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Our immune system is a powerhouse that works hard constantly to protect the body from disease. In a fight against cancer, researchers have found great potential in harnessing and boosting the efforts of the immune system to attack the cancer cells. This treatment, known as immunotherapy, is still developing but has shown promise for a number of cancers already.
For patients with rare cancers such as mesothelioma, immunotherapy can provide hope in the face of such a dire prognosis. Mesothelioma often isn’t properly diagnosed until it has developed to a later stage with fewer treatment options. Some patients have seen success with immunotherapy and credit the treatment for giving them their life back. Keytruda®, in particular, has shown promise for some patients and has helped them live beyond the typical 12 – 21 months.
This June marks the 5th annual Cancer Immunotherapy Month, which celebrates the lifesaving potential of immunotherapies. In honor of this month, we reached out to medical professionals in various fields to hear their opinions on the emerging treatment and what lies ahead.
The Potential of Immunotherapy
Immunotherapy works by either stimulating the body’s immune system to work smarter and attack the cancer cells, or by introducing man-made immune proteins to fight the cancer cells, such as monoclonal antibodies. There are many kinds of immunotherapy, though the majority of these therapies are only currently available through clinical trials.
So far, immunotherapy has typically been used as a stand-alone treatment or in combination with surgery. Some researchers believe with further study, immunotherapy could one day replace the more conventional treatments, like chemotherapy and surgery.
“I think we will learn how to combine immunotherapy with conventional treatment first but eventually, as we develop immunotherapy options and understand which patients benefit from which drugs, we will begin to replace existing treatments,” Dr. Ezra Cohen, the translational science director at UC San Diego, recently told the Mesothelioma Cancer Alliance.
Other researchers believe immunotherapy will likely be utilized in combination with the typical cancer treatments. For many cancer patients, a multimodal treatment approach has proven more effective than a singular treatment.
“Immunotherapy is a phenomenal new tool in our armament of treatment options for patients. However, it is certainly in its developmental stages in most cancers,” said Dr. Bradley Corr, assistant professor on the gynecologic oncology team at the University of Colorado. “The way I see the research going and potential for its use is more as an addition to rather than a replacement for conventional treatment options.”
In some cases, immunotherapy has already been seen as an almost miraculous treatment. Mesothelioma patient Mavis Nye was first diagnosed in 2009, and today is in remission after joining an immunotherapy clinical trial. After four years of standard chemotherapy, Mavis was basically out of options.
On her deathbed, she was finally able to participate in a clinical trial studying Keytruda, a monoclonal antibody drug that works by targeting proteins in cancer cells and disrupting their growth. After two years on the trial, Mavis’s tumors continued to shrink into obscurity. Her success with the drug has given other mesothelioma patients hope. Keytruda has also shown promise for melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma (HNSCC).
“The most exciting thing is watching people who previously were dying of untreatable cancers, like melanoma of the skin, have their tumors “melt away” during treatment. I think the key word is dramatic; a potentially dramatic benefit as a life changing event,” said Dr. Eric Whitman, a surgical oncologist from Atlantic Medical Group who specializes in melanoma.
While immunotherapy has proven to be effective for a number of cancers, there are still many types that have yet to see success with this new treatment. “Because of the success we’ve seen for immunotherapy in immune responsive cancers such as melanoma, the initial outlook towards its use in other malignancies was high,” explained Dr. Corr. “Unfortunately, we haven’t seen similar response rates in all cancer types across the board.”
Researchers are working to better understand how the immune system works and why certain cancers are not seeing such positive responses to this treatment. There are hundreds of kinds of cancer, and even similar diagnoses won’t be exactly the same, adding to the difficulties they face in their studies.
“We are just starting to understand why some types of cancers seem more likely to respond to currently available immunotherapy,” Dr. Whitman explained. “It appears that the difference may not entirely be the cancers themselves, but the environment and architecture of the tumor as it grows, which may make it relatively harder or easier for immunotherapy drugs, and of course the immune system itself, to effectively attack the cancer.”
Others are developing new approaches for its use. As mentioned, immunotherapy has often been used on its own or as a post-surgical treatment. An ongoing mesothelioma clinical trial at Baylor University is among the first studying the effectiveness of immunotherapy before surgery. The trial is testing variations with checkpoint inhibitors and studying the immune responses of the patients’ tumors.
Though it’s still early, initial findings have shown promise for effective long-term results. The trial’s lead researcher, Dr. Burt, believes immunotherapy will become a critical component in multimodal treatment for mesothelioma and possibly other cancers as well.
As these current trials progress and new studies emerge, the possibilities for immunotherapy will likely continue to grow with more understanding.
“As much success as we have seen, we are still really in the beginning stages of understanding the complexities of the interaction between cancers and our immune systems,” Dr. Whitman insisted. “I expect our understanding of this interaction to grow by several quantum leaps over the next few years.”
Importance of Immunotherapy Research
Research like this is our greatest asset in the fight to end cancer once and for all. These emerging treatment methods have the potential to transform the standard for cancer care, and bring us closer to a possible cure for even rare cancers like mesothelioma.
Support for these studies through better awareness, increased funding, and continued participation from eligible patients is critical. This research has already positively influenced many patients and their families, and one day could possibly eliminate cancer for all.