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Immunotherapy: Changing the World of Oncology

By: :: Published: December 17, 2014

“This year marks a turning point in cancer, as long-sought efforts to unleash the immune system against tumors are paying off — even if the future remains a question mark.”

Oncologists are developing new weapons in the war against cancer. Traditional cancer treatments aim radiation and chemotherapy at cancerous cells but harm healthy cells in the process. Immunotherapy targets the immune system of cancer patients, rather than tumors. Here’s how the groundbreaking treatment works: A protein receptor on the surface of T cells, called CTLA-4, prevents T cells from launching full-out immune attacks. Studies of cancer patients reveal that antibodies against CTLA-4 extend the lives of people with metastatic melanoma, suggesting that the T cells and the immune system can be set free to attack cancer cells by using antibodies against CTLA-4. In short, immunotherapy stimulates the immune system to work harder to attack cancer cells.

Last week’s “60 Minutes” featured a patient who was diagnosed with stage four, metastatic pancreatic cancer and given four and a half months to live. That prognosis was given two years ago. The patient, David Roy, who is currently participating in immunotherapy clinical trials, is optimistic about the future of cancer treatment: “We are on the edge here, of going from the oil lamp to electricity. And it is going to happen.” Many experts tend to agree. Typically a grounded-in-reality group, oncologists have lauded immunotherapy as a landmark achievement in cancer treatment — so much so that Science magazine named cancer immunotherapy its “Breakthrough of the Year” in 2013.

Clinical trials have cemented immunotherapy’s potential and swayed even the skeptics. There are stories that provide living proof: a woman with a grapefruit-size tumor in her lung from melanoma who is alive and healthy 13 years after immunotherapy treatment; a six-year-old near death from leukemia who is now in third grade and in remission; a man with metastatic kidney cancer whose disease continued fading away even after treatment stopped.

Although immunotherapy’s potential has been solidified from trials and various outcomes, there is still a high degree of uncertainty around its current effectiveness, application and side effects. When treating patients with cancer immunotherapy, some physicians have seen tumors grow before completely vanishing months later. Some patients’ immune systems continue to respond even after immunotherapy treatments have been stopped. And some patients experience malignant side effects such as inflammation of the colon or the pituitary gland.

The next five years will be a pivotal era for cancer care. Many oncologists feel as though “a corner has been turned and we won’t be going back.” However, there are many key questions that remain unanswered. Our understanding of the true impact of immunotherapy will become clearer through cutting-edge research on issues such as identifying predictive biomarkers for tumors that will respond to the treatment and exploring ways to make immunotherapy more effective. Implications from current research and experiments could dictate the future of oncology. 

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