Memorial Sloan-Kettering Cancer Center.
Memorial Sloan Kettering Memorial Center (Memorial Sloan Kettering) is one of the best and oldest oncology centers in the world. MSKCC is located in New York, USA.
In addition to world-class medical services, much attention in this center is paid to clinical research and development of new cancer treatment methods.
Dozens of experts in the field of pediatric oncology are working on safer methods of therapy and improving the quality of life of sick children.
Clinicians at the Sloan-Kettering Memorial Cancer Center are working together with other US research centers to study the pathogenesis of cancer in children (mechanisms for the emergence and spread of cancer cells), as well as over new biological agents. MSKCC experts in this case are responsible for transferring the results of scientists' work into clinical practice - this is called translational research.
Risk-adapted therapy.
The Sloan-Kettering Memorial Cancer Center has achieved tremendous results in the treatment of neuroblastoma, certain types of leukemia and lymphoma, and sarcomas in children and adolescents. First of all, this concerns risk-adapted therapy, in which patients are divided into groups with different intensity of therapy depending on risk factors and the expected response to treatment. To assess the risk, the center's experts have learned how to effectively use the latest imaging techniques and laboratory tests.
Experience of children's oncologists MSKCC allows to guarantee the most sparing, but at the same time, effective treatment with a minimum of side effects for children with a low risk of spreading the tumor or returning the disease after therapy. The purpose of such treatment is not only to defeat the disease, but also to enable the child to lead an almost full life, filled with normal children's pleasures. This is practically impossible to achieve without an innovative risk-adapted approach.
Clinical trials.
In MSKCC, a child can become a participant in a new method of therapy for a particular type of cancer. Clinical teams of the center have extensive experience in conducting clinical trials of I and II stages in the earliest stages of drug development.
More than half a century of working on new options for treating cancer in children in Memorial Sloan Kettering have borne fruit: the percentage of cancer patients has grown to 70%, while in the middle of the last century most children with cancer were doomed.
The Sloan-Kettering Memorial Cancer Center cooperates with the American organizations Children's Oncology Group (COG) and the Bone Marrow Transplant-Clinical Trials Network (BMT-CTN). MSKCC serves as the focal point for the Pediatric Oncology Experimental Therapeutics Investigators' Consortium (POETIC).
Examples of unique methods of cancer treatment in children:.
Treatment of neuroblastoma with 3F8 antibodies.
The standard treatment for neuroblastoma in the US usually involves intensive chemotherapy, often combined with stem cell transplantation. Such therapy has limited efficacy and serious side effects.
Over 20 years, the Sloan-Kettering Memorial Cancer Center uses a unique method of treatment with antibodies (immune proteins) called 3F8. The introduction of 3F8 in combination with surgical treatment and chemotherapy significantly increased the survival rate of children with neuroblastoma. At the same time, the course doses of chemotherapy drugs decreased, which means that the treatment became less toxic.
Every day the doctors of the center conduct treatment with 3F8 protein on an outpatient basis, which sometimes allows them not to detach the child from ordinary life. Recently, scientists have developed an improved version of antibodies that will more selectively affect the cells of neuroblastoma. Due to their high specificity, new antibodies can be used for a longer time than other biological preparations.
In addition, today, researchers at the American Center are working on other types of antibodies to fight neuroblastoma. Also scheduled clinical trials of antibodies against sarcoma of bone in children and adolescents.
Treatment with radioactive antibodies.
Tumors that metastasize into the brain and spinal cord are very difficult to treat. At the disposal of American oncologists now have radioactive antibodies that penetrate into the cerebrospinal fluid, radiate radiation and help fight metastatic tumors in the CNS more effectively. Speech about the antibodies 8H9, which in the US are available only in Memorial Sloan Kettering.
Center experts say that promising results were demonstrated in the treatment of children with neuroblastoma, which gave metastases to the central nervous system. Many patients managed to achieve a long remission. Together with specialists in nuclear medicine, radiation safety, medical physics and neurosurgery from other centers, MSKCC experts are working to improve these antibodies in order to achieve a long post-effect.
Center doctors also use radioactive antibodies to treat other aggressive tumors in children, including the dermoplastic small cell tumor (DSRCT). According to the latest protocols, patients with DSRCT begin treatment with intensive chemotherapy in combination with a biological drug bevacizumab (bevacizumab). If possible, the tumor is surgically removed with subsequent chemotherapy. Today, employees of the center test radioactive antibodies, which are additionally introduced into the abdominal cavity.
Cell therapy.
To fight infections and cancer, our body needs a healthy immune system. A special type of immune cells, T-lymphocytes, help fight infections. When a patient is transplanted with bone marrow or stem cells, then first his immune system is weakened and the number of T cells is insignificant. Therefore, there are fears associated with cytomegalovirus infection (CMV) or the Epstein-Barr virus. These infections can cause serious complications, up to the development of a new cancer.
Researchers at the Sloan-Kettering Memorial Cancer Center were the first in the world to show that the Epstein-Barr virus can be more effectively controlled if additional small amounts of T cells are added from the bone marrow of the donor. They also began to "teach" these lymphocytes in the laboratory to recognize virus-infected cells, that is, activated T cells before administration to the recipient. This technique is called adoptive immunotherapy (adoptive immunotherapy). Today, the center conducts tests, during which scientists will search for the most effective scheme of adoptive immunotherapy.
For many recipients with viral infections after organ or bone marrow transplantation, donor T lymphocytes are no longer available. In these cases, it is possible to train T-cells from other donors to fight with the necessary infection, and then introduce them to the patient. This technique is also handled by MSKCC researchers.
Scientists use adaptive immunotherapy when teaching immune cells to attack cancer cells that produce abnormal proteins inherent only to them. Two such proteins produce many types of cancer cells: WT1 (a protein named after the Wilms tumor) and NY-ESO-1, discovered in Memorial Sloan Kettering. In clinical trials, T lymphocytes are used that are grown in the laboratory specifically to kill such cells.
Vaccines and immunomodulatory therapy.
At the moment, Memorial Sloan Kettering is testing the newest biological drug, ipilimumab,. It is an antibody against a molecule that is on the surface of some lymphocytes. If you "disguise" this molecule with antibodies, you can free up significant resources of the immune system to fight cancer.
For the treatment of osteosarcoma in children, a drug muramyl tripeptide. This substance stimulates macrophages that must devour cancer cells.
In a randomized, placebo-controlled study, the researchers found that muramyltreeptide in combination with the traditional chemotherapy regimen significantly improved patient survival.
A new potent vaccine against cancer cells showed very good results in patients with high-risk metastatic neuroblastoma. In the past, it was almost impossible to achieve a second remission with this disease, but today this is not the limit. Most of the children who received this vaccine during the tests are still alive, and they feel satisfactory.
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