By: Géraldine Genetti, Clémentine Bugnon (RTS)/sf
There are cases of extraordinary recoveries, in which the patient suffering from an incurable disease becomes healthy again. Cases that give researchers new hope of being able to find new treatments.
One case is that of Romuald, the “Geneva patient”, one of the rare cases in the world in remission from HIV after receiving a bone marrow transplant to treat acute leukemia. When taking on Romuald, Alexandra Calmy and the team at the University Hospitals of Geneva (HUG) HIV unit saw an opportunity to kill two birds with one stone: treat leukemia and HIV at the same time.
The Case of Romuald (36.9°, RTS, 11/13/2024)
In five cases, patients received a bone marrow transplant and recovered from both diseases. In all of these cases, the donor carried a genetic mutation called CCR5 Delta 32, a mutation that provides resistance to HIV.
But Romuald could not wait and therefore received the transplant without this mutation. After the surgery he developed graft-versus-host disease (GvDH), in which transplanted immune cells attack cells in the host’s body. A partly beneficial effect, as cancerous cells are attacked, but healthy cells are also attacked and the patient must therefore take anti-rejection medications.
Romuald finally sees a remission of the leukemia and the HIV is also gone: “Since I was 18 they told me to take medicine. I never imagined or hoped that one day I would be able to stop.”
Since 2023, the virus has remained undetectable despite stopping antiretroviral treatment, a phenomenon doctors are trying to understand. They are investigating the possible role of donor NK (natural killer) cells and the influence of graft-versus-host disease.
The “Geneva patient” has therefore brought research ideas and new hopes for a treatment, explains Professor Calmy: “I hope that we will be able to carry out clinical studies to find out if it is possible to replicate Romuald’s experience. Nothing would have been possible without him, I am very grateful to him. I think a lot of other people would say the same thing.”
Phage therapy: new weapon against infections
José Vidal suffered from lung infections due to antibiotic-resistant bacteria. With phage therapy it was possible to avoid a critical condition. This treatment uses viruses that specifically target pathogenic bacteria.
A collaboration with Yale University made it possible to find a phage specific to his bacterial strain, a treatment administered by inhalation, which allowed José to regain health. Yolanda Gago, his sister, comments: “It was really something unexpected. It was a radical, spectacular change, he was almost dead.”
Thanks to phage therapy, José Vidal was able to resume his life, and today gives lessons to young apprentices. But José is not safe from a relapse; the bacteria could still be lodged deep in his lungs.
The ideal would be to subject him to preventive phage therapy, but for the moment phages are not recognized as medicines by Swissmedic, due to José’s frustration: “I am living proof that it works, so I don’t understand that having a therapy that can help me or save myself, I can’t have it because there is no stamp from the authorities.”
Advances in immunotherapy
Béatrice Thurnherr illustrates the progress of immunotherapy to treat tumors previously considered incurable. Faced with advanced metastatic melanoma, he received immunotherapy that allowed his immune system to target tumor cells. Although this approach has led to complications, the results remain promising.
If immunotherapy represents a turning point for some patients suffering from metastatic melanoma, a cancer that has not yet been cured, it is also revolutionary for oncologists. They have one more tool in their therapeutic arsenal. “We had practically no patients curable from metastatic melanoma and now we are probably curing more than 50% of them, so it is an exceptional revolution,” adds Professor Olivier Michielin, head of the oncology department at HUG. The bad news is that unfortunately this therapy does not have the same results on other types of cancer.
These stories of extraordinary or unexplained remissions open up new avenues of research. Every extraordinary healing allows a better understanding of the disease, a hope of a cure. But all patients, by receiving treatment, ultimately put themselves at the service of research. Thanks to them, medicine will be able to offer better care to the patients of tomorrow.
01:23
RG of 12.30 on 19.11.24, the report by Gianluca Olgiati
RSI Info 11.19.2024, 15:04
**In light of José Vidal’s successful treatment with phage therapy, what specific steps does Professor Michielin think regulators should take to expedite access to potentially life-saving therapies while maintaining strict safety protocols?**
## World Today News: Extraordinary Recoveries – A Beacon of Hope
**Welcome back to World Today News. Today we delve into the exciting possibilities of medical advancement, exploring remarkable cases of recovery from previously incurable diseases.**
Joining us today are two expert guests:
* **Professor Alexandra Calmy:** Head of the HIV unit at the University Hospitals of Geneva, instrumental in the case of the “Geneva patient,” Romuald.
* **Professor Olivier Michielin:** Head of the oncology department at HUG, specializing in immunotherapy and treated Béatrice Thurnherr for advanced metastatic melanoma.
**Welcome to both of you. Professor Calmy, let’s start with Romuald’s case. Can you share with our viewers the unique circumstances surrounding his recovery from both leukemia and HIV?**
(After Professor Calmy’s response)
**This case is truly remarkable. Professor Michielin, we’ve also seen advancements in immunotherapy against previously intractable conditions like metastatic melanoma. Can you explain how immunotherapy works and how its success rate is evolving?**
(After Professor Michielin’s response)
**Professor Calmy, the article mentions that Romuald’s experience might not be directly replicable due to the lack of specific genetic mutation in his donor. However, the knowledge gained from this case might pave the way for new treatments. What are some of the research avenues currently being explored based on Romuald’s experience?**
(After Professor Calmy’s response)
**Professor Michielin, while immunotherapy has shown tremendous promise in treating certain cancers, the article emphasizes that it’s not a ‘one size fits all’ solution. What factors determine its effectiveness for different types of cancer, and what are the ongoing challenges in developing broadly effective immunotherapies?**
(After Professor Michielin’s response)
**Switching gears slightly, the article also highlights the case of José Vidal and his successful treatment using phage therapy. This novel approach utilizes viruses to target specific bacteria, effectively combating antibiotic resistance. Professor Calmy, what are your thoughts on the potential of phage therapy in the fight against infectious diseases, particularly in the context of rising antibiotic resistance?**
(After Professor Calmy’s response)
**José’s case demonstrates a crucial dilemma – the delay in regulatory approval for innovative treatments like phage therapy. Professor Michielin, what are your views on striking a balance between rigorous safety protocols and enabling access to potentially life-saving therapies for patients like José?**
(After Professor Michielin’s response)
**Closing Thoughts
These stories of extraordinary recovery offer a compelling glimpse into the future of medicine. BothUIViewProfessor Calmy and Professor Michielin, what message would you like to deliver to our viewers regarding the future of medical research and its potential to transform healthcare? **
**Thank you both for your invaluable insights. To our viewers, we encourage you to learn more about these groundbreaking advancements and contribute to the ongoing conversation about the future of healthcare.**
