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Researchers in the US have used a modified measles virus to 'wipe out' myeloma

Media outlets, both traditional and social, are awash with the news that researchers in the US have apparently cured cancer with the measles virus – for example, the Washington Post, Daily Mail, Daily Mirror, Daily Telegraph and (with a much more measured headline) Reuters.

But while the story is dramatic – a 49-year old US woman’s myeloma blood cancer seems to have completely disappeared following treatment – the actual science is a lot more complex than simply injecting her with an armful of measles. A number of the stories implied that the woman had been treated with an extremely high dose of the regular measles vaccine, but we need to be absolutely clear here:

This treatment did not involve a standard measles vaccine or virus – the researchers used a genetically modified virus, and there’s no evidence that the regular measles or MMR jab can cure, prevent or cause any type of cancer.  

In fact, we’ve been here before – the approach is similar (although different in certain key respects) to the modified HIV-type virus used to successfully treat a young girl with leukaemia. Overblown headlines about her treatment also flew round the social media world before the scientific truth had got its boots on.

It’s also similar in that this is just one single success story from a very early stage trial, and a lot more work needs to be done to prove that it could be a safe and effective treatment for cancer.

What is this virus treatment?

The researchers at the Mayo Clinic in the US, led by Dr Stephen Russell, are using an approach called ‘oncolytic virus therapy’, which is generating a lot of excitement in the cancer research community around the world.  In fact, we’ve written about some of our work in this area a couple of times already.

Briefly, it involves treating patients with viruses that have been genetically engineered to specifically infect cancer cells, rather than causing the particular illness that they usually bring. When injected into the body, the viruses seek out and destroy the tumour cells, multiplying inside them to create even more cancer-killing viruses. At least, that’s the theory.

To date, researchers have created oncolytic viruses from a number of different types of modified virus, including the herpes virus (which causes cold sores), pox viruses and adenovirus (common cold). But while tests in cancer cells grown in the lab and animals have been remarkably successful, this promise unfortunately hasn’t yet translated into success in clinical trials with actual cancer patients.

What did they do?

In this study, published in the Mayo Clinic Proceedings (the clinic’s own peer-reviewed journal), Dr Russell and his team were building on previous research they’d done using a genetically modified version of a ‘crippled’ (attenuated) measles virus, used in some vaccines, which could kill cancer cells.

The virus also contained an extra gene swiped from the human thyroid gland, containing the instructions to make a protein that shuttles iodine from the bloodstream into cells. This addition meant that the researchers could track exactly which cells in the body the virus had infected, by injecting small amounts of radioactive iodine into the blood and then monitoring using a type of scan called SPECT-CT.

In this paper, the scientists describe the cases of two women, 49-year old Stacy Erholtz and another unnamed patient, who were part of a larger clinical trial started by the clinic a few years ago. Both had a type of blood cancer called myeloma that starts in the bone marrow – an ideal target for the measles virus, which particularly likes to infect bone marrow cells.

The women had received a range of treatments over nine and seven years, respectively, including a range of different chemotherapy drugs. Stacy had also had two bone marrow transplants. But while the treatments had held their cancers at bay for several years, they were now at the end of the road.

As part of an experimental, early-stage clinical trial, the researchers injected both patients with around 100 billion units of the measles virus – enough to vaccinate 10 million people if it had been a regular vaccine virus – over the course of an hour. Then they waited to see what would happen.

What were the results?

Almost straight away, the patients became feverish and unwell as their immune systems kicked into action against the massive virus load. They soon got better, and over the next few months the researchers watched as the levels of cancer cells in the patients’ bodies started to fall and their tumours shrank. For Stacy this was particularly noticeable as she had a large tumour on her forehead, which melted away as the virus got to work.

Although the initial responses were impressive, the two women had very different outcomes. Stacy’s cancer seemed to completely disappear, although according to Dr Russell in this video, her forehead tumour apparently came back after around 9 months but is now being controlled with radiotherapy.

