London Diabetes Trial: Diabetes (1)

The development of MultiPepT1De, and the science behind it, has been funded by the Wellcome Trust, Juvenile Diabetes Research Foundation (JDRF) and Diabetes UK.
The primary goal of the study is to assess the safety of the treatment, but researchers will also be looking at its effectiveness, including whether any protective effect continues after the injections have stopped.
Professor Peakman said laboratory and animal model research had produced promising results, and early studies in patients showed some potentially important immune and metabolic changes.
Jack Meaning, aged 29, an economist, was diagnosed with type 1 diabetes in October 2014. He was on a trial of an earlier, simpler version of the immunotherapy, MonoPepT1De, which has now been completed, although the results have yet to be published.

Protective response:
All the volunteers will receive six injections, four weeks apart.
In healthy people the immune system has a complex system of checks and balances to enable it to destroy harmful pathogens - but not healthy tissue. Part of the regulation is done by T regulatory cells, which suppress the immune response from attacking the body.
The injections contain peptides - small fragments of protein molecules found in the insulin-producing beta cells of the pancreas.
It is hoped these will prompt T regulatory cells in the immune system to mount a protective response to the beta cells, so re-training the immune system.


The hormone insulin is used to control blood sugar levels.

Diabetes:
There are two main types of diabetes -

• Type 1 - where the pancreas does not produce any insulin
• Type 2 - where the pancreas does not produce enough insulin - or the body's cells do not react to insulin

Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood.
Around 10% of all diabetes is type 1, but it is the most common type of childhood diabetes, so it is sometimes called juvenile diabetes or early-onset diabetes
In type 2 diabetes, the body either fails to produce enough insulin to function properly, or the body's cells do not react to insulin. Around 90% of adults with diabetes have type 2, and it tends to develop later in life than type 1.

Skin Cancers Reduced Dramatically

Drugs eliminate 20% of tumours in Skin Cancers

                                            

 Melanoma is a dangerous and aggressive type of skin cancer

A fifth of people with advanced melanoma have no sign of tumours in their body after treatment with a pair of immunotherapy drugs, a study shows.

The first survival data on using ipilimumab and nivolumab in combination showed 69% of patients, in a trial on 142, were still alive after two years.
UK doctors leading the trial said the results were "very encouraging".
Melanoma, the most serious form of skin cancer, is the sixth most common cancer in the UK
It kills more than 2,000 people in Britain each year.

More studies on the emerging field of immunotherapy will be presented later.

Immunotherapy revolution:

The immune system is a powerful defence against infection. However, there are many "brakes" built in to stop it attacking our own tissues. Cancer - which is a corrupted version of healthy tissue - can take advantage of those brakes to evade assault.

Ipilimumab and nivolumab are designed to cut the brakes.
Both have become standard therapies in melanoma, but most researchers believe combination therapy will be essential.
The trial showed the survival rate after two years for ipilimumab alone was 53% and no patient's tumours had completely disappeared.
The equivalent figures for combination therapy were 69% and 22%.
However, more than half of patients had severe to life-threatening side effects which stopped their treatment.
Dr. James Larkin, who ran part of the trial at the Royal Marsden Hospital in London, told the BBC News website: "It is very encouraging to see that survival rate.
"It will be important in terms of working out the benefit of these treatments in the longer term, but nevertheless it's a relatively small study still."
A much larger trial involving nearly 1,000 patients has already started releasing data, but has not run for long enough to produce survival figures.

Vicky Brown, 61 and from Cardiff, was diagnosed with malignant melanoma that had spread to her lungs and breast in April 2013.
She started the combination therapy later that year.
"It worked within a month. There were lumps I could actually feel and they disappeared quite quickly," she told the BBC.
She did face severe side effects including an upset liver and inflamed bowels and a year later the cancer returned.
She is now on her second course of combination immunotherapy, which again seems to have shrunk the tumours.
"My granddaughter is now coming up to four and I now have a second grandchild and not to have been part of their lives would have been heartbreaking, so I'm really thankful," she added.

Historically, when a treatment fails and a cancer starts to grow again then that drug has become useless. But Dr. Larkin thinks "we're dealing with something different here".
He added: "This combination of drugs alters the balance of immune system, two years down the line the immune system might have stopped recognising the tumour.
"To me it is extremely encouraging that giving the combination again we can reintroduce recognition by the immune system - it is like a booster dose."
Both drugs were developed by Bristol-Myers Squibb.
Professor Richard Marais, from Cancer Research UK, said the results were "exciting" and "offer new hope to melanoma patients and their families".
However, he added: "It's important to remember that there's an increased likelihood of severe side effects when these drugs are combined.
"We need to identify which patients are most likely to benefit from this combination and also which patients are most likely to experience the side effects.
"That will help doctors to ensure each patient gets the best treatment they need."