Hosts: Vincent Racaniello, Alan Dove, Rich Condit, and Kathy Spindler
The TWiV gang answers follow-up questions about the Ebola virus outbreak in West Africa, then discuss treatment of disseminated multiple myeloma with oncolytic measles virus.
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Download TWiV 298 (76 MB .mp3, 106 min)
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Links for this episode
- Use of unregistered interventions for Ebola virus disease (WHO)
- Response to anthrax and H5N1 incidents (CDC)
- Remission of disseminated cancer after treatment with oncolytic measles virus (Mayo Clin Proc)
- New viruses for cancer therapy (Nat Rev Micro)
- Cattaneo on TWiV
- Image credit
- Letters read on TWiV 298
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Send your virology questions and comments (email or mp3 file) to firstname.lastname@example.org
Great show as always. To chime in on the massive dose used, I think it’s worth keeping three things in mind: 1) this isn’t a traditional inoculation. Here, you’re trying to productively infect all cancer cells in a person, far and wide. So I think it’s reasonable to assume you’ll need a massive dose to achieve a usable multiplicity in an entire person (note: some gene therapy trials have used over 10^13, so one might debate whether 10^11 is even high). Presumably, much of the virus is cleared since it doesn’t (physically) have access to CD46 [high] cells or might be titrated out by CD46 [normal] cells, plus there’s potential residual immunity as you mentioned. 2) This is a dose escalation trial to assess safety. Based on these early results, they might have undershot dose but this is likely all the FDA would allow. Maybe they can spread larger doses out over time to attenuate “cytokine storms”. 3) These patients have no other options. They are “astronauts” risking their lives but their lifespan and quality of life are limited without pushing the envelope. The patient with recurring disease is the likely outcome of under dosing. There are significant risks either way.
Thanks for making the time to educate and entertain me during me soul-crushing commute. It’s much appreciated.
Many thanks for answering my comments regarding the Ebola virus in your last podcast. I have family living just south of PR Congo (formerly Zaire) several of whom might appreciate sound, scientific information such as this. Thanks for taking the time to share what you know thus far.