Science is a fascinating thing. Researchers devote their entire careers to discovering and developing new drugs and treatments. And it can take years—even decades—for the “next great breakthrough” to be revealed. Oftentimes, research that is hypothesized to change the future of medicine doesn’t pan out after all. But when it does, it can be a real game changer.
This is how I feel about immunotherapy. Simply put, immunotherapy is the prevention or treatment of a disease using certain parts of a person’s own immune system. In some cases, immunotherapy uses substances made from living organisms to dampen the immune response and treat inflammatory diseases such as arthritis. In cases such as cancer, these substances enhance the power of the immune system to fight cancer.
Immunotherapy became prominent a couple decades ago, thanks to a new class of drugs called TNF inhibitors that suppress the body’s response to tumor necrosis factor (TNF), a compound that is part of the inflammatory response. These drugs were initially created to treat rheumatoid arthritis.
Now I don’t use the term “game changer” lightly.
Into the 90s’, rheumatoid arthritis inevitably had devastating effects. The disease caused persistent joint pain and destruction, swelling, and stiffness, leading to a poor quality of life. Typical treatments at the time consisted of pain control and systemic steroids to reduce inflammation to try to prevent further joint damage.
More invasive procedures included joint replacements and the chemotherapy drug methotrexate, which can have terrible short- and long-term side effects.
Then along came TNF inhibitors. This new therapeutic option gave a lot of hope when they previously had none. Immunotherapy has enabled many to live largely pain free with no more surgeries.
The Future of Immunotherapy
Today, very similar therapies are applied to other inflammatory conditions like Crohn’s disease, psoriasis, and even cancer.
The scientific community has dreamt of these types of advances for years. Cancer treatment, in particular, is going through a profound metamorphosis. However in this case, we are finding new ways to make the immune system stronger and more aggressive toward the cancer. We are seeing a dramatic shift toward immunotherapy for many forms of cancer, including breast, skin, brain, pancreatic, and prostate. In many (though not all) cases, it has the capacity to cure the cancer. But in all cases, treatment directly targets the cancer cells, rather than the cancer cells as well as healthy cells, the way chemotherapy and radiation does.
There are several ways this can be achieved. Monoclonal antibodies are lab-made versions of proteins naturally produced by the body. These antibodies bind to receptor sites and attack a very specific part of a cancer cell. Immune checkpoint inhibitors are drugs that enhance the action of the immune system so that it can better and more accurately recognize and attack cancer cells. And finally, cancer vaccines initiate an immune response so that the body is better able to fight off the disease. Vaccines can be created from actual cancer cells from the patient’s own body (they are removed, altered, and killed), antigens (fragments of a cancer cell), or special immune cells that help the body recognize and attack cancer cells.
A growing body of research has yielded awesome results.
In one study of patients with advanced melanoma, 34 percent of patients taking nivolumab (a monoclonal antibody) survived for five years. This was double the amount that researchers expected would survive using traditional treatment.1
Another study looked at the effect of this same drug on squamous cell carcinoma. Of the 361 patients in the trial, twice as many patients taking nivolumab versus traditional treatment were alive a year later.2
You may recall that former President Jimmy Carter, at the age of 91, received a similar immunotherapy drug called Keytruda to treat his stage IV melanoma that had spread to other areas of this body. It resulted in doctors finding no evidence of cancer! This is amazing, especially considering how advanced President Carter’s disease had become.
Is immunotherapy the absolute answer to cancer? It’s too early to tell. But it certainly shows an incredible amount of promise.