Connecting Nobel Medicine 2018 to Vietnam

The 2018 Nobel Prize in Medicine honours American scientist James P. Allison and Japanese Professor Tasuku Honjo for their breakthrough discovery in cancer treatment. This therapy has already been used in cancer treatment in Vietnam more than a year!

Modulation of immune cells in cancer treatment at the Gene-Protein Research Centre under the Hanoi Medical University. (Photo: Nam Anh)
Modulation of immune cells in cancer treatment at the Gene-Protein Research Centre under the Hanoi Medical University. (Photo: Nam Anh)

Improving the lives of patients

Every day, the study group on the immune cells in cancer treatment of the Gene-Protein Research Centre of Hanoi Medical University regularly receive phone calls from cancer patients registering for new treatment based on the mechanism of the two scientists who have just won the 2018 Nobel Prize in Medicine. From the beginning of the year, at Hanoi Medical University’s Hospital, 20 patients have been undergoing this pilot therapy.

Do Tien H, 30, from Hanoi, discovered pharyngeal cancer in the third stage in 2015. He repeatedly followed radiation therapy at Bach Mai Hospital. In the middle of 2017, the disease recurred and the tumor spread into the spine, forcing him to have spinal surgery and continuous radiation therapy. In September 2018, Hai was introduced to Hanoi Medical University’s Hospital for treatment under immune therapy, inhibiting cancer cells within three months through six courses. His condition has been significantly improved.

Hai said, in the past, his resistance was low, and he always got colds, cough, fever, and pains when facing unfavoured weather, but now he feels very well. Currently, the pain is no longer the same as before but only numbness. “I felt that healthy cells when being infused into the body have proved their effectiveness, and the resistance has increased markedly. Hopefully, the next three transmissions will not only help reduce pains but also decrease my disease’s severity,” Hai said.

When it comes to cancer, many people immediately think about the mental and physical depletion of patients, the side effects caused by chemotherapy and radiation therapy and especially the terrible pains at the final stage of cancers. But the therapy being applied experimentally at Hanoi Medical University’s Hospital has helped patients and their families overcome these obsessions.

A breakthrough in cancer treatment

Immunotherapy is considered the 21st century’s approach in the treatment of cancer around the world. It is to enhance the resistance of the patients themselves to the exotic and abnormal agents, including cancer or other types of diseases. "Every day, in a normal body, there are around 3,000 abnormal cells produced. When the resistance is good, the immune system recognises these cells and destroys them. But for some reason, if the immune system does not recognise them, from only one abnormal cell, it will develop into tumors over a few years,” said Associate Professor, Dr. Tran Huy Thinh, Deputy Head of Department of Chemistry - Biology and Vice Director of the Gene-Protein Research Centre - Hanoi Medical University.

When carrying out biopsy on slices of cancer cells, it is found that the cancer cell is located next to the immune one without being destroyed. There exists an "underground" mechanism for these two types of cells to "shake hands" with each other. Therefore, it is necessary to "lock" this cooperation. This is also the mechanism of the immune therapy. Prof., Dr. Ta Thanh Van, Rector of Hanoi Medical University cum Director of the Gene-Protein Research Centre, is an excellent Vietnamese student of Prof. Tasuku Honjo in Japan. Prof. Van is also the first to bring Prof. Honjo's breakthrough cancer treatment application to Vietnam. He had three years (from April 2003) working at Prof. Honjo's lab as a scientist and a post-doctoral research student at Kyoto University. At that time, Prof. Honjo has been a big name in the field of molecular biology, owning four breakthrough inventions equivalent to four Nobel Prizes.

Prof. Ta Thanh Van (R) and Prof. Tasuku Honjo in Japan.

“Because Honjo's research team often engages in spearhead and hot fields in the world, such as immunology and cancer, the work intensity is extremely stressful. The whole lab is like a factory, and lights are never turned off. Everyone enjoys canned meals and just take public baths. Every month the lab produces research that is posted in the world’s famous scientific journals,” recalled Prof. Van.

In Honjo's lab, Prof. Van pursued the research topic on the mechanism of the enzyme encoding gene involved in the synthesis and transformation of antibodies in humans. It is activation-induced cytidine deaminase (AID) that has important applications in cancer pathology, immunodeficiency and autoimmune disease. This work was published in the world’s famous journal Nature Immunology in 2003 and has been highly regarded by the scientific community.

Having had a huge opportunity to stay abroad to work, Prof. Van still decided to return to Vietnam and set up the Hanoi Medical University’s Gene-Protein Research Centre following his teacher’s advice. Here, the research team by Van and his colleagues applied Prof. Honjo's immune therapy but followed a different approach. It is self-treatment in cancer treatment.

“Two 2018 Nobel Prize winners followed the principle of activating cellular immune activators right in the tumor on the body. And the therapy at Hanoi Medical University is that we take the immune cells from in the body of the patients, then multiply and activate them outside the body. From the initial number of several million, the cells are then activated into billions before being put back inside the patient's body,” Prof. Van analyzed.

This is a new therapy that is only available in scientific works but no one has thought of implementing it. Responsible for expertise and technology transfer to Vietnam, Prof. Van has spent a lot of effort persuading and explaining to gain the consent from the relevant scientists, professors and the professional council members.

Along with that are the infinite issues regarding facilities, human resources and funding for research. But as the person to bring this therapy to Vietnam, along with great benefits for patients, Prof. Van has had to remove bottlenecks step by step, like sending staff to join training abroad, building a standard laboratory, and receiving technology transferred from Japan. He introduced Assoc. Prof., Dr. Tran Huy Thinh to go study in Prof. Honjo's lab and Thinh then followed his path to become another of Honjo's excellent students, with two works published in international leading scientific magazines.

In 2017, the new therapy was approved by the Ministry of Health for a clinical trial at Hanoi Medical University’s Hospital, for patients with lung, breast, liver, stomach and colon cancers at the stages 3B and 4. Each procedure consists of six infusions in three months, with each infusion separated by two weeks. Initial results were quite positive. Final stage cancer patients are almost painless and witness their resistance increasing significantly. Many of them who were having a fever have seen it cut off, or have seen their infections swept away, even though they had tried taking antibiotics and the use had proved ineffective. It is expected that at least 75 patients will be tested for this therapy.

A world-leading medical achievement applied in Vietnam has affirmed the constant efforts of medical staff for the happiness of patients. Vietnam now has more than 126,000 new cases each year and nearly 110,000 people die from cancer. Hopefully, with the new treatment, these numbers will gradually decrease.