Live Cell Therapy

Live Cell Therapy

HOPE FOR GENETIC HEALING

Intriguing new approaches to cancer and AIDS

USING GENETIC MANIPULATION TO outwit deadly diseases is a scientific dream that so far hasn't come true.

But two reports last week in the Proceedings of the National Academy of Sciences may bring back the excitement to gene therapy, with promising developments in the treatment of cancer and AIDS.

In one experiment, scientists from the University of California, Los Angeles, combined genetic engineering and standard vaccine therapy to destroy, apparently permanently, a pernicious type of brain tumor in rats. Led by molecular biologist Habib Fakhrai, the researchers took cells from a lab culture of a cancer called 9L gliosarcoma. They introduced them into the brains of healthy rats, where the malignant cells multiplied. Then Fakhrai's team genetically altered some of the other cultured cancer cells by blocking a gene that makes a protein called TGF-beta. In this cancer, and in some human cancers, TGF-beta plays a nasty trick on the immune system by deactivating T-cells, which kill invaders. Shielded from attack by the immune system, the cancer spreads with impunity. But when the researchers placed the altered tumor cells in the rats' brains, not only were the genetically engineered tumor cells destroyed by the immune system, so were all the untreated cancer cells. Twelve weeks after the experiment, all 11 rats that had received the genetically altered cells were alive and healthy, and all five control rats were dead. Even after the survivors were reinjected with more malignant tumor cells, they still beat the disease. By using genetic intervention to engage the immune system, says Fakhrai, "you're boosting the body's own defenses, and usually they're much more potent than anything else we could do." Human tumors that produce TGF-beta and might be fought this way include those of the brain, breast, colon and prostate. The researchers hope to begin preliminary human testing this summer.

Another gene-therapy experiment reported last week offered an intriguing new approach to the treatment of AIDS. Biochemist Dr. Gary Nabel and his team at the University of Michigan Medical Center took blood from two HIV-positive patients and isolated their infection-fighting T-cells. Then they inserted an HIV gene that had been modified to inhibit replication of the virus. When they marked the altered T-cells and placed them back in the patients (through transfusion), the cells survived in their bodies four to five times longer than the subjects' untreated T-cells. "This is one critical step," Nabel says, "to exploring other genetic therapies." And perhaps to prolonging the lives of T-cells long enough to prolong AIDS patients' lives.

Using Gene Therapy to Beat Cancer

An experiment using genetically altered cancer cells may point the way toward developing against some cancers.
1 Getting Cancer

Researchers inject lab-grown cancer cells into rats' brains, where they reproduce and grow into a tumor.
2 Re-Engineering

Leftover cancer cells are reprogrammed so they cannot make TGF-B, a protein that shields them from the immune system.
3 A Cure at Work?

The cells, now irradiated so they no longer reproduce, go into the rats, whose immune systems respond by destroying the cancer.
4 Confirmation

Even after reinfection with 3,000 times a fatal dose of cancer cells, the rats remain healthy. The vaccine is a success.

ILLUSTRATIONS

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By JEAN SELIGMANN with ADAM ROGERS

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GENE THERAPY CANCER TREATMENT BEGINS

In the first gene therapy attempt to fight cancer with cancer, physicians at the National Institutes of Health last week gave a cancer patient an experimental dose of his own tumor cells genetically engineered to bolster his immune system.

Steven A. Rosenberg of the National Cancer Institute injected 200 million live tumor cells containing added genes for tumor necrosis factor (TNF) into the thigh of a 46-year-old man with advanced melanoma, the most lethal form of skin cancer. Rosenberg had taken the malignant cells from the man's skin and used a crippled retrovirus to insert into them extra copies of the gene for the immunity-stimulating protein TNF.

In three months, Rosenberg plans to remove some of the man's white blood cells, called lymphocytes, which the extra TNF genes have stimulated to attack the engineered tumor cells. After multiplying 200 billion of the lymphocytes in a second laboratory culture, he intends to readminister them to the patient, in the hope that they will home in on and kill most of the man's melanoma tumors.

Rosenberg began the new therapy just hours after receiving approval from the agency's Recombinant DNA Advisory Committee and the NIH director. He first proposed the experiment at a meeting of cancer experts in May (SN: 5/25/91, p.326).

Rosenberg has permission to test the gene therapy treatment on 15 patients - five each with advanced melanoma, colorectal cancer and kidney cancer - over the next year. He also has clearance to treat some of these 15 patients with their own tumor cells engineered to carry a gene for a second immune-stimulating protein, interleukin-2.

Rosenberg says the immunity boosting genes should help the patients' bodies to recognize and fight their cancers. By removing and multiplying the cancer-fighting lymphocytes in the experiment's second step, he says he expects to increase each patient's anti-cancer arsenal.