Original title: A million yuan anti-cancer needle can clear cancer cells and cure cancer, cancer pain can not be treated with pain killers... (Introduction)

Are these rumors about anti-tumor drugs credible (theme)

Science and Technology Daily reporter Dai Xiaopei intern Zhu Keying

The research and development progress and safe use of anti-tumor drugs have always been one of the most concerned issues in cancer prevention and treatment. "The CAR-T product with a dose of 1.2 million yuan can clear cancer cells and cure cancer" "Cancer pain can not be treated with painkillers" "Boron medicine can cure liver cancer and lung cancer"... Are these rumors about anti-tumor drugs true? The reporter interviewed relevant experts.

Myth 1: A million yuan anti-cancer needle can clear cancer cells and cure cancer

Expert response: "clearing cancer cells" does not mean "clinical cure"

T cells are immune cells and the main force of the immune system attacking cancer cells. The principle of CAR-T therapy is to take out the T cells in the patient's body and install tumor chimeric antigen receptor (CAR) on the T cells in vitro, so that the T cells have stronger cancer cell recognition ability and lethality, so as to achieve the purpose of killing cancer cells. Previously, the State Drug Administration approved the launch of China's first CAR-T cell therapy product, and it was rumored that this product was worth 1.2 million yuan per injection, which was the "magic drug" to clear cancer cells and cure cancer.

"Not all tumors are suitable for CAR-T therapy." Wang Ying, director of the Immune Cell Therapy Center of the Hematology Hospital of the Chinese Academy of Medical Sciences (Institute of Hematology of the Chinese Academy of Medical Sciences), said that the 1.2 million yuan injection of CAR-T cell therapy products can make cancer cells clear and cure cancer is not accurate.

At present, CAR-T therapy related products are mainly used to treat hematological malignancies that are easy to relapse and difficult to treat, such as multiple myeloma, lymphoma, acute lymphoblastic leukemia, etc. According to some follow-up data, some patients with malignant blood tumors can be clinically cured by CAR-T therapy. However, "clinical cure" and "cancer cell clearing" cannot be equated.

First of all, the so-called "cancer cell clearing" only means that cancer cells are not detected at the sensitivity level that can be achieved by existing detection methods, which does not mean that there are no cancer cells in the body. Secondly, the so-called "cancer cell clearing" expresses that the patient's disease has been alleviated, but the remission effect has not recurred for more than 5 years, so the patient can be considered to have obtained a "clinical cure".

"Compared with traditional chemotherapy, although the remission rate of patients receiving CAR-T treatment is higher, some patients will relapse. Therefore, not every patient who has been relieved by CAR-T treatment can achieve clinical cure. There are a few patients who have not been relieved by CAR-T treatment." Wang Ying said.

Turning to the future of CAR-T therapy, Wang Ying believed that, in addition to hematological tumors, there are also studies promoting the application of CAR-T therapy to solid tumors and autoimmune diseases, such as refractory systemic lupus erythematosus.

Myth 2: Painkillers cannot be used for cancer pain

Expert response: it can regulate rational drug use

The White Paper on the Quality of Life of Chinese Cancer Patients in 2020 shows that 57.4% of cancer patients will suffer from pain to varying degrees, which will seriously affect the quality of life. Painkillers are important weapons to deal with cancer pain. However, there are rumors that cancer patients cannot use pain relievers for reasons including addiction caused by the use of opioid pain relievers, and ineffectiveness of pain relievers when pain worsens due to early use of pain relievers.

"Opioids are common painkillers, which may be addictive, but the possibility is very low." Li Zhigang, chief physician of the pain department of Beijing Tsinghua Changgeng Hospital affiliated to Tsinghua University, told reporters that foreign data showed that only one of the 10000 patients who use opioids may be addicted. The domestic management of opioids is stricter than that of foreign countries, and the addiction will be lower, almost negligible. Fan Bifa, president of Pain Branch of Chinese Medical Doctor Association and director of Pain Department of China Japan Friendship Hospital, also believes that rational and standardized use of opioids will rarely lead to so-called addiction and other problems.

So, will early use of painkillers lead to ineffectiveness of painkillers in late cancer? "This involves drug resistance. Many drugs may be resistant to drugs after long-term use, such as antihypertensive drugs, diuretics, etc. This is not the 'patent' of painkillers." Li Zhigang said, "The standardized and reasonable use of painkillers in the early stage of illness, the final clinical benefits far outweigh the risk of drug resistance."

Li Zhigang stressed that the idea that cancer pain patients cannot use pain relievers is wrong. On the basis of scientific evaluation, pain doctors will provide patients with comprehensive, dynamic and individualized medication programs to help cancer pain patients standardize and rational medication. In clinical practice, 80% - 90% of patients can effectively relieve cancer pain and improve their quality of life through reasonable and standardized analgesic treatment.

Rumor 3: Boron medicine can cure liver cancer and lung cancer

Expert response: there is no enough evidence to support the treatment effect

It is rumored that boron medicine can cure lung cancer, liver cancer and other common tumors. The so-called boron drug refers to a kind of boron containing drug injected to patients before treatment with boron neutron capture therapy (BNCT). This drug has a strong affinity with cancer cells and will quickly gather in cancer cells, while it is rarely distributed in other tissues. Then the focus is irradiated by neutron. When the irradiated neutron is captured by boron in the cancer cell, it can release extremely lethal rays through nuclear fission.

Compared with traditional radiotherapy, BNCT is more accurate and has less damage to the healthy tissues around cancer cells. It can also achieve good results for some tumors that are not sensitive to traditional radiotherapy. Small scale clinical studies carried out by Chinese scholars have shown that BNCT is an effective treatment for central nervous system tumors, head and neck tumors, skin and mucous membrane malignant melanoma and other tumors. However, the therapeutic effect of this therapy on lung cancer and liver cancer has not been supported by sufficient relevant evidence for the time being.

It is worth noting that China's first self-developed boron neutron capture treatment clinical medical equipment project was launched in Dongguan People's Hospital in 2022, and is expected to enter clinical trials in the second half of this year. According to public reports, relevant studies are using BNCT to try to treat liver cancer, lung cancer, pancreatic cancer, breast cancer and other tumors, but no specific clinical data has been disclosed. "When spreading medical progress, we must make scientific, comprehensive and objective statements, otherwise it is easy to breed rumors," said Wang Ying.