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Empowering ‘millions of women’ against HIV

AMP study in sub-Saharan Africa tests an antibody infusion that could put protection in women’s hands

Oct. 21, 2016 | By Mary Engel / Fred Hutch News Service

CAPRISA eThekwini research clinic in Durban, South Africa

Community outreach worker Musa Gumede, left, clinical trial volunteer Banqobile Mzeka, middle, and community advisory board member Nkosikhong “Uzzi” Mpungose gather at the CAPRISA eThekwini research clinic in Durban, South Africa, one of the sites in the AMP HIV Prevention Study.

Photo by Robert Hood / Fred Hutch News Service

Dr. Nyaradzo Mavis Mgodi is often asked about an antibody now being tested in clinical trials to see if it can protect women from HIV.

She begins by talking about Mary Moyo.

Mary was 18 when she married 27-year-old Mike in Harare, Zimbabwe. When Mary became pregnant, she and Mike were tested for HIV.  Mary tested negative, but Mike was found to have HIV.

Their doctor recommended that Mike use condoms to protect his wife from infection. Mike refused, saying he had paid lobola, or bride price, to Mary’s parents and could do whatever he wanted. He beat her if she refused to have unprotected sex.

“All over southern Africa, women like Mary suffer silently,” Mgodi said, after recounting Mary’s story most recently at the international AIDS 2016 conference in Durban, South Africa. “There are millions of women who need empowerment. That is why we are embarking on the AMP study.”

A researcher at the University of Zimbabwe-University of California San Francisco Collaborative Research Program in Harare, Mgodi will discuss what AMP — antibody-mediated prevention — could mean for women like Mary today at a meeting of the 2016 HIV Research for Prevention, or HIVR4P, conference in Chicago. The international gathering of researchers and activists focuses on all methods of preventing HIV infections.

Mary’s story had a happier ending than many, Mgodi said. She fled the beatings — and the marriage — before becoming infected with HIV. Now she is trying to start her life over.

Mgodi is determined to help her and other sub-Saharan African women by finding a way they can protect themselves from HIV infection without their partners' help.

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Gene therapy goes global: Portable device could make future cancer, HIV cures affordable

Portable 'gene therapy in a box' could make future cancer, HIV cures affordable in developing countries

Oct. 20, 2016 | By Mary Engel / Fred Hutch News Service

Dr. Jennifer Adair gene therapy in a box

Fred Hutch's Dr. Jennifer Adair stands before the portable "gene therapy in a box" device that she began developing when she became head of her own lab in 2014. "I was so motivated by the problem that it's undertaking — specifically, distribution to places in the world that don’t have any access to this type of therapy now," she said.

Photo by Robert Hood / Fred Hutch News Service

A tabletop device that enables medical staff to genetically manipulate a patient’s blood to deliver potential new therapies for cancer, HIV and other diseases would eliminate the need for multimillion-dollar “clean rooms,” making gene therapy more possible for even the poorest of countries.

The so-called “gene therapy in a box,” developed by scientists at Fred Hutchinson Cancer Research Center, delivered modified blood stem cells that were as good as — or better — than those manufactured in highly regulated clean rooms and required less than half the staff, according to a study published today in Nature Communications. The adapted cells also successful repopulated the blood system when tested in two different animal models, the study noted. It hasn’t yet been tested in humans.

The portable device suggests a solution to one of the most vexing challenges of gene therapy: how to make these emerging, high-tech treatments accessible and affordable, beyond a handful of specialized research centers to clinics worldwide.

“We either had to think about how to build million-dollar infrastructure and clean-room facilities in clinics all around the world, which is not feasible, or we had to think about simplifying this process into what I originally envisioned as a black box,” said Fred Hutch researcher Dr. Jennifer Adair, the study’s lead author. “This was the first proof that ‘gene therapy in a box’ could work. Gene therapies or cell therapies that involve genetically modified cells are not restricted to a very small number of highly sophisticated facilities anymore.”

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Physician-scientist Dr. Bruce Clurman named executive vice president and deputy director of Fred Hutch

Clurman will focus on team science, interdisciplinary collaboration in pursuit of new cures, said President and Director Dr. Gary Gilliland

Oct. 18, 2016 | By Rachel Tompa / Fred Hutch News Service

"I couldn’t imagine wanting to work like this anywhere else,” said Dr. Bruce Clurman, the incoming executive vice president and deputy director of Fred Hutch. Clurman's new position takes effect Nov. 1.

Photo by Bo Jungmayer / Fred Hutch News Service

In his 25th year as a physician and researcher working at Fred Hutchinson Cancer Research Center, Dr. Bruce Clurman is getting ready to step into his newest role — executive vice president and deputy director of the Hutch.

