Chapter 1157: Rural Absurd Past Events Chapter 1157: Immunotherapy, The Last Chance

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Protagonist:

Li Xiulan

After Wang Xiaohua persuaded him, Wang Zhanggen finally stopped making a fuss about going back.

The conflict between Wang Dashan and Du Xiaojuan has also been temporarily suppressed.

However, because of this matter, a not insignificant rift has formed between the two; whether it can be repaired later remains an unknown.

Before long, the hospital sent word that Wang Zhanggen's clinical trial screening had passed; he can go to the hospital tomorrow for a new round of comprehensive physical examination, and then proceed immediately to the trial after the exam.

This trial involves an immunotherapy regimen.

Medically termed "CAR-T Cell Therapy".

The treatment principle is based on a biological theory: the reason humans get cancer, and the reason cancer cells can spread wildly in the body, is that the cancer cells have already undergone "immune escape" — meaning the body's immune cells no longer attack these immune-escaping cancer cells.

Therefore, one only needs to reawaken the immune cells' capture and phagocytosis of this type of cancer cell to achieve targeted elimination of cancer cells in the body.

The specific method is to first extract immune T cells from the patient's body, genetically modify them in vitro, then expand the modified T cells in vitro; once they have propagated to a sufficient quantity, these modified T cells are reinfused into the body.

This technology was still very immature at the time, generally applicable to hematopoietic system tumors such as leukemia and lymphoma; for cases like Wang Zhanggen's — liver cancer with multi-organ metastasis — it could only be used as an experimental treatment, after signing various liability waivers.

Wang Zhanggen's case amounts to a desperate measure for a hopeless case.

Additionally, Wang Xiaohua quite agrees with this treatment plan; at least theoretically, it can be called a method that treats both symptoms and root cause.

Unlike the indiscriminate killing of chemotherapy and radiotherapy, if the T cells can be modified to an ideal state, this treatment can act solely on cancer cells.

However, theory is theory; whether theory can be translated into practice requires a very long period of time.

When this treatment method is perfected in the future and can truly benefit all humanity, Wang Zhanggen will also count as having made a tiny contribution to advancing this treatment method.

The development and perfection of every cancer treatment regimen is inseparable from the successive clinical trials of patients.

After Wang Zhanggen finished his physical examination and had blood drawn, the next step is to go back and wait.

The hospital needs to isolate Wang Zhanggen's blood sample and collect the T lymphocytes inside.

After collecting the T lymphocytes, in vitro genetic modification and expansion are needed; this is the most critical step, and also the most lengthy one.

Generally this step requires a long time of 7 to 21 days to complete.

Because this involves links such as viral vector transduction, CAR expression, and large-scale cell culture expansion.

These are things generally only understood by people studying biomedical science.

Even Wang Xiaohua was hearing about immunotherapy for the first time.

He then looked up relevant materials and literature to understand a thing or two about it.

As for Wang Dashan and Wang Erhai, regarding this treatment method, they were completely baffled, utterly unaware of the treatment principle.

They only knew the hospital had expert doctors recommending they try this, so they decided to let Wang Zhanggen give it a try.

Wang Xiaohua also learned that this treatment method is far more complex than imagined.

It is not a matter of taking the cells out, modifying them a bit, and then reinfusing them into the patient.

After the T cells have been cultured to a sufficient quantity in vitro, the next step is safety testing — such as sterility testing, purity testing, viability testing, and so on.

If the in vitro cultured T cells are found to be contaminated, then all previous efforts are wasted; blood must be drawn again and the process restarted from scratch.

This involves medical rigor; if contaminated T cells are infused into a patient, who knows what severe side effects might occur.

After safety testing is completed, the T cells still cannot be infused into the patient; a step called "lymphodepleting chemotherapy" is still needed — colloquially, clearing lymphocytes from the cultured cells to enhance CAR-T engraftment efficacy.

Finally, the CAR-T cells are reinfused into the patient via intravenous infusion.

From blood draw to reinfusion, the whole process takes at least twenty-plus days, at most over a month, or even longer.

Wang Zhanggen's condition is already very poor; currently, every so often he needs to go to the hospital to drain ascites.

It is unknown whether he can still wait that long.

During this waiting period, Wang Zhanggen stayed very uncomfortably in Wang Dashan's villa.

Because Du Xiaojuan took the child and moved out to live elsewhere, he harbored a constant grudge, feeling Du Xiaojuan was looking down on him.

So he proposed: since the T cell reinfusion won't happen that quickly anyway, why not go back to Shanggou Village to stay first.

If ascites needs draining, just go to the County Hospital.

Wang Dashan disagreed with Wang Zhanggen's request; if something happens to Wang Zhanggen in Shanggou Village, rescue might not arrive in time — after all, that mountain backwater, even going to the County Hospital takes at least half an hour.

Wang Xiaohua, however, felt that since Father wants to go back, let him go back.

First, both parents are genuine rural people; it is normal they are unaccustomed to living in the city.

Second, the rural environment is fresh and suitable for recuperation; perhaps letting Father go back to stay could improve his mindset a bit.

As for worrying about accidents, Wang Xiaohua and Wang Erhai can go back to Shanggou Village together to accompany him.

Wang Erhai also felt it would be better for Father to return to Shanggou Village.

The main reason is, if Father continues staying here, it might really affect Big Brother and Eldest Sister-in-law's relationship.

Finally, persuaded by Wang Xiaohua and Wang Erhai, Wang Dashan relented.

This afternoon Wang Xiaohua and Wang Erhai helped pack the luggage, then took Wang Zhanggen and Li Xiulan back to Shanggou Village.

Once they left, only Wang Dashan remained in this huge villa.

Because Du Xiaojuan and the child are now living in a rented large flat apartment nearby.

Wang Dashan sat in the empty living room, smoking to himself.

His mind kept recalling Du Xiaojuan's words and deeds during this period.

He increasingly felt this woman was cold-blooded and selfish, caring only for herself, completely disregarding others.

Du Xiaojuan wasn't like this before; she used to be considerate of his feelings everywhere, considerate of Wang Zhanggen's face as an elder.

But ever since she had children, her personality had changed a great deal.

She lost rationality, her emotions were easily excited, and she gained selfishness and domineeringness.

So thinking about it now, even Wang Dashan began to have a bit of suspicion: was having children with Du Xiaojuan ultimately correct?

Perhaps the children should be born, but they should not have been born at this critical juncture when Father fell ill.

It's just that some things are not within human power to control.

Who could have anticipated that Wang Zhanggen would suddenly be diagnosed with cancer?