A Fateful Test

It was a bold proposal. Dr. Jordan Gutterman of Houston's M.D. Anderson Hospital and Tumor Institute had applied to the American Cancer Society for a grant of more than a million dollars to buy interferon, a scarce and expensive substance that has shown promise in cancer research. To buttress his request, Gutterman reported that of ten advanced breast cancer patients he had treated with interferon, four had shown shrinkage of their widespread tumors. Those results, following encouraging news about interferon in animal and human tests by other researchers, seemed too compelling to ignore. Exceeding even Gutterman's expectations, the A.C.S. set aside $2 million to buy interferon and last week announced that beginning in mid-November the substance would be used in its first mass test--in five medical centers on 150 patients suffering from one of six types of cancer.*

Interferon is a large hormone-like protein produced by the cells of all vertebrate animals. It was discovered in 1957 in Britain by Virologists Alick Isaacs and Jean Lindenmann during their investigation of a curious phenomenon: people are almost never infected by more than one virus at a time. Seeking an explanation, the researchers infected cells from chick embryos with influenza virus. What they found was a substance that protected the chick cells from both the flu and other viruses. Because it interfered with the infection process, it was dubbed interferon.

Subsequently, other researchers learned that the protein had antitumor as well as antiviral properties. Though exactly how it works is still a mystery, interferon appears not only to block the uncontrolled cell division that is characteristic of cancer but also to stimulate the body's immune system to kill cancer cells. Interferon has another plus; apparently because it is produced in the body, it has none of the unpleasant and debilitating side effects that accompany conventional cancer chemotherapy.

Though interferon has raised the hopes of doctors and laymen alike since its discovery (in a 1960 Flash Gordon comic strip, medics used it to combat an extraterrestrial virus), it is so difficult to recover from cells that only minute quantities have been available for testing. Most interferon, including the supply that will be used in the new tests, comes from Finland, where it is extracted at great expense from white blood cells collected from Red Cross blood donors. As a result, as little as a millionth of an ounce of pure interferon costs close to $1,500.

Interferon is likely to remain expensive for some time to come. Scientists have not yet fully determined the structure of the interferon molecule and thus cannot bring down the cost by synthesizing it. Nor have they isolated the gene that orders interferon production in the cell. Once that gene is determined, Gutterman says, the technique of recombinant DNA could be used to insert it into a laboratory strain of E. coli bacteria, which would then multiply and produce interferon inexpensively and in large quantities.

Until that day comes, and indeed until and if the new tests of interferon demonstrate that it is truly effective, medical experts are warning cancer victims and their relatives against undue optimism Says A.C.S. official and former National Cancer Institute Director Frank J Rauscher Jr.: "Interferon is just one of thousands of substances being tested for antitumor activity. The only way to find out if interferon is any good is to buy the material and get the research started That's where we are today."

*Patients with advanced cases of certain cancers of the skin, bone, lymph system, breast, lung and bladder will receive interferon at Houston's M.D. Anderson; the Sloan-Kettering Institute for Cancer Research and the Columbia University College of Physicians and Surgeons, both in Manhattan; Buffalo's Roswell Park Memorial Institute; the Stanford University Medical Center in Palo Alto, Calif.

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