Adventist La Grange Memorial Hospital issued the following announcement on Oct. 31.
If you haven’t heard the word “immunotherapy” before, you’re about to hear it everywhere. On October 1, 2018, this groundbreaking method for treating cancer earned researchers James P. Allison and Tasuku Honjo the Nobel Prize. Duane Mitchell of Smithsonian.com has compared immunotherapy’s impact on modern medicine to Neil Armstrong’s first step on the moon. The pharmaceutical industry foresees an entirely new class of drugs that will transform cancer care over the coming years.
At the heart of all this feverish excitement is an idea beautiful in its simplicity yet game-changing in its possibilities: using your body’s natural immune system to attack cancer cells. To better understand immunotherapy’s potential and how it might translate into more effective treatment for Chicago-area cancer patients, we talked to Ira Oliff, MD, regional medical director of Presence Health’s oncology department (now part of the AMITA Health Cancer Institute). This conversation has been condensed for clarity:
What is immunotherapy? How does it work?
Immunotherapy attempts to employ the immune system — the body’s defense against “foreign” invaders such as bacteria, viruses and parasites — to treat disease. With respect to cancer, that involves manipulating or stimulating the immune system to attack malignant tumors or cells.
To understand how this works, it helps to understand how your immune system normally operates. T-lymphocytes, known as T-cells, circulate through the body looking for abnormal cells to attack. These T-cells identify an abnormal cell via the proteins being expressed on its surface. If the T-cell detects an abnormal protein, it will initiate an attack against that cell.
Likewise, T-cells are prevented from attacking healthy cells by the activation of different protein molecules on the T-cell’s surface, known as “immune checkpoints.” These immune checkpoints act as an off switch to the T-cell’s attack.
Historically, cancer tumors have been able to hide from your immune system by producing the checkpoint protein PD-L1. Immunotherapy circumvents this by using checkpoint inhibitors (monoclonal antibodies) that prevent immune checkpoints — namely PD-1, PD-L1 and CTLA-4 — from binding to their targets. In effect, it removes the brakes from your body’s immune system and allows it to “see,” and attack, cancer cells.
How are immunotherapy drugs administered?
Immunotherapy drugs are administered as intravenous infusions, usually in an outpatient setting. They can be administered by themselves, or in combination with other cancer drugs.
Which types of cancer can be treated with immunotherapy?
Some of the most common cancers treated include melanoma, lung cancer, bladder cancer, kidney cancer, cancers of the head and neck, Hodgkin’s lymphoma and stomach cancer. Immunotherapy is typically used during their advanced stages. Keep in mind, however, that not all patients with these forms of cancer will respond to immunotherapy. Research is currently underway to determine why that is.
Are there any risks to immunotherapy?
By interfering with mechanisms that inhibit the immune system, these drugs can allow it to attack normal organs. Common side effects of this can include fatigue, cough, nausea, loss of appetite, skin rash and itching. More serious side effects might include shortness of breath, diarrhea and kidney or liver damage. Improving our ability to limit or prevent these side effects is another area of active research.
Is immunotherapy available through the AMITA Health Cancer Institute?
Several immunotherapy drugs have been FDA-approved and are routinely administered at any AMITA Health cancer care center. In addition, several affiliated facilities offer clinical trials related to investigational immunotherapy drugs and treatments. Anyone wishing to learn more about immunotherapy should contact the AMITA Health Cancer Institute.
If immunotherapy has so much potential, why aren’t more drugs available?
All FDA-approved drugs need to be evaluated for safety and efficacy via clinical trials. Multiple different immunotherapies are the subject of active clinical investigations at this time. Along with testing its use at earlier stages of cancer, we are also trying to understand why some patients respond to immunotherapy and others don’t, what can be done to improve that response rate and how to prevent side effects.
It is vitally important that patients with cancer volunteer for such trials so that these drugs can be properly evaluated. We should expect several more promising drugs to become available in the coming months and years as a result of these trials. Learn more about the clinical trials currently active at the AMITA Health Cancer Institute.
Do you think we’re entering a new era of cancer care?
Immunotherapy has changed the landscape for cancer treatment in recent years, but I would consider it to be more evolutionary than revolutionary. It hasn’t resulted in a big universal cure. There are many patients with cancer who are not candidates for such therapies, and still more who do not benefit from these drugs. Addressing this will be a primary focus as newer and more effective therapies are uncovered through research. Immunotherapy may be rightly regarded as constituting a new era in cancer care, but it is certainly not the final frontier.
Original source can be found here.
Source: Adventist La Grange Memorial Hospital
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