Fred Hutch President and Director Dr. Gary Gilliland announced Clurman’s appointment, effective Nov. 1, on Tuesday. Clurman will step into the position vacated by outgoing Executive Vice President and Deputy Director Dr. Mark Groudine, who has served in those roles for 11 and 19 years, respectively. Groudine will continue to lead his basic research laboratory and will serve as special advisor to the director’s office. Clurman will work alongside Fred Hutch’s other executive vice president and deputy director, Dr. Fred Appelbaum, who has held that position since 2013. Clurman will also serve on the board of Seattle Cancer Care Alliance, Fred Hutch’s clinical care partner.

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‘We have an army’: Vice President Joe Biden delivers 'Cancer Moonshot' goals

Top priority, catalyzing scientific breakthroughs, calls for interdisciplinary approaches to speed cures

Oct. 17, 2016 | By Sabin Russell / Fred Hutch News Service

Vice President Joe Biden and President Barack Obama

President Barack Obama holds a summary of the Cancer Moonshot Report presented to him Monday by Vice President Joe Biden, left.

Photo by Susan Walsh / AP

With a sheaf of recommendations in hand, Vice President Joe Biden visited the Oval Office on Monday to deliver the final report of his Cancer Moonshot Task Force, just nine months after President Obama famously put him in charge of it.

Packaged within 38 pages, the report lays out a strategy “to achieve a decade of progress in 5 years,” placing heavy emphasis on harnessing the power of the immune system to fight tumors, and using supercomputers to pick precise therapies by sifting mountains of biomedical data.

At the White House, Biden blended soaring rhetoric about America’s capacity to achieve great things with a sober assessment of the challenges facing this moonshot. “There’s only one moon,” he said. “There are 200 cancers.”

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Replenishing immune cells after remission

New approach, not yet tested in humans, aims to restore immune-powering B cells in cancer patients following successful CAR T-cell therapy

Oct. 17, 2016 | By Bill Briggs / Fred Hutch News Service

Dr. Stan Riddell

Dr. Stan Riddell

Fred Hutch file

Like deployed troops never told the war is over, modified immune cells dispatched to hunt and kill blood cancers continue their work long after the job is complete, leaving many patients in remission but chronically prone to serious infections.

It is one side effect of a promising immunotherapy that uses re-engineered cells, known as CAR T cells, to target malignant B cells in people with leukemia and lymphoma. After the cancer is gone, CAR T cells can keep finding and attacking healthy B cells that are needed to ward off invading bacteria and viruses.

Now, scientists at Fred Hutch, Seattle Children’s Research Institute, and the Technical University of Munich have demonstrated that activating a “kill switch” can turn off CAR T cells after doctors deem the cancer is defeated, allowing normal B cells to again flourish, according to a study published Monday in the Journal of Clinical Investigation. 

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HIV prevention gains bring hope — and challenges

Injectable PrEP and other options are in the pipeline, and that makes clinical trials more complicated

Oct. 14, 2016 | By Mary Engel / Fred Hutch News Service

Injectable PrEP will be tested against Truvada for HIV prevention

Illustration by Kimberly Carney / Fred Hutch News Service

A clinical trial set to begin later this year will test whether an experimental drug injected every two months protects against HIV infection as effectively as a once-a-day pill called Truvada. If it does, the long-acting PrEP drug — for “pre-exposure prophylaxis” — would add another major tool to an HIV prevention toolbox that for the global pandemic's first 30 years was limited to education, testing and condoms.

The study comes as the HIV field enters what researchers are calling a new era of prevention, with additional clinical trials launching that will test infusions of anti-HIV antibodies and a promising vaccine candidate. That’s extraordinarily good news for a pandemic in which 35 million people worldwide have died from AIDS-related illnesses since the first cases were reported in 1981 and 2.1 million are newly infected each year.

But prevention advances, as welcome as they are, come with a twist: They complicate the task of designing the very clinical trials needed to test additional tools.

A prime example involves the experimental, injectable drug called cabotegravir. Because it is a new version of a PrEP rather than an entirely new method of prevention, it will be tested against the PrEP pill, Truvada, which was approved for use in 2012, rather than against a placebo.

These types of trials are more complex to design, run and interpret than trials that simply show whether something works.

“Once you have something that actually works to prevent HIV, you move from trials where you’re trying to prove something works to trials where you’re trying to prove that something works as well as the existing thing,” said Dr. Deborah Donnell, who helped design the trial. “It is a hard trial to do, scientifically. It’s just easier to prove that things are different than to prove that things are the same.”

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