美国国家公共电台 NPR Doctors In China Lead Race To Treat Cancer By Editing Genes

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Doctors In China Lead Race To Treat Cancer By Editing Genes¹

RACHEL MARTIN, HOST:

The new genetic³ engineering technique known as CRISPR is revolutionizing scientific research and stirring up a whole lot of excitement about new ways to treat diseases. NPR health correspondent Rob Stein recently traveled to China, where scientists are racing⁴ ahead of the rest of the world in using CRISPR to treat cancer.

ROB STEIN, BYLINE⁵: To see how Chinese doctors are using CRISPR, I traveled to the city of Hangzhou. It's about two hours southwest of Shanghai by bullet train. Hangzhou's famous for its big, beautiful lake where tourists take boat rides...

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STEIN: ...And dance to music blaring from speakers along the waterfront. But Hangzhou's also home to the Hangzhou Cancer Hospital. When I visited early one morning, the lobby was already packed with patients, family members, doctors, nurses.

WU SHIXIU: Hi. I am Wu Shixiu.

STEIN: Oh, hi, Dr. Wu.

Dr. Wu Shixiu runs the Hangzhou Cancer Hospital and is on the leading edge of using this new gene²-editing technique to treat cancer in people. Dr. Wu takes me upstairs to watch as he uses CRISPR to treat one of his patients. CRISPR lets scientists make very precise changes in DNA⁶ much more easily than ever before.

UNIDENTIFIED WOMAN: (Over intercom, speaking Chinese).

STEIN: When we get into the patient's room, Deng Shaorong is sitting up in bed. He's thin and looks frail⁷. Dr. Wu starts asking him questions as a nurse takes his blood pressure.

WU: (Speaking Chinese).

DENG SHAORONG: (Speaking Chinese).

STEIN: Deng's 53. He has cancer of the esophagus, stage 4 - the worst. I get a chance to ask them a few questions through my interpreter.

When did you first get sick?

DENG: (Through interpreter) It's over a year now.

STEIN: And you went through other treatment first?

DENG: (Through interpreter) He went through radiotherapy and chemotherapy both. And then it's not really working, so the doctor suggested this type of treatment.

STEIN: The treatment involves Dr. Wu sending some of Deng's blood to a biotech company about two hours away. There, scientists extract key immune system cells called T cells and use CRISPR to edit the genes in the cells. That gene editing unleashes⁸ the T cells so they can attack the cancer.

DENG: (Through interpreter) He's very excited. He feels like he's very lucky.

STEIN: Just then, a nurse rushes into the room. She's cradling a plastic pouch⁹. It's filled with a yellowish fluid. She hangs the pouch from a hook on the ceiling, pulls out an IV tube to attach to the pouch and slides a long needle into Deng's arm.

What is that they just brought in? What is that?

WU: This is a T cell.

STEIN: The immune system cells?

WU: Yes, yes.

STEIN: This is the actual experimental therapy?

WU: Yes. And now it's beginning.

STEIN: Dr. Wu's patient, Mr. Deng, stares at the needle as millions of genetically-modified immune system cells slowly drip into his body.

DENG: (Through interpreter) He can only hope it will get rid of the cancer.

STEIN: This is his second infusion¹⁰. Deng says he started feeling better soon after his first, about a month ago.

DENG: (Through interpreter) When he first arrived, he is on a wheelchair. And right now, he feels stronger. He can walk freely.

STEIN: Dr. Wu says he's treated 21 patients with advanced cancer of the esophagus and that more than a third have gotten better. One patient is still alive almost a year later. Usually, patients like this would die within months.

So it's not curing them, it's just keeping them from getting worse, just keeping them alive.

WU: Yes, yes.

STEIN: That's a big deal, I guess, for these patients 'cause...

WU: Yes. They have no choice. If they have not received this treatment, they will die - most of them will die in three to six months.

STEIN: Three to six months?

WU: Yes.

STEIN: And so far, Wu says, the only side effects have been minor¹¹, maybe an occasional fever or a rash. Nine patients did die, Wu told me later, but Wu says that was from their cancer, not the treatment.

WU: (Through interpreter) To be a cancer doctor, you see so many deaths. So it's great to use a new treatment to save patients' lives, even if just to prolong their lives a little longer.

STEIN: And this isn't the only study doctors in China are doing to test CRISPR gene editing for cancer. China has at least nine studies - for lung cancer, bladder cancer prostate cancer and more. In the United States, only one has been approved, and that's just now about to get going. Why? Why is China so far ahead? I asked Wu about that.

WU: (Through interpreter) Chinese patients want to be cured of very much. There's a Chinese saying - a living dog is better than a dead lion. So patients are willing to try new cures. That's why the ethics¹² committee and the lab are very positive about this.

STEIN: Wu says it only took a few months for that one ethics committee at his hospital to sign off on testing CRISPR on patients. But that makes some worry that some Chinese doctors may be rushing ahead too quickly.

CARL JUNE: So China's like a Wild West.

STEIN: That's Dr. Carl June, a University of Pennsylvania scientist involved in the U.S. study. His study went through two federal agencies and painstaking¹³ review by two more committees at his hospital before getting the go-ahead.

JUNE: You know, China is - they've made it a very high priority. They made a, you know, a national priority to develop this. There is some very high-quality research in China, and then there are some others that are not high quality.

STEIN: June doesn't think the U.S. should relax its safeguards to protect patients, but he worries the U.S. is falling behind like it did at the beginning of the space race.

JUNE: It was kind of like Sputnik 2.0.

STEIN: Sputnik was the Soviet¹⁴ satellite that shocked the U.S. when it became the first manmade object to orbit the Earth.

JUNE: CRISPR technologies have created a Sputnik moment where vast new improvements can occur if we focus on them and make it a priority. I want it to be done safely, But I want it to be a high priority.

STEIN: And he'd like to see a level playing field, where researchers around the world follow the same rules. For his part, Dr. Wu says his team explained all the possible risks to the patients very carefully. And he's already started treating patients with another kind of cancer, cancer of the pancreas.

WU: We just beginning. We just see the benefit to it for patients. We should improve it - more benefits for the patient.

STEIN: You want to improve it to get even more benefits for patients?

WU: Yes. But if you no try it, you never know.

STEIN: You don't try it, you'll never know?

WU: Yes. It's my opinion.

STEIN: His patient agrees. He says...

DENG: (Speaking Chinese).

STEIN: ...He's not worried at all. He believes in science.

Rob Stein, NPR News, Hangzhou, China.

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