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Gene Therapy
                  for the
            Treatment of Cancer
DAVID Y. DY, MD, MS, MBE, FPCS, FACS
Surgical Oncologist

AMY G. DY, MD, FPPS, FPSMO, FPSPO
Pediatric Oncologist
Mig’s story
Migs’ Story

2009
 11 years old, boy, Filipino
 Painless blood in urine
 Cystoscopy: bleeding mass in bladder
 Dx: Rhabdoid tumor of the urinary bladder
 Tx: Partial removal of urinary bladder
Migs’ Story

 Hospital in China
   Locoregional and systemic chemotherapy
          (Gemcitabine/Cisplatin)
   Immunotherapy


   2 mos: pelvic recurrence
     Cryosurgery
     Brachytherapy
Mig’s story

 Progressive and metastatic
      disease
 (R) flank pain
 Came back to Philippines
 Urologist: total excision of bladder and
  rectum
Mig’s story

Gendicine: IT 9
           IA  2
           IV  1
 + 6 Chemo (ICE)

Outcome: No tumor seen on 2nd look surgery
         PET CT : no active disease
OUTLINE

 WHAT IS A GENE?
 HOW IS GENE MEDICINE MADE
 HOW DOES IT WORK?
 HOW IS IT USED?
 OTHER CASES
WHAT
IS
A
GENE ?
ORGAN




             ORGAN SYSTEMS
HUMAN BODY




                                     SEGMENT
  CELLS                              OF COLON
                    TISSUE
THE
CELL
CELL
NUCLEUS
CHROMOSOMES




23 pairs or 46
chromosomes in the
nucleus of each cell
in our body
CHROMOSOME # 3



•ONCOGENES

•TUMOR
SUPPRESSOR
GENES
P53             TUMOR SUPPRESSOR GENE
chromosome 17
(17p13.1)
P53 tumor suppressor gene
 when a cell's
  DNA is
  damaged, it
  acts as an
  "emergency
  brake" to stop
  the resulting
  cell division
  that can lead
  to cancer.
P53 tumor suppressor gene
 It also acts as
  an
  executioner,
  programming
  damaged cells
  to self-destruct
  before their
  altered DNA
  can be
  replicated.
P53 tumor suppressor gene
 when it mutates, p53 can lose its
 suppressive powers or have the
 devastating effect of actually
 promoting abnormal cell growth

 p53 is the most commonly mutated
 gene found in human tumors
HOW IS
GENE THERAPY MEDICINE
MADE?
TWO COMPONENTS


                 ADENOVIRUS
 p53 gene
Genetic Engineering             Adenovirus

                                                  P53 Gene

                                             ns ert
                                         I
     bad gene         Remove


                                  rAd-p53
   RECOMBINANT HUMAN ADENOVIRUS p53 INJECTION MEDICINE
HOW DOES
GENE THERAPY
WORK?
 The adenovirus
  containing the
  p53 tumor
  suppressor gene
  binds to the
  receptor in the
  cell membrane of
  the cancer cell
 The
  adenovirus is
  then
  packaged in a
  vesicle
 The vesicle
  proceeds to
  the cell
  nucleus
 The vesicle
  breaks down,
  releasing the
  adenovirus
  near the cell
  nucleus
 The
  adenovirus
  injects its
  gene, which
  contain the
  p53
 The
  adenovirus
  injects its
  gene, which
  now includes
  the p53
  tumor
  suppressor
  gene, into the
  cell nucleus
 The cancer
  cell then
  makes p53
  protein
 The p53
  protein
  causes the
  cancer cell to
  self destruct
  without
  affecting
  surrounding
  normal cells
HOW IS
GENE THERAPY
ADMINISTERED?
Direct injection to tumor
Injection into pleural and peritoneal cavities
Intravenous infusion
Intra arterial infusion
P53 Gene Therapy is            Safe

• First used since year 2003

• Over 16,000 patients already treated

• No serious side effects

• Common side effects are self-limited fever
OTHER PATIENTS
Liver Cancer
 Male, 60 y.o.




•治疗前   before treatment   介入 + 基因治疗后   after interventional therapy+gene therapy
Advanced Lung Cancer
Male, 62 y.o.




  Before treatment     after chemotherapy+gene therapy
Lung cancer
Male, 55 y.o.
Cancer of the lower lip
Male, 67 y.o..
GENE THERAPY
GENE THERAPY
Landline: 63-2-9618035
   Mobile: +639175536300
Email: surg.onc1@tullamarine.ph

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