Medical issues and perspectives

A 25-year-old woman with type 1 diabetes has become insulin-independent after receiving a transplant of reprogrammed stem cells derived from her own body. The groundbreaking procedure, conducted by Deng Hongkui and his team at Peking University, is the first of its kind for treating type 1 diabetes. The researchers extracted cells from three patients, reverted them to a pluripotent state, and used chemically induced pluripotent stem (iPS) cells to generate insulin-producing islets. These islets were transplanted into the woman’s abdominal muscles—a novel site for such transplants, which allows for easy monitoring via magnetic resonance imaging (MRI).

Two-and-a-half months after the transplant, the woman began producing sufficient insulin, eliminating the need for external insulin injections. She has maintained stable blood glucose levels for more than a year, with over 98% of her day spent within the target range. The researchers are expanding the study to include 10–20 additional participants, as the preliminary results are highly promising for the other two individuals in the trial. However, more research is needed to confirm the long-term efficacy of the procedure, especially in preventing immune system rejection without immunosuppressants.

This approach, using a patient’s own cells, offers hope for avoiding immune rejection, a common challenge with islet transplants from donors. However, scaling this personalized therapy remains a challenge. Other research groups are pursuing donor-derived stem cell treatments. Vertex Pharmaceuticals has reported success in using donor-derived embryonic stem cells to create insulin-producing islets in type 1 diabetes patients, with some participants achieving insulin independence. Future developments focus on making these treatments more accessible and minimizing the need for immune-suppressing drugs, thereby offering a potential cure for millions living with diabetes.

The American Oncology Institute (AOI) at Citizens Specialty Hospital in Hyderabad is pleased to announce the successful treatment of a 72-year-old male patient with advanced prostate cancer. The patient, who initially experienced acute urinary retention in 2014, consulted a urologist and was diagnosed with prostate carcinoma after a biopsy. He underwent bilateral orchidectomy and received multiple lines of chemotherapy at different hospitals, experiencing several relapses.

In 2022, the patient returned to AOI with a recurrence of the disease but surprisingly low PSA levels. The doctors at AOI decided to perform a repeat biopsy, which revealed a transitional cell variant of prostate carcinoma. Considering the patient’s age, frailty, and extensive prior treatments, the medical team conducted next-generation sequencing on the tumor tissue, which showed MSI high and TMB high status, warranting immunotherapy.

Dr. K.V. Krishnamani, Medical Oncologist at AOI, explained the multidisciplinary approach: "The advanced nature of the patient's cancer required a combination of molecular testing and immunotherapy. This comprehensive strategy not only addressed the cancer but also significantly improved the patient's quality of life. His response to the treatment has been very encouraging, showcasing AOI's advanced care capabilities."

The patient received immunotherapy every three weeks, and now, two years from the start of this treatment, his disease is in complete remission. He is clinically well, ambulatory, and in much better health than he was in 2022. This case highlights the necessity of specialized molecular testing, the importance of repeat biopsies in recurrence cases, and the excellent results achievable with immunotherapy in such patients.

Harish Trivedi, CEO of CTSI-South Asia, emphasized the importance of leveraging cutting-edge diagnostics and personalized medicine in cancer treatment. Dr. Prabhakar P, Regional COO of AOI, highlighted AOI's commitment to integrating advanced technology with expert clinical knowledge to provide personalized treatment plans.

Dr. Krishnamani also stressed the importance of regular screenings for early detection of prostate cancer, which significantly improves treatment outcomes. He encourages all men over 50 and those with a family history of the disease to undergo routine check-ups and screenings.