus in general that has people excited. The move by the FDA opens a whole new front in the fight against cancer, which often returns after other treatment options such as chemotherapy, radiation, or surgery.
The concept of using viruses to fight cancer actually stretches back for more than a century. The theory behind it is when normal cells turn cancerous, they replicate out of control but, here’s the key, their virus-fighting machinery shuts down which makes them vulnerable. However, its not as easy as it sounds. The R&D field is littered with oncolytic viruses (“onco” is for cancer and “lytic” is lysis, or bursting) that didn’t make it through the clinical trials.
The key to success, according to Imlygic researchers, was learning to engineer the virus into something useful. They had to keep it from infecting healthy cells or causing cold sores, but make sure that it’d get pieces of viral and tumor protein to break up properly to alert the immune system (and express a new protein that also boosts the signal to the immune system). It wasn’t easy. Although scientists know about the workings of the virus, they’re still unclear on exactly how the immune system works.
Approval kickstarting more cancer funds and research?
With dozens of ongoing clinical trials of similar ‘oncolytic’ viruses, researchers hope that the approval of Imlygic will generate the enthusiasm and cash needed to spur further development of the approach. “The era of the oncolytic virus is probably here,” says Stephen Russell, a cancer researcher and haematologist at the Mayo Clinic in Rochester, Minnesota. “I expect to see a great deal happening over the next few years.”
Already the applications of Imlygic could reach beyond melanoma. Dr. Robert Andtbacka, an oncologist at the University of Utah who’s been involved in Imlygic’s development since before it had a brand name, told Tech Insider that he and his team are already looking at adapting the method to treat head, neck, breast, and liver cancers in clinical trials.
He said Imlygic’s most promising applications may be in combining it with other treatments, so patients could receive it before or after surgery, or with chemotherapy or other drugs. When skin cancer can’t be removed by surgery anymore, patients today only few options. Andtbacka said Imlygic is a powerful new tool for oncologists to target melanoma, especially in its late stages.
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