When her triple negative breast cancer returned to the same place she thought it was removed, Beata Halassy decided to treat it herself. This Croatian, then aged 50, is a virologist at the University of Zagreb and she rightly thought that the viruses in her laboratory could help her. The first time the cancer appeared, she underwent a mastectomy and later chemotherapy. On this second occasion, Halassy informed his oncologist that he wanted to experiment with oncolytic viruses and he joined the project.
The cancer had already invaded the pectoral muscle at the start of the study. Halassy chose two types of viruses capable of infecting the type of cells causing his cancer: a measles virus and another stomatitis virus. He modified these pathogens so that they could attack his cancer and injected them directly into the tumor. As described in the article signed by herself, the tumor reduced in size, detached from the pectoral and the inflammation surrounding it disappeared after two months of therapy.
The tumor was ready to be removed and they did. From this moment Halassy has been cancer-free for four years. Additionally, he claims he only had a slight fever during treatment when he introduced the stomatitis virus. Halassy finally managed to publish his article in Vaccines after many other scientific journals slammed the door in his face. Although his story is very striking, the scientific community explains that in reality it does not bring anything new and even thinks that its publication could be counterproductive.
an anecdote
“This is nothing more than an anecdote. From a scientific point of view, it is of no importance because “We already know that oncolytic virus therapy works.”says Fernando Peláez, director of the biotechnology program at the National Cancer Research Center (CNIO). As Peláez explains, these therapeutic viruses have been studied for several decades, and in 2016 the T-VEC product for melanoma even appeared on the market. This drug is nothing more than an oncolytic virus injected directly into the tumor.
These viruses are part of what we already call anticancer immunotherapies and act in two simultaneous ways. First, they are genetically engineered to directly attack cancer cells, but also, when they destroy them, they can cause the immune system to learn to recognize and eliminate them on its own. “They have a lot of potential, but they haven’t hatched yet.”. This is a very avant-garde branch of research,” explains Alfredo Corell, professor of immunology at the University of Seville.
“It’s a very physiologicalwhich has few side effects and can be a good combination with chemotherapy, radiotherapy and, of course, surgery”, explains Corell. Marcos López Hoyos, head of the immunology department at the Marqués de Valdecilla University Hospital, also agrees. This is a “promising” therapy already in progress and it will be one of the most advanced anti-cancer therapies, like the famous CAR-T cells, but there is still much to study.
Skip phases
Indeed, one of the aspects that scientists criticize Halassy for is that he skipped several phases of the scientific study procedure. Corell explains that before experimenting on humans, you must pass an ethics committee at your own institute and register the study in a database: “From the start, an ethical filter and another method design filter were ignored”. There are currently several laboratory studies that are in the initial phases, testing the safety of these oncolytic viruses.
“You first have to clearly demonstrate that these viruses are safe, then the effectiveness and the doses that you are going to use. But we are only at the beginning. It is very possible that these viruses will be useful to the future, but we are still defining it,” explains López Hoyos. The three experts also emphasize the fact that there is no guarantee that the effects of therapy on her will be extrapolated to anyone.. It is necessary to increase the number of participants to truly know the response of a drug.
“When you experiment on yourself, you have no way to compare the results, there is no control and you don’t really know why the tumor shrank. Additionally, it combines two different types of viruses, How do you know which of them was effective? »reasons Peláez. “We should do a clinical trial with the two viruses separately, with more patients, with inclusion and inclusion criteria, to see what type of tumors we are going to treat… All this has obviously been ignored and, by Therefore, the results are not extrapolated,” explains Corell.
Ethical issues
However, it was the ethical implications of his work that led several journals to reject him. Halassy ignored the recommendation to undergo chemotherapy and, although she did well and her oncologist was present throughout the process, scientists fear this may encourage those considering rejecting treatment based on scientific evidence. “Put yourself in a situation where the virus had no effect or was directly harmful. You would have lost very valuable treatment time,” says Corell.
“Using yourself in an experiment is reprehensible, anything can happen! But it also represents a relative grievance, a lack of fairness,” denounces Peláez. Halassy has the viruses necessary to perform this therapy, but it is not accessible to almost anyone. “It also promotes the idea that there is a magic cure for cancer that we don’t want to share. But while these viruses offer hope, they will not be a solution for everyone. In the field of cancer, treatments are being discovered for small niches of patients. If something works for 10% of patients, that’s already a lot,” continues the CNIO expert.
Precisely, Peláez explains that having to inject directly into the tumor poses a logistical problem for virotherapy. The first cancers for which it was tested are also the most accessible to an injectionlike the skin or the breast. The three experts are convinced that in the coming years we will hear more about these oncolytic viruses as an adjunct to cancer treatment and increasingly in the early phases of the disease. Until then, it is necessary to continue studying its safety and effectiveness.