Can immunotherapy cure tumors?

Can immunotherapy cure tumors?

Immunotherapy uses the body's natural defense system (immune system) to fight cancer. It works by enhancing its ability to recognize cancer cells or changing its behavior to attack them directly. If immunotherapy is included in your treatment plan, knowing these 10 facts can help you prepare effectively.


1: Cancer immunotherapy is a powerful treatment that taps into your body’s natural defense system.

Our immune system is equipped with killer T cells designed to fight off cancer cells. However, cancer sometimes outsmarts our immune defenses. This is where immunotherapy comes in.

Much of what we know about the role of the immune system in cancer comes from researchers at The Cancer Research Institute (CRI). Since 1953, CRI has been the world's foremost nonprofit organization dedicated exclusively to advancing immunotherapy and its scientific basis to improve cancer care.

2: In 1891, immunotherapy pioneer Dr. William B. Coley made history when he saved an inoperable cancer patient.

history when he saved an inoperable cancer patient.

Back in the late 1800s, surgery was almost the only option for cancer patients, which troubled Dr. William B. Coley. His frustration grows, especially after he is unable to save his close friend.

In 1891, inspired by a case, Dr. Colley decided to take a bold step. He tried an unconventional approach with a man who had an advanced throat tumor and had trouble eating. Remarkably, Dr. Kohli's pioneering approach worked, and the patient quickly returned to his or her normal life.

In his honor, CRI presents the annual William B. Coley Award, which recognizes scientists who work to deepen our understanding of the immune system's ability to fight cancer and advance the development of effective immunotherapies for patients.

3: Immunotherapy has been named “Advancement of the Year” by ASCO each of the past two years.

Immunotherapy is highly recognized by the American Society of Clinical Oncology (ASCO). In February, they named it Improvement of the Year again. This breakthrough treatment is proving its worth, providing long-term benefits to patients with a variety of cancers. Eight immunotherapies were approved in 2017 alone, including durvalumab and avelumab, marking significant progress in the field. These achievements are largely due to decades of hard work by Cancer Research Institute (CRI) scientists.

Often hailed as the "Father of Modern Cancer Immunology," Dr. Lloyd J. Old played a key role in advancing immunotherapy. He led CRI's scientific and medical endeavors for four decades, from 1971 to 2011. During this time, Dr. Old made important discoveries about the connection between the immune system and cancer, laying the foundation for the development of today's successful immunotherapies.

4: Currently, there are five types of immunotherapy available for more than 20 cancers.

As of June 2017, the US FDA has approved 32 immunotherapies for various cancers, including melanoma, lung cancer, bladder cancer, kidney cancer, lymphoma, leukemia and prostate cancer. These immunotherapies boost the immune system's ability to fight cancer in different ways:

Cell-based immunotherapies: These therapies strengthen a patient’s immune system by introducing advanced therapies such as immune cells (such as bone marrow transplants) and CAR T cells.

Immunomodulators: These substances directly stimulate immune cells to fight cancer. The first immunomodulator, IFN-α, was approved by the FDA in 1986 for the treatment of leukemia.

Vaccines: Vaccines educate and activate the immune system to respond to potential threats.

Antibody-based targeted therapies: These therapies directly target cancer cells or other supporting elements of the tumor. The first antibody, rituximab, was approved in 1997 for lymphoma treatment.

Oncolytic viruses: These modified viruses infect cancer cells, causing them to rupture and attract the attention of the immune system.

5: Cancer depletes immune cells. Checkpoint immunotherapy can wake them up.

Sometimes, the immune system may be prevented from attacking cancer, even though it has the natural ability to do so. Immune checkpoint pathways can inhibit cancer-fighting immune cells, making them less effective in fighting cancer. To solve this problem, scientists created checkpoint inhibitor immunotherapy. These therapies block these pathways, boosting immune cells and reinvigorating their cancer-fighting abilities. They are particularly effective against severely mutated tumors that are already recognized by the immune system.

