Cancerland by David Scadden

Author:David Scadden
Language: eng
Format: epub
Publisher: St. Martin's Press

SIX

SNUPPY THE HOUND AND IPSCS

As we announced the creation of the Harvard Stem Cell Institute, the science around cancer and the other diseases we would study continued to race forward. Research on the immune system, which got a big boost with the work done on T cells—a subtype of white blood cells—during the AIDS crisis had progressed steadily under the leadership of scientists like Steven Rosenberg at the National Cancer Institute.

For years, Rosenberg had doggedly plotted the relationship between cancer and the cells the body can deploy to defeat it. The wellspring of these immune cells is the bone marrow, which deploys them via the bloodstream and lymphatic system. (Hence, the vital importance of blood and bone.) In 2004, Rosenberg started a small human trial—seventeen patients in all—using genetically altered T cells against the most serious form of skin cancer, melanoma. Perhaps the most intriguing thing about his approach was that it drew from the two most promising areas of cancer science: genetics and stem cells.

Understanding Rosenberg’s work requires recalling that for every mutation that evolves into a disease called cancer, we experience countless ones that are identified and halted by our natural defenses. This defense depends on the fact that malignant cells emit chemicals called antigens, which signal the waiting fighters of the immune system to take action. These defenders, which are mostly T cells and B cells, must also possess an antigen receptor that responds to the antigen and continues the immune response.

When cancer progresses, it’s often because we don’t have enough immune cells equipped with the right receptors. However, a few properly outfitted immune cells generally do appear, and they will get through to do a bit of damage to the growing malignancy. Rosenberg theorized that if he could find these effective immune cells and somehow create more of them, he might be able to intervene and tip the scales.

Rosenberg had become intrigued by the potential of the immune system when, as a surgeon, he performed a gallbladder surgery on a man who had had a stomach cancer removed in a previous operation. Reports from the original surgery noted that the cancer had metastasized to his liver, but when Rosenberg searched for those tumors, he couldn’t find them. Further investigation confirmed the patient no longer had cancer at all. Intrigued, Rosenberg wondered if the man’s immune system was somehow superpowered. Knowing that the blood was one place where he might access this power, he experimented with a transfusion of the cancer-free patient’s blood to one with a similar malignancy. The transfusion didn’t work as a cure, but it did set Rosenberg on a lifelong quest to discover how the seeming miracle of the missing metastases occurred. The key, he knew, was in the man’s immune system, which had failed against the mass in his stomach but managed to succeed in his liver. “Something began to burn in me,” explained Rosenberg later in life, “something that has never gone out.”

Over decades, Rosenberg and others gradually deciphered the chemical process that guided the interactions between cancer cells and immune cells.

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