Avastin (Bevacizumab) is an anti-cancer drug that is part of relatively new class of drugs known as monoclonal antibodies (note the “mab” at the end of the generic drug name). Actually monoclonal antibody technology is a little older than most other genetic engineering techniques but still relatively new. So just what is a monoclonal antibody? Well that requires a bit of ‘splaining. Let’s start with the immune system, we know that a large part of the specific or adaptive immune response comes from the production of antibodies by specific cells of the immune system. These antibodies in turn comprise different classes of secreted proteins which consist of a constant region, seen in all antibodies of a particular class, and variable and hypervariable regions, where amino acids are first shuffled around before becoming part of the antibody. These variable regions are what give antibodies different affinities for foreign proteins and other epitopes. There are millions if not billions of different antibodies each of which can glom onto a different foreign invader.
It has been known for some time that in multiple myeloma, a cancer of white blood cells, there is sometimes a very prominent, narrow gel electrophoresis spike when the urine of these cancer patients is analyzed. This finding came to be known as “Bence Jones proteinuria.” It was later discovered that these Bence Jones proteins being spilled into the urine were antibodies, but not an assortment of different antibodies, they were all the exact same antibody for any particular cancer patient.
Now to be a little more specific multiple myeloma is a cancer of the plasma cells, the mature white blood cells which produce antibodies. Once it was realized that each plasma cell produces one unique antibody than something important about cancer could be inferred from Bence Jones proteinuria. Multiple myeloma patients were spilling one particular antibody into their urine because a single plasma cell had become cancerous and multiplied itself so many times that now there was more of that one particular antibody floating around than the body knew what to do with.
This means that in the case of multiple myeloma, and it is believed in all cancers, the disease does not arise from some sort of field effect, as would be seen for instance in infection or toxic exposure, but from a single aberrant cell which reproduces itself many times over, a clone of cancer cells. In this light all cancers can be described as monoclonal, though in the case of multiple myeloma we have a cancer that produces monoclonal antibodies.
Going back now to specific or adaptive immunity there are a couple other points which need to be brought out. Through a very complex process, if the immune system encounters a great deal of a particular toxin, virus, bacteria etc, it is able to up-regulate the production of those specific cells which make antibodies which “stick” to the invader. This helps render the infection harmless and easily disposed of, subsequently the body maintains a “memory” of that particular foreign exposure and can ramp up production of those antibodies much more quickly if the foreign exposure is encountered again in future.
This is the whole reasoning behind the frequent and massive immunization campaigns, though there are many glaring differences between a vaccine and naturally encountered infection. Because of these differences it is desperately important that prospective studies look at actual disease rates between immunized and non-immunized groups and not simply whether an antibody immune response has been generated to a needle jab. Sadly these needed studies are to date pitifully few and far between.
Secondly, the immune system needs to have a “database” of what is “self” versus what is “non self” or foreign. Otherwise, the body would be mounting an immune response against its own tissues. Immune system confusion over what is foreign or not then is believed to underlie those diseases classified as “auto-immune” diseases. The process for how the immune system learns to differentiate self from non-self is complex and not fully understood however any neonatologist will confirm that an infant’s immune system is not fully developed and behaves differently than that of a child or adult. Indeed, much of the specific immunity for a neonate, even up to one year of age is provided by maternal antibodies that have been donated by the mother.
These immune differences should lead to extreme caution, which is terribly lacking, for any neonatal immunizations. Not only would such immunizations be expected to deplete the maternal antibodies which protect the infant as its own immune system matures, but also there is at least the theoretical possibility that a neonatal vaccination might generate tolerance for the foreign antigen. That is to say the immature immune system would classify the foreign epitope as “self.” In such a case neonates immunized at birth would be at increased risk of acquiring the very disease they had been immunized against. Certainly, there are no studies that I know of which disprove this especially as such studies would likely take decades to perform and be quite expensive.
Of course there are many other reasons to be especially wary of neonatal vaccinations. Commonsense wise, it just doesn’t seem to be very caring in the “first do no harm” vein to treat an infant as “welcome to the world … here’s some mock massive infections for you to deal with.” We have talked in a previous post about the frequent lack of dosage adjustment between infant and adult vaccinations. There are also the various adjuvants and toxins that are generally present in most vaccinations along with the vaccine. Further, there are valid epidemiologically grounded concerns associating vaccination with various developmental delays and likely playing a role in both development of autism and sudden infant death syndrome.
Finally in a case such as the recently adopted position of vaccinating at birth for Hepatis B one sees the heights of unreasoning recklessness. Hepatits B is a blood borne/sexually transmitted disease. The mother may be tested for this disease prior to delivery. Providing the parents aren’t planning to take their infant to the tattoo parlor on the way home from the hospital, if the mother does not have hepatitis B the chances of the baby having or developing hepatitis are for all intents and purposes zero. This addition to the vaccination schedule is in my opinion medical malpractice. In all areas of medicine, though of likely greatest necessity in neonatology, caution and prudence are the order of the day. I challenge anyone to provide me a reasonable risk/benefit analysis for subjecting a newborn to vaccination against an easily diagnosable sexually transmitted disease. One might also care to check out what the vaccine related website ThinkTwice has compiled on this topic
People who have spent time on this site realize that I am not a big fan of vaccinations. I’ve looked at the topic a few other times in the past for those who want further reading. As a compromise or first area to apply political pressure, I would guess that much, perhaps even half the damages caused by excessive vaccinations could be stopped if the practice were reigned in in the infant and pediatric age groups, i.e. the very age groups subjected to the most intense vaccination schedules. No vaccinations before the age of two, no more than one vaccination a year before age five, no more than two vaccinations a year before age ten. Is such a compromise really so much to ask? Of course it would require going back to how things were done in 2006 when influenza vaccination was not recommended for children, and back to how things were done in the 1980s when Hepatitis B vaccine was not routinely given to newborns, but again it doesn’t strike me as such a radical or impossible change.
Of course it would also be nice to see the whole government coverage of vaccine maker’s liability for injury and death done away with. Then we might start to see a real evaluation of the true risks/benefits of vaccinations. However as long as the taxpayers subsidize any harm done by the vaccine makers how can there be any expectation of a balanced approach on the part of vaccine makers?
Well, I’ve gone completely off from what I intended to write about. I meant to talk about how the breast cancer indication for Avastin (the best selling cancer chemotherapeutic in the world) has just been pulled by the FDA secondary to overwhelming evidence that Avastin is entirely useless in this disease and the FDA was completely in error when it declared it safe and effective. Ooops, were sorry … actually though, they never did apologize to any of the patients they misled by declaring Avastin safe and effective when it is neither. They did seem sheepish about how the ruling might affect Roche pharmaceuticals but no apologies to the families of dead and bankrupted breast cancer patients, is that too much to ask either? They must have been too busy threatening farmers and supplement makers. Well will try and cover Avastin in more depth in part two.