However, the other woman was less lucky and after just two months her cancer had come back worse than before, although at the time of writing she is still alive. The researchers also managed to use the iodine-shuttling protein to see where the virus infection had taken hold in her body. It revealed that the virus had indeed infected all her tumours, even though it hadn’t managed to eradicate them.

Why did it work?

As we mentioned, many cancer-killing viruses have not been as successful in human trials as they have been in the lab. One reason that the measles virus might have worked in Stacy’s case is that it was injected at such high doses.

The Mayo Clinic team have been testing their modified measles virus over several years, and initially started testing doses around 100,000 times lower than in these two patients. This suggests that there may be some kind of ‘critical level’ of virus in the body that has to be reached before it can take effect – knowledge that may be useful for other virus researchers around the world.

One other thing to note about the two patients in this trial – neither of them had antibodies against the measles virus in their blood that might have ‘mopped it up’ and made it less effective. This may have been because they had not been exposed to the virus or vaccinated against it, or their previous cancer treatment could have wiped them out.

Today, many people are vaccinated against measles as children, which involves injecting a very small amount of non-infectious measles virus, so are likely to have antibodies against it. So one of the next steps for the Mayo Clinic team is to work out how to get round this problem – perhaps by only giving the treatment to people who don’t have measles antibodies, by masking the virus in some way (like our own researchers’ approach with adenovirus), or by modifying the virus so it looks suitably different from the real thing that it can’t be recognised by measles antibodies.

However, it’s certainly not a good reason to suggest skipping the measles or MMR vaccine in childhood – measles is an unpleasant disease at best and fatal at worst, and is still one of the leading global causes of death among young children.

Where next?

Stacy’s story is certainly an impressive result from an exciting field of research, and we look forward to seeing more results from the Mayo Clinic team’s trial as they come through.

But these are just two patients, only one of whom had a strong response to the therapy, and one success story does not make a miracle cure. We need to see results from many more patients to know whether the virus is safe and effective at treating cancer and that Stacy’s incredible outcome wasn’t just a fluke.

It’s also important to note that the measles virus approach won’t work for all cancers. Myeloma was chosen for this trial as the measles virus specifically targets the bone marrow. It would need significant genetic modifications before it could be persuaded to attack other types of cancer cells, and other oncolytic viruses are being designed to target different types of cancer.

In this short video about the research, Dr Russell is hopeful about the prospects for his modified measles virus, saying “We believe it can become a single shot cure.”

But despite the bold words and headlines, which might make you think that a measles-based cancer cure is just around the corner, the best approach to this new study is cautious optimism. It’s incredible science – and a fantastic outcome for one woman and her family – but (as ever) more work still needs to be done.

Kat

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Susan Williams August 9, 2014

Any advancement toward more effective cancer treatment in important. Being aware of the research and trial results is most helpful.

Roy Román Torres August 1, 2014

After all comments and corrections it is still needed to focus on the idea we are far away from the magical bullet that can aim at cancer cells without afecting, somehow, the rest of our body. I´m hematologist and I fully agree with Kat´s cautios optimism propousal since the most advanced reserch world is only at the gates of such a field of investigation. The complex biology of hematological and any other kind of cancer is an unquestionable challenge and perhaps it won´t be conquered untill huges amounts of wills, brains, and resources would be globally destinated to really intend to do so (instead for other darker porpouses). I only hope they don´t choose modifing the virus so it can scape the previous inmunization because nature is quite amazing and life always manage to find its own ways and what should have been a great solution can suddenly become a great mistake. I think that the most conscious and respectull science will be the only one that could make it happen and it should be a scientific source the first in announcing such an improvement since social media have shown they are more interested in “hitting first” with the big news wich sometimes doesn´t make any good at all.
R2T

Lauren davies July 19, 2014

So i know this sounds weird but can enzymes and lymphocytes cure/eat cancer?

