I wanted to let all of our patients, followers, and friends know that I had the opportunity to go to Nashville the 1st week of July 2018 to the United Mitochondrial Disease Foundation Meeting. I presented a nice poster at that meeting entitled, “Antibiotic Over Usage Causing Modern Plagues: Mitochondrial Dysfunction Promoting Neurodegeneration and Tumorigenesis.”
Dr. Elliott’s poster presentation at UMDF 2018
My co-research participants were Mr. Jiang, Director of Research at our Foundation and Dr. Catherine Baucom my surgical oncologist associate.
This poster emphasized the misuse of antibiotics and how they are causing problems in patients and in people because our mitochondria are siblings of bacteria and they share some of the same protein machinery that manufacture proteins that bacteria do.
Mitochondria are siblings of bacteria
So, if antibiotics can help us with bad germs and some of the bacteria that causes severe infections, they can also cause Mitochondrial dysfunction in the rest of our cells.
These slides show antibiotics cause significant, sometimes detrimental changes in cells in culture
Our research suggests that the dysfunction that antibiotics cause to our mitochondria can be minimized by taking a strong antioxidant such as N-acetylcysteine (NAC).
Overview of how antibiotics damage mitochondria.
In summary, our research suggests that antibiotics can kill normal human cells by hurting the mitochondria. We are currently working on trying to find a potential solution so that we can maybe prevent the ongoing damage to our mitochondria.
Last week, in part one of this series of The New Cancer Immunotherapy, we discussed there are 2 types of cancer vaccines.
Personalized Cancer Vaccines
Therapeutic Cancer Vaccines
We briefly discussed the indications for personalized cancer vaccines last week, and this week the focus of this blog is Therapeutic Cancer Vaccine. At the present time, there are not too many therapeutic cancer vaccines. There are a lot of targeted monoclonal antibodies to tumors that are passive immunotherapy, but as far as active adaptive immunotherapy, there are not very many therapeutic vaccines approved at this time.
The therapeutic cancer vaccine is a type of personalized vaccine that will be associated with a combined approach to:
vaccine to activate the effector system to the target
inhibit and depress the suppressive system such as the T-regulatory cells and many others
disrupt the immunosuppression in the tumor microenvironment
T-regulatory cells
TGF-B
HLA-G and possibly HLA-E
IL-10
Arginase
Ferritin and free iron
myloid derived suppressor cells (MDSCs)
Cancer associated fibroblasts (CAFs)
Indoeamine 2,3-dioxygenase (IDO)
A vaccine in both cases is similar except you do not have to fight to disrupt the tumor microenvironment in the adjuvant setting or in Stage IV patients that is in total remission or has very low tumor burden.
The Therapeutic vaccine will be used with other therapeutic modalities and timed during the treatment protocol to have maximum effect. There are many things to monitor to determine as to when to vaccinate. Once the effector system is turned on you may want to use checkpoint inhibitors and if response is not where we want it then more attack on the tumor microenvironment is indicated.
Both types of vaccines need other complementary adjuvants.
a good probiotic
no ketogenic diet for 10 days (5 days before and 5 days after the vaccine)
take an AHCC great immune mushroom product before the vaccine and during the vaccine period
if the patient is on a fermented wheat germ, it should be stopped 5 days before the vaccine and held for up to 1 week after the vaccine
N-acetylcysteine (NAC) – this should be taken for 2 weeks after the vaccine. Activating lymphocytes last longer without exhaustion and also develop better and longer memory when this antioxidant is given during clonal expansion.
in Stage IV patients – may need to condition injection site with immunomodulators that stimulate Toll like receptors.
These are just a number of important conditions that need to be created for cancer immunotherapy to have its best effect. It is much more complicated than I have explained here, but it is a good start and overview.
I want all to know that we are also addressing some of the more complex issues especially in tumor immunosuppression and the tumor microenvironment, and how we can combine checkpoint inhibitors with the vaccine and other immunomodulators to improve overall results.
If the Stage IV patient is to stay in remission after treatment, the secret will be that they have developed a good host immune system turned on to their particular target to the cancer they had. Therefore, personalized cancer vaccines should be truly personalized because each patients cancer is different even though it may be the same cell type. There are multiple mutations that people share and many times they are not the same mutation from one person to the other. There is still much to learn about cancer vaccines and cancer immunotherapy, but the field is expanding rapidly and for it to be practical for the community and affordable we believe using the patients own tumor and doing personalized vaccines as to what that tumor expresses gives the patients the best opportunity to have cancer remission.
Cancer Immunotherapy is a very broad term. This is a two part series we will discuss, and part 1 is an overview of how we have been using immunotherapy to treat cancer.
Most of you know that I am involved in cancer immunotherapy and supporting the host immune system in the cancer patient for 30 years. We have developed a breast cancer vaccine and received a patent on that in 1994. Our cancer vaccine has been used in patients with a depressed immunity to their own breast cancer after receiving standard of care treatment. We published a paper on that in 2013 showing that definitely improved disease specific survival. Several years ago, I published an editorial that host immunity in clinical oncology was ignored in the United States.
In the last 4-5 years there has been a big interest in the immune system where cancer is concerned and a big push to develop personalized cancer vaccines, DNA vaccines and what they call check-point inhibitors which have gotten publicity lately. Now the oncology community is realizing that the immune system plays a very important role in how the patient deals with their cancer and how they survive their cancer. It is also recognized that some chemotherapy which is immunosuppressant used in the proper setting can be complemented by immunotherapy and that they are at times synergistic. A new era for cancer immunotherapy is evolving and that is a great thing. In my practice, I have decided to concentrate on innovative, personalized cancer vaccines.
Cancer vaccines can be divided into two groups –
personalized cancer vaccines
therapeutic cancer vaccines
Personalized Cancer Vaccines
What are the indications for personalized cancer vaccines? they should be used in the adjuvant setting (after chemo, surgery, and radiation). That means that this type of vaccine should be used in patients who have been treated for their cancer with standard of care treatment and they should have their immune system evaluated. Since surgery, chemotherapy, and radiation all affect the immune system, the immune system should be evaluated around 12 weeks after any of these modalities are used. If patients have depressed lymphocyte specific immunity to their own cancer, they should be considered for a vaccine in the adjuvant setting to decrease their risk of recurrence.
We already have proof of principle in breast cancer with the vaccine that we have developed. This adjuvant vaccine theory should be applied to all solid epithelial tumors and possible soft tissue tumors such as colon, lung, breast, prostate and melanoma. It is also possible with further experience and research that this type of vaccine could possibly be preventive if directed to its target.
In the Part 2 of this series we will discuss therapeutic cancer vaccines and when to use personalized or therapeutic vaccines.
