Over the last few years, there’s been a lot of talk about using viruses to fight cancer and as the best vector for gene therapy to finally conquer diseases once thought incurable. But aside from several promising trials in the lab and in select hospitals, not much from this research has been cleared for use in real world patients. Until now, as a genetically modified herpes virus received the formal green light to help combat advanced melanoma in clinical practice. Considering how many ups and downs this technology had over the last 35 years, this is very important first step in showing that we finally know what we’re doing and the science is mature enough to treat the average Joe and Jane. Labs which may have put viral therapy on the back burner, worried that the current regulatory climate would be too conservative to ever approve their products can get back to work and ramp up their viral pipelines. And of course, millions will soon benefit from this promising new class of drugs to send more and more cases of cancer into remission.
But of course there are some limitations. The currently approved drug, T-VEC, hasn’t shown all that much life-extending potential in the lab and needs to be injected directly into the tumors. It gave patients with advanced melanoma an additional 4.4 month which was just a whisker away from desired statistical significance for the population being tested. However, since these were very advanced cases, with many likely comorbidities, and it triggered an immune response that finally saw the tumors as foreign invaders and helped control their attempts to spread. Given in concert with existing therapies, it should be very effective, and if it is, its manufacturer can seek approval for use in less advanced forms of melanoma against which it should do even better. In short, it may not be the “cure” we’ve always wanted, but it’s a very important step forward and a very encouraging sign of things to come, and widespread clinical use of viral therapies will give us new insights into how to better refine them to make them safer and more potent.
Of course we need to keep in mind that the result of all this work will not be the mythical cancer cure advertised by many quacks and snake oil peddlers. Cancer seems to have existed almost as long as multicellular life on Earth, and while some creatures found ways of coping with it, it’s still a constant threat because it’s such a complex degenerative condition affecting virtually any cell type there is in our bodies. We probably can never hope to completely eliminate it, but it’s a realistic goal to develop a wide array of treatments that quickly send it into remission, which will turn what was once a death sentence into a fight we can win more often than not. With several types of cancer that’s exactly the case with conventional treatments. Imagine how much better targeted viral therapies which could spare more healthy cells than chemotherapy and radiation will be for patients over the next decade. And while there will always be a ghost of a recurrence hanging over their head no matter how hard we try, knowing that there is a really good chance to once again beat it, may make up for nature’s insistence on turning some of our cells evil…
[ illustration by Art of the Cell ]