Lots of good NET cancer news

There was good news on many fronts—including NET cancer—at the Dana-Farber Cancer Institute’s Gastrointestinal Cancer Visiting Committee sessions Friday. But concerns about budget issues hung heavy in the air as well.

…there is a lot of promising research going on…

Dr. Matt Kulke presented on the Institute’s newly established Program in Neuroendocrine and Carcinoid Tumors and cited a considerable array of progress at both the basic research and drug trial levels. After years of collecting blood samples, work as begun on sequencing the genomes of those with the disease against those who do not. The hope is that work will lead to new ideas on how to attack NET cancer.

NET cancer genome

Collecting and storing the samples cost Dana-Farber about $1 million. Beginning the analysis of those samples has cost $500,000 so far. None of the money for either of those processes came from the federal government or from drug companies. The entire bill has been footed by DFCI donors–who will continue to take responsibility for funding the project.

…the question of viruses as a potential treatment vector was discussed briefly…

But DFCI is in a unique position to carry out this research. The Institute is home to the Center for Cancer Genome Discovery and has made an ongoing effort to champion genetic research into cancer. Since that Center was established about ten years ago the cost of running a genome test—as well as the speed with which it can be done—has plummeted. And DFCI has worked hard to keep the center on the cutting edge of the technology.

NET cancer drug trials at DFCI

Most of the drugs we have in the arsenal—including the drugs currently in trials—are aimed at slowing or stopping the growth of NET cancer. Other than surgery—which really only works well on the disease when it is caught very early—we have nothing in trials that offers a possible cure for those with more advanced forms of the disease.

But there is a great deal in the pipeline at DFCI that may extend high quality life for NET cancer patients. There are seven separate trials ongoing there at the moment ranging from early Stage I to late Stage III.

…a new type of endoscopy using infrared rather than white light…

None of these drugs were originally developed with NET cancer in mind. Rather, researchers have been looking at drugs that are already on the market that attack a pathway we know is involved with the growth and function of NET cancer.

That method led to FDA approval of Sunitinib and Everolimus in May of 2011. Telotristat Etiprate, which is currently in human trials, may soon join those two drugs. After a nearly 30-year drought during which no new drugs were approved for the disease in the US, that represents major progress.

Discovering NET cancer remains tough

But there is not much on the horizon that will improve our ability to detect NET cancer in its early stages. That makes finding new approaches to curing the disease even more important.

…there is a great deal in the pipeline at DFCI…

There was one potential bright spot in this area, however. One of the other presentations talked about a new type of endoscopy using infrared rather than white light. It seemed to me this technology might make the detection of NET cancer tumors more likely during colonoscopies, though the discussion of the new method was limited to more traditional tumors.

Oncolytic NET cancer virus

The Swedish NET cancer virus did not come up during the formal sessions, though the question of viruses as a potential treatment vector was discussed briefly as a possibility. However, I raised the issue of that particular virus in private discussions with both Dr. Charles Fuchs, the head of the DFCI Gastrointestinal Department, and Dr. Kulke. Dr. Fuchs said he saw no reason the virus could not be patented and tested in this country—and Dr. Kulke concurred. He is meeting with Professor Magnus Essand, the developer of the virus, in a few weeks and said he would have a discussion with him about the virus then.

The entire bill has been footed by DFCI donors…

Both, however, pointed out other issues with the development of the virus: safety protocols and ethical considerations. The problem with viruses is that, like drugs, you cannot be sure what they will actually do when you give them to humans no matter what prior testing suggests. And unlike drugs, viruses can spread among the human population through various forms of contact. Further, they can mutate if they escape into the wild in ways we cannot anticipate.

Potential viral problems

They also reminded me of an attempt a number of years ago to use a virus to fight a genetic disorder. Someone died in an early trial because of his reaction to the virus.

The hope is that work will lead to new ideas…

Viral research in the US is subject to a laundry list of ethical and safety protocols drugs do not face to the same extent. Even if the virus can be patented here and a drug company be found to fund the trials, the testing will have those additional hurdles to clear.

But while there is a lot of promising research going on, especially in NET cancer, the financial side of things is anything but rosy.

Next: The Fiscal Cliff and NET cancer