Immunotherapy is a personalized approach against the disease and might be able to avoid chemotherapy and radiation.
Immunotherapy is a new approach to treating cancer, and oncologists say that this is one of the most promising therapies in recent decades.
In principle, immunotherapy is simple. It is a way to activate the immune system’s ability to seek and destroy the invaders. This is how the body fights bacteria and viruses. But it does with cancer, which occurs when healthy cells mutate to outwit the built defenses. That’s where immunotherapy comes in.
“Instead of using external forces such as a scalpel or radiation, natural immune reaction of the body against cancer itself advantage,” said Dr. Steven Rosenberg, a pioneer of immunotherapy and chief of surgery and tumor immunology at the National Institute Cancer (NCI).
These strategies do not target the cancer itself, but work on the body’s ability to fight him. These therapies trigger the immune system to fight cancer cells, keeping healthy cells intact.
In the last decade, scientists have come closer to realizing the promise of immunotherapy. Some trials of the latest generation of these therapies have already produced surprising results. Studies in people with certain types of B – cell leukemias and lymphomas who did not respond to any other treatment, over 80% of them saw their cancer disappear.
“It is unprecedented to see such results in early trials,” said Dr. Stanley Riddell, oncologist and researcher immunotherapy works in one of the trials with colleague Cameron Turtle at the Center for Cancer Research Fred Hutchinson in Seattle.
Market experts estimate that in 10 years these treatments generate anywhere between 35 billion to 70 billion a year in sales. That would make immunotherapy, by far, have the most valuable drugs in history, eclipsing cholesterