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魏则西死后, 还癌症免疫疗法以“清白”
It’s time to clear the air on immunotherapy

在网上寻医治疗所患软组织癌的21岁中国大学生魏则西惨死事件在中国引起强烈反响。魏则西在停止化疗,前往北京一家排名居首的医院寻求免疫新疗法后,却发现癌症来势更为凶猛,且更具毁灭性。
 
The tragic death of Wei Zexi, the 21-year-old Chinese university student who sought treatment for his sarcoma on the internet, has sparked heated controversy across the country. Wei stopped his chemo to seek an immunotherapy treatment at a top ranked hospital in Beijing, only to find that his cancer became more aggressive after the new treatment.

魏则西在今年5月去世前一天曾发帖称:“我花费数十万在这家医院接受的免疫治疗根本无效。经过研究我发现这种疗法技术已经过时,在西方国家已弃之不用。”

“The immunotherapy treatment I received at this hospital, after hundreds of thousands of dollars, was ineffective, and through my own research, I ‘ve found that the treatment technology was outdated and was no long used in the West,” Wei wrote in a post the day before he died in May. 

虽然目前尚不清楚魏则西所接受的具体疗法为何,或其所接受的治疗是否满足质量要求,但其临终遗言却令“免疫疗法”变得声名狼藉,并使其成为众矢之的。在一些媒体报道中,免疫疗法也被直指为虚假疗法或过时技术。

While it is unclear what specific type of treatment he received, or whether the treatment was provided with quality, Wei’s last words before he died had given “immunotherapy” a bad name and put it under a negative spotlight. Some media reports have also labeled it as fake therapy, or an obsolete technology.

但实际上,以激发患者自身的免疫系统来对抗癌症的试验性免疫疗法在西方医学界正方兴未艾,并在人类对抗癌症病魔的历程中给人们带来了新的曙光和希望。

But in fact, immunotherapy, an experimental treatment that tries to rally the patient’s own immune system to fight cancer, has gained tremendous momentum in Western medicine, providing promising hope and optimism in the human journey battling the disease.
 
长期以来,利用免疫系统来对抗癌症一直是个医学梦想。可是癌细胞总是能设法躲过免疫系统而难被其识破,或是令其失效从而令其完全丧失攻击力。但据《纽约时报》报道,名为检查点抑制剂的新一代药物已经应运而生,它可以令免疫系统有效地对具有威胁性的癌细胞进行识别,并防止癌细胞阻断人体防御系统从而战胜癌症。

Harnessing the immune system to fight cancer has long been a medical dream. Cancer always finds ways to hide from the immune system or shut down its ability to fight. But according to the Times, new generation of drugs, which called checkpoint inhibitors, have been developed that allow the immune system to recognize cancer as a threat and to fight it by preventing cancer from shutting down the body’s defence system. 

这种新型药物已经获得美国食品及药品管理局批准,可用于治疗肺癌、肾癌和膀胱癌等多种癌症。其中一种药品被称之为Jimmy Cater药,因为美国前总统Cater在恶性黑色素瘤扩散至肝脏和脑部后,曾经依靠这种药将癌细胞歼灭。

The drugs have been approved by the FDA to treat a variety of cancers – including lung, kidney and bladder. One of the drugs is known as Jimmy Cater drug, which brought former president’s melanoma in remission, even though it had spread to his liver and brain. 

据《纽约时报》报道,新泽西州一位53岁的行业高管在2014年被确诊罹患4期非小细胞肺癌。在化疗无效后,他在2015年3月使用了两种不同的检查点抑制剂,尽管这些药物带来了一些副作用,但他的肿瘤开始出现萎缩。到了今年春天,他体内的癌细胞已完全消失,他也得以重返工作岗位和高尔夫球场。

According to the Times report, a 53-year-old industry executive from N.J. was diagnosed with stage 4 non-small-cell lung cancer in 2014. Not responding to chemotherapy, he was put on two different checkpoint inhibitors in Mar.2015. Since then, the tumors kept shrinking despite some side effects. By the spring this year, his cancer was totally gone. He is now back to work and golf. 

漫长历程
A long journey

免疫疗法在人类对抗癌魔的持久战中历程艰辛。据《纽约时报》报道,其起源可以追溯至1862年,当时一名美国外科医生意外发现患者在出现丹毒细菌感染后,体内的癌细胞便消失不见。由于当时人们对免疫系统还一无所知,因此这名医生怀疑是细菌杀死了肿瘤,于是他开始从加热灭活的细菌中提取毒素,在无意中启动了最为初始免疫疗法。这种新型治疗方法效果不一,有些患者得以治愈,还有些人则病情更重。

Immunotherapy has come a long way in human journey to fight cancer. According to the Times, it started as early as 1862, when an American surgeon accidentally discovered that patients’ cancer went away after suffering erysipelas -- a bacteria infection. Suspecting that bacteria destroyed tumors, rather than the immune system unknown back then, he accidentally began to practise a crude form of immunotherapy by developing toxins with an extract of heat-killed bacteria. The treatment brought mixed results – while some patients were cured, others became quit ill.

后来,随着放疗和化疗取得突飞猛进的发展,毒素疗法逐渐被摒弃,免疫疗法几乎被淹没在历史长河中,直到James Allison 博士在1990年代研制了一种可以阻断免疫系统检查点的抗体。在动物试验大获成功后,一制药公司开发了人体使用的抗体治疗药物,并在2011年获得美国食品及药品管理局批准,从而开启了免疫疗法的新纪元。

Radiation and chemotherapy became a big blow to the treatment and the toxins were later taken off the treatment list. Immunotherapy had almost buried alive in history until Dr. James Allison developed an antibody to block the checkpoints in the immune system in the 1990s. After a stunning victory in animal tests, one drug company created a human version of the antibody, which was approved by FDA in 2011, marking the new era of immunotherapy. 

重重挑战
Challenges

尽管人们对免疫疗法抱以厚望,但其目前仍只是试验性疗法,其有效率仅为20-40%。医生们仍在苦苦探寻为什么这类药物对一些患者疗效惊人,而对另一些人却全然无效的原因。目前看来,突破点在于发现新的可阻断其他尚未发现的免疫检查点的药物。

Despite the promising results, immunotherapy is still used an experimental treatment, with a response rate of only 20-40%. The doctors are still facing challenges of finding why the drugs worked for some patients amazingly well while not working for others at all. It seems that more drugs to subdue other undiscovered checkpoints are yet to be developed.

目前尚不清楚魏则西是属于免疫治疗失效的患者,还是其根本就未曾得到高质量的免疫治疗。但这些失败的病例却丝毫不能影响科学届对免疫疗法的乐观和信心,相信会在不远的将来免疫疗法会带来惊人疗效。不管怎么说,这些引人瞩目的成功病例导致免疫疗法获得突飞猛进的进展,在催生数十亿元注资的同时,数百个临床试验也陆续展开。

It is unclear whether Wei Zexi falls into the category of patients who were not responding to the treatment or, he wasn’t provided with quality immunotherapy treatment at all. But some patients’ bad experiences have not made the scientific community less optimum about the amazing results that treatment may offer in the near future. At any rate, the remarkable success stories have led to rapid growth of immunotherapy as billions of investments are injected and hundreds of clinical trials are underway.  
 
 
 

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