TIL Therapy: Using Your Immune Cells to Fight Cancer
Featuring: Matthew Dons, Director of Make Cancer History
In short
Matthew Dons, diagnosed with stage IV colon cancer in 2016, shares how he has survived seven years by pursuing autologous adoptive cell transfer — a process where your own white blood cells (T-cells, NK cells, and dendritic cells) are removed, grown in a lab, and reinfused to fight cancer. The resource explains how this approach differs from checkpoint inhibitors, CAR-T, and cancer vaccines, and why combining gentler treatments while protecting your immune system matters for long-term survival. It also covers why Japan may offer earlier access to these therapies at lower cost.
- •Ask your oncologist about autologous adoptive cell transfer, specifically therapies using T-cells, NK cells, and dendritic cells together — NK cells can attack unlabeled cancer cells, which matters more at later stages.
- •When choosing treatments, ask which options are least likely to suppress your immune system or bone marrow, since a weakened immune system can undermine immunotherapy.
- •Japan may offer earlier access to some immunotherapies at significantly lower cost than the US — Matthew Dons received intensive treatment there for around $25,000.
- •Combining immunotherapy with approaches like hyperthermia, radiofrequency ablation, or low-dose targeted drugs may improve results — bring a list of these combinations to discuss with your care team.
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Brad Power December 6, 2023 “When you think about the cancer, you've got your immune system, and cancer does immunosuppression. ” – Matthew Dons “The standard care in Japan is much higher for cancer.
Meeting Summary
Among the treatment options that advanced cancer patients may consider, immunotherapies have the major advantage that they can lead to very durable responses (a “cure”), while most other therapies work for a while, then fail. Cancer treatments tend to be toxic or invasive. Sadly, they are often ineffective. Immunotherapies have many advantages, but they are newer than traditional treatments like surgery or chemotherapy, so are harder to access.
An international search, including Japan, can uncover more treatment options and more access, especially to immunotherapies. Matthew Dons, Director of Make Cancer History, is uniquely qualified to talk about a global search for cancer treatments, and especially immunotherapies. When he was diagnosed with stage IV (metastatic) colon cancer in 2016 at the age of 36, it seemed unlikely he’d live more than a year.
Seven years later he’s still doing well, thanks to a treatment based around boosting his immune system by growing his own white blood cells. Matthew is neither a doctor nor a researcher; he is an example of what we call a “super patient”. ) He has studied immunotherapies extensively to guide his own care, and he has advised many patients around the world about how to access such therapies.
Over the years he has developed some distinctive ideas about what works and what doesn’t. Why should you consider growing your white blood cells to treat your cancer?
Immunotherapies (a treatment leveraging your immune system), such as growing your white blood cells to treat your cancer, offer one of the best paths to a durable response -- they are fighting a biological system (your cancer) with another system (your immune system), rather than the hit-and-miss, less durable approach of targeting a biomarker with a single drug or poisoning your cancer with chemotherapy.
Certain immunotherapies offer a treatment option to nearly every cancer patient because they are neither targeted to a specific “tissue of origin”, like lung cancer or colon cancer, nor are they targeted to a biomarker, a protein that your cancer cells overexpress, like BRCA or EGFR. The medical term for growing your white blood cells to treat your cancer – autologous adoptive cell transfer – is a mouthful of medical jargon.