Dr. James P. Allison was the first to discover an immune checkpoint pathway called the CTLA-4 receptor. His findings led to the development of ipilimumab, an anti-CTLA-4 checkpoint immunotherapy approved by the FDA in 2011 for the treatment of melanoma. Since then, more checkpoint pathways (such as the PD-1/PD-L1 pathway) have been discovered, leading to the development of more immunotherapies. Currently, there are six FDA-approved checkpoint immunotherapies, including ipilimumab and nivolumab (used in combination to treat melanoma), pembrolizumab (used in advanced lung cancer), and atezolizumab (used in some cases for advanced bladder cancer).

6: Biomarkers help personalize immunotherapy for each patient.

Traditionally, treatments have been one-size-fits-all, based on the location of the tumor rather than its unique characteristics. But now, with immunotherapy, doctors use measurable biomarkers to predict the best approach.

For example, checkpoint inhibitor immunotherapy works better in patients whose biomarkers show the immune system has recognized the tumor. If a tumor expresses a specific protein, such as NY-ESO-1, doctors know that immunotherapy targeting it may be effective.

7: Immunotherapy plays a significant role in improving the lives of children with cancer.

For decades, children have benefited from immunotherapy through bone marrow transplants. Recently, targeted antibodies and checkpoint immunotherapies have proven successful against certain childhood cancers. Dinutuximab is now approved to treat neuroblastoma, and pembrolizumab is approved to treat Hodgkin lymphoma in children.

Researchers are actively working to enhance bone marrow transplantation and molecular-based immunotherapy. Emerging approaches such as CAR T cells hold great promise for children, especially those with leukemia.

Importantly, some current treatments have serious long-term side effects in children. Immunotherapy offers a potentially safer and more effective alternative for these younger patients.

8: Immunotherapy achieves groundbreaking milestone by extending the lives of patients with advanced melanoma.

When melanoma spreads to other organs, treatment options are limited. However, groundbreaking discoveries about the immune checkpoint CTLA-4 led to the development of the anti-CTLA-4 checkpoint immunotherapy ipilimumab, which became the first treatment proven through clinical trials to improve survival in patients with metastatic melanoma. method.

Since the FDA approval of ipilimumab in 2011, other immunotherapies have been approved for the treatment of melanoma, including anti-PD-1 checkpoint immunotherapies such as pembrolizumab and nivolumab, and the oncolytic virus T-Vec. The FDA also approved the combination of ipilimumab and nivolumab to treat melanoma.

Many patients are spending more quality time with their families because of this combination immunotherapy.

9: Immunotherapy doesn’t just work in humans; It works on dogs too!

Cancer is a common problem in older dogs, and Penn is at the forefront of extending the benefits of immunotherapy to our furry friends. The Penn Veterinary Cancer Center and the Mason Canine Cancer Immunotherapy Research Center are leading these efforts.

Dr. Mason's team has treated many dogs. Take, for example, Lewis, a golden retriever with bone cancer: After limb-sparing surgery, Lewis received a genetically modified bacterium similar to CRS-207 that targets a tumor-specific protein. The bacterial vaccine is designed to activate his immune system against hidden metastases and provide long-term protection if the cancer returns.

But vaccines are only one method. Bryant is having his immune system engineered to produce tumor-targeting antibodies, while Halle received anti-CD20 CAR T-cell immunotherapy for leukemia. These treatments offer hope to dogs battling cancer.

10: Immunotherapy is the only treatment approved to fight tumors, regardless of where they originate.

On May 23, 2017, the FDA approved pembrolizumab, an anti-PD-1 checkpoint immunotherapy, regardless of tumor location. Instead, its approval depends on the genetic stability of the tumor.

Now, individuals with metastatic cancer that exhibits genetic instability (identified by MSI-hi or dMMR biomarkers) can receive this immunotherapy even if other treatments have failed. In the clinical trials leading to this approval, patients with 15 different tumor types were included, and nearly 40% had a positive response. These tumors are often susceptible to immunotherapy because their high DNA mutation rates produce abnormal proteins (neoantigens) that the immune system recognizes as foreign.

In some cases, immune cells have initiated responses against these neoantigens but become exhausted through the PD-1/PD-L1 pathway. Here, checkpoint immunotherapies that block this pathway could tip the balance in favor of the immune system and the patient.