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This is a brief update on Terence from his brother Dennis:
Terence has decided to proceed with the p53 gene therapy protocol, which is an
experimental protocol in Phase I clinical trials here at the UCSF Med Center. It involves
using a genetically engineered adenovirus to deliver a gene, p53, to the tumor, which
codes for a tumor suppressor protein. P53 is mutated or damaged in cancerous cells, which
is one reason they are cancerous in the first place. The virus is used to replace the
defective gene with an active, wild-type gene; if the cells take it up, and the gene is
functional, it should program the cells to stop growing, and to die.
It's a great idea, and the closest thing to a magic bullet that high-tech medicine has
come up with so far. It's also highly experimental and unproven; Terence is the fourth,
or fifth person in the world to ever receive this therapy. The other patients were all
treated recently so there is no data on whether it has worked for them or not. It has
worked rather spectacularly in animal models, which is one reason we felt it was worth a
shot.
He's now in recovery, having completed the first and easiest step of what is a two stage
process. First, he was given a biopsy to determine that the tumor was still alive, and
active, and to collect tissue for later uses. This first procedure, other than getting a
biopsy, is not therapeutic, it is part of the protocol, to determine if the cells do in
fact take up the gene and express it. It's important for the research that this be known,
but does not directly benefit Terence (but it will afford an idea if the therapy is likely
to work). Then, a catheter was implanted into the tumor bed, and the virus cocktail was
administered over about 10 minutes. Now he has to remain in the hospital for three days,
with the catheter implanted. He can get up and move around, and does not seem to be set
back much from this first procedure (he was conscious and under very light anesthesia
during this phase). So he is staying in the hospital over the next few days so they can
monitor him and also to minimize the risk of
On Monday, he will receive the "big op," which is a craniotomy in which they will remove
the bulk of the tumor, and will administer additional adenovirus/p53 to the tissue that
remains following surgery. This second operation, the craniotomy and debulking of the
tumor, and in which he will get more adenovirus, is designed to be therapeutic. He will
in any case get the craniotomy, which is being done by one of the world's best
neurosurgeons, Dr. Mitch Berger. He will also get an additional dose of the p53 gene,
which, if it is taken up into the tumor cells and expressed, will definitely be
therapeutic if it works.
If it does not work, Terence will still benefit from the craniotomy; and, the gene therapy
does not preclude him from receiving additional treatments down the line, which was one
reason we decided to go for it; it did not require that we "burn any bridges," as the
doctor put it. So far, so good. We are keeping our fingers crossed and hopes up for a
similarly successful outcome on Monday.
Keep your good vibrations coming our way, and look for an additional update to come your
way by the middle of
next week.
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forwarded by
Ian J.Lewis
www.ndimension.org.uk