Charles Wallace July 5, 2014

I was diagnosed with Multiple Myeloma is 2011. I have been living with the fear that my life would be cut short by this incurable disease. I have been hoping and praying that a cure would be developed sooner than later. Although the Measles Vaccine treatment sounds promising there are still many years of research needed before we will know if this product will be beneficial in curing Multiple Myeloma. We must stay the course and take advantage of any treatment regimens available to extend our survival.

shubham June 24, 2014

will this be effective for tumors of emiloblastic carcinoma type cancer ?
rasp

Alistair June 5, 2014

I had measles (twice) when I was 15 (and thoroughly unpleasant both episodes were). I was dianosed with Malignant Melanoma when I was 39 – clearly a lot more work to be done in this area.

Yvette June 4, 2014

Do you think adding the virus to our DNA to prevent cancer eventually, do you think that would be a bad ethical decision?(tampering with human DNA?)

John June 4, 2014

@Anita Griffiths. Let us focus on the people who are actually dieing first. MM is a bone marrow cancer and thus an ideal candidate for measles vaccination. The doctors will follow whatever path the studies indicate. IF people treated this way show to be highly resistant against Crohns they will surely look into that further but you cannot just inject a possibly lethal dose of vaccin into a patient that isn’t terminal. It’s like shooting at a mosquito with a cannon.

kanehi May 28, 2014

I believe nanotech is the way to go in defeating cancer. If only scientists could find a way to program nanos to attack specific cancer cells.

Anita Griffiths May 23, 2014

I think using the Measles virus and modifying it so that it’s reaction can be used to spread useful viruses that eliminate or control cancer is a very good innovation.
Do you think these existing viruses can be used to control the spread of Crohns disease as well. I ask this because it seems to me that Crohns is similar to Cancer in attacking the bowel and indeed Crohns does turn Cancerous in later stages. Even though it was discovered that the single Measles and Measles in the original MMR vaccine caused Crohns disease and needed amending.

Anon May 20, 2014

Thank you for correcting the erroneous information presented in the original article about the CT and the 2nd patient. It is so very critical for us patients to be able to rely upon accurate reporting of such emerging research. In a rush to get the story out, some outlets have reported inaccuracies. Nice to see you correct and update.

Kat Arney May 19, 2014

We are extremely sorry for this error and any upset that it may have caused. The post has now been corrected. Thank you for letting us know.
Kat

Marta I Hill May 19, 2014

Please note and a correction is requested the second lady patient is still alive. Thank you. MAYO CLINIC reported that they are both alive and so has her daughter.

suzierose May 19, 2014

It seems there is a terribly bad error in this write-up under the section Where next…you state that “these are only two patients, only one of whom is alive’

The daughter of the other patient says her mother is very much alive and she is quite upset.

Please correct that text.

Marta I. HIll May 19, 2014

Thank for this CLARIFCATION, I have multiple Myeloma, have survied now 7 years and some of the artilces plastered in the MEDIA are not accurrate at all creating false hope please publish this again in all the media venues….this is certainly a great advance in RESEARCH and clinical trials but by no means a cure, I just read a headline article: ” Luekemia is cured by Mesales Vaccine” !!! Us patients appreciate your concern and spreading correct info… very much!

Kat Arney May 19, 2014

Hi Paul and Simon,
You’re right – it was SPECT-CT. We’ve now corrected this mistake, thanks for pointing it out.
Best wishes,
Kat

Paul Browne May 19, 2014

They used SPECT. From the paper:

“SPECT-CT Imaging Studies

Radioiodine uptake was visualized on SPECT-CT obtained 6 hours after oral administration of 5 mCi of iodine 123. The scans were obtained at baseline and on days 8, 15, and 28 after virus administration using a Philips BrightView SPECT-CT scanner. To suppress thyroidal NIS expression, liothyronine sodium (25 μg, 3 times daily) was administered orally for 4 days before the first (baseline) scan and was continued until completion of the day 28 scan.”

Simon Hastings May 18, 2014

Did they really use a CT? Not SPECT (which could do this much more easily), or maybe a PET scanner in singles mode? You’d need to inject an unbelievably large amount of the radioactive isotope to get this working otherwise. CT could work, don’t get me wrong, it’s just that the helical scanning works great with a straight through source but is really pretty terrible with a diffuse source. So either you (and they) are using what, a generation 1 CT, or this wasn’t the right word.