•Autologous: using your cells to treat your disease, a Latin term meaning “from your body”
•Adoptive cell transfer : taking your healthy cells, e.g., white blood cells, growing them in a lab, then putting them back into your blood
•Apheresis: the name for the process that takes your blood, runs it through a machine to separate out one or more constituents, and returns the remainder back to you For example, in the treatment Matthew Dons has received in Japan, he’s gotten a huge number of extra white blood cells of various types (T-cells, NK cells, and dendritic cells) that were taken from him using apheresis, then grown in a lab, then reinfused into him. Another example is an autologous dendritic cell therapy called Provenge (Sipuleucel-T) for metastatic prostate cancer, which has shown a four-month increase in mean survival in clinical trials, and greater than one year in real world experience. Growing your white blood cells is different from other immunotherapies you may have heard of and considered, such as (1) immune checkpoint inhibitors (e.g., Keytruda/pembrolizumab, OPDIVO/nivolumab), (2) CAR-T (chimeric antigen receptor T-cell) therapy, or (3) personalized neoantigen vaccines. 1.Immune checkpoint inhibitors : Immune checkpoints stop your immune system from attacking yourself. Immune checkpoint inhibitors remove these brakes on your immune system. Keytruda is one checkpoint inhibitor that was approved in the U.S. in 2016 for skin cancer. Then in 2017, it was approved in the U.S. for all tumor types and all cancer origins, if you have what's called “MSI high”, microsatellite instability high, which means your cancer is quite mutated. If you are an advanced cancer patient, checkpoint inhibitors are less likely to be effective because you have a very poor immune system, and removing the brakes generally won’t help. (For more on checkpoint inhibitors and MSI, please see our discussion with Heather Tomlinson, “How MSI and Other Tests Can Guide Immunotherapies for Cancer Treatment” here.) 2.CAR-T cell therapy: CAR-T cell therapy is also an adoptive cell transfer therapy, i.e., it is also putting T-cells, a type of white blood cell, into your blood. In the CAR-T process, they take a commercial cell line, and then genetically engineer T-cells to match the genetics of your cancer, which means they're very highly targeted. However, because they are engineered foreign cells (not autologous), your body has a high chance of reacting against the therapy. And the T-cells are only able to attack cancer cells that they recognize as cancer cells by an antigen or neoantigen label. (For more on CAR-T, please see our discussion with Andrew Rech, “Immunotherapy in Prostate Cancer - CAR-T and the Tumor Microenvironment” here.) 3.Personalized cancer vaccines : Personalized cancer vaccines can be used to introduce or stimulate selected T-cells to attack cancer cells. The vaccine is trying to get your body to produce enough of the right T-cells, and then combine it with things like checkpoint inhibitors or whatever makes sense to make sure that those T-cells can do their job and win the battle against your tumor. (For more on personalized cancer vaccines, please see our discussion with Willy Hoos, “Personalized Cancer Vaccines” here and with Lisa Butterfield, “Cancer Vaccines” here.) By using three kinds of immune system white blood cells, Matthew Dons had a better chance of a response than these other immunotherapies. While T-cells need to recognize labels on the cancer cells, NK cells can attack cancer cells without labeling, while dendritic cells help identify and present antigens. NK cells can attack cells that are not labeled as cancer cells, are not presenting an antigen, or not labeled with a neoantigen. This is very important for late stage patients, because NK cells are able to attack cells that they recognize as being cancer, but not because of the labeling. As a late stage patient, many of the cancer cells that you have are these unlabeled ones. NK cells show good uptake in bones, even for late-stage cancer patients like Matthew Dons. Why might you not want to consider growing your white blood cells to treat your cancer?
•Hyper progression : A theory in immunotherapy, citing patient experience. Immune system weakening and cancer's ability to evade immune responses are major factors in hyper progression.
•Evidence: NK cell therapies don’t have much clinical evidence. What are principles for long-term survival from cancer? 1.Access new treatments as quickly as possible : Do not wait for the approval. If the science seems sound, and early results seem good – go for it. 2.Combine treatments : For example, combine immunotherapy and hyperthermia, which increases blood flow and enhances immune response. 3.Get as much treatment as your body can take : Choose a combination of gentler treatments. 4.Choose treatments that cause less immune suppression . For example, if you're going to have radiotherapy, find the one which causes the least bone marrow suppression. 5. clinics carefully: Clinics should own their labs for quality control. How can immunotherapies be enhanced?
•Combine with targeted drugs : For example, before your immunotherapy is administered, you can get a low dose of a targeted cancer drug (like cetuximab, which is used to treat advanced bowel cancer and head and neck cancers), which will mark the cancer cells, a bit like a neoantigen, making the cancer cells more visible to the T-cells.
•Combine with radiofrequency ablation : A minimally invasive procedure that shrinks the size of tumors procedure by the heat generated from medium frequency alternating current. It has been successfully applied in liver cancer before checkpoint inhibitors.
•Combine with high-intensity focused ultrasound . This is meant to be a drop-in replacement for radiotherapy, just like radiofrequency ablation was, to ablate the tumors.
•Condition dendritic cells for cancer treatment : For example, promising results in primary brain cancer.
•Combine with “cryoablation”: (extreme cold) to freeze and kill abnormal cancerous and precancerous cells.
•Inject therapies into the tumors : The alternative the Japanese have come up with is to take dendritic cells and inject them in between your ribs because there's loads of lymph nodes there.
•Condition with heat shock proteins
•Use the tumor tissue to condition the dendritic cells
•Analyze white blood cell activity in blood samples
•Get metronomic chemotherapy : a low dose of chemotherapy given continuously, with no breaks Why should you consider getting your immunotherapy in Japan?
•Advanced treatments: The standard care in Japan is very high for cancer. It's probably a few years ahead of the US, and maybe 10 years ahead of the UK.
•Access: Matthew Dons got his experience with immunotherapy in Japan, including tumor lysate-pulsed autologous dendritic cell therapy.
•Low Cost: Healthcare in Japan is far less expensive than in the US. It’s because of how the Japanese health system is regulated and with the buying power of Japan because there's a large, elderly population. For example, for Matthew Dons, the standard, intensive treatment was around $25,000.
•Safety: In Japan, medical mistakes are very rare. In the US, medical mistakes are the third biggest killer. When you are getting cancer treatment you are often looking at treatments that give you a few percent advantage over standard care. Medical mistakes eat away at that advantage. What can you do to help with the global effort to cure cancer? There’s no serious global effort to cure cancer. For some of the most deadly cancers, like colon cancer, which kills about one million people every year, some of the new drugs only add two months to your life. We’ll never have a cure for cancer with the current approach. We need something new. A new approach to treating cancer, focusing on “cancer agnostic” drugs and treatments is already getting great results in some countries. Make Cancer History is a non-profit organization based in Tokyo with one aim: to cure cancer all over the world. That means helping scientists develop cheap, safe treatments that anybody can use. These treatments aren’t owned by any company, they are in the “public domain”, meaning any health system can use them without paying a license fee. With your help we can cure cancer and make it a thing of the past. The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. Meeting Notes SUMMARY KEYWORDS treatment, cancer, cells, cancer cells, tumors, patient, immunotherapy, white blood cells, checkpoint inhibitors, japan, t cells, therapy, clinic, dendritic cells, nk cells, immune system, drug, brain cancer, chemo, doctor SPEAKERS Matthew Dons (91%), Brian McCloskey (4%), Roger Royse (3%), Amit Gattani (2%) OUTLINE 1.Cancer treatment options with medical disclaimers. (0:02) 2.Immunotherapy in Japan for cancer treatment. (1:13) 3.Colon cancer treatment options with a personal story. (2:50) 4.Cancer treatment in Japan with a focus on immunotherapy. (7:09) 5.Cancer treatment using white blood cell therapy. (14:11) 6.Cancer immunotherapy and checkpoint inhibitors. (20:46) 7.Immunotherapy and cancer progression. (25:35) 8.Personalized immunotherapy for cancer treatment. (32:26) 9.Cancer treatment outcomes for patients with multiple treatments. (39:39) 10.Cancer treatment strategies with a focus on immunotherapy. (44:01) 11.Cancer treatment options and their effectiveness. (50:26) 12.Immunotherapy for cancer treatment in Japan. (57:49) SUMMARY
•Brian McCloskey introduces the Cancer Patient Lab session, emphasizing the importance of consulting a doctor before pursuing any healthcare program.
•Matthew Dons shares his experience with immunotherapy in Japan, including a neoantigen peptide vaccine, which he has brought to the US for a fraction of the cost.
•Matthew Dons shares his story of being diagnosed with stage 4 colon cancer in 2016 and how he found alternative treatment in Japan.
•He was misled by poor survival rates in Europe.
•Matthew Dons: In Japan, medical mistakes are rare, giving an advantage in cancer treatment.
•Matthew Dons explains adoptive cell transfer immunotherapy, different from checkpoint inhibitors like OPDIVO and Keytruda.
•Matthew Dons discusses cancer agnostic treatment, explaining differences between tumor and tissue agnostic treatments.
•Matthew Dons discusses adoptive cell therapy for cancer treatment using white blood cells grown from the patient's own body.
•Matthew Dons explains the process of fra CES, a blood separation technique, to a listener.
•T cells and NK cells can attack cancer cells without labeling, while dendritic cells help identify and present antigens.
•Matthew Dons explains the hyper progression theory in immunotherapy, citing patient experience.
•Matthew Dons explains pseudo progression in cancer treatment, a phenomenon where tumors appear to grow despite immunotherapy.
•Researcher discusses using dendritic cells to target cancer cells through peptide- based immunotherapy.
•Personalized cell processing for immunotherapy is crucial, with clinics owning their own labs for quality control.
•Personalized cancer treatment can be improved through analysis of white blood cell activity in blood samples.
•Explanation of how targeted drugs can enhance immunotherapy for cancer patients, with examples of drugs like Panitumumab and Cetuximab.
•Researchers found promising results in treating cold tumors with radiofrequency ablation before checkpoint inhibitors in liver cancer patients.
•Matthew Dons discusses cancer treatment options, including checkpoint inhibitors and combination therapies, and their effectiveness in different patient populations.
•Matthew Dons emphasizes the importance of combining treatments, such as immunotherapy and hyperthermia, for optimal cancer treatment results.
•Matthew Dons discusses hyperthermia therapy as a potential cancer treatment, highlighting its ability to increase blood flow and enhance immune response.
•Matthew Dons advocates for combining multiple treatments to improve cancer survival chances, prioritizing gentler treatments with less immune suppression.
•Matthew Dons discusses their experience with immunotherapy for cancer, including receiving treatment in Japan and experiencing a range of side effects.
•Matthew Dons emphasizes the importance of considering the toll of international travel on the body when seeking treatment abroad.
•Dr. Jones discusses using frozen tumor tissue to condition dendritic cells for cancer treatment, with promising results in primary brain cancer.
•Matthew Dons emphasizes underutilization of RFA and cryoablation in cancer treatment.
•Matthew Dons discusses alternative cancer treatments, including high intensity focused ultrasound.
•Dr. Ted Aneuma is a pioneer in immunotherapy in Japan, leading a clinic that uses metronomic chemotherapy with long-lasting effects.
•Matthew Dons discusses personalized cancer treatment costs in Japan, ranging from $25,000 to hundreds of thousands of dollars.
Full transcript
Brian McCloskey Welcome everybody to the Cancer Patient Lab. Roger Royse 1:13 Today's presenter, Matthew Dons, is going to tell us all about a really interesting therapy in Japan. I met Matthew probably a year ago through a Facebook group. It was a long, circuitous way to get to them. I was very interested in immunotherapy at the time, and I was trying to find places that would offer it since we're in the US, and we have the FDA to deal with.
Also some other other types of therapies beyond standard of care. That's when I came across Matthew’s Facebook group, where it describes the kind of stuff they do in Japan, such as NK cell expansion, and dendritic cell expansion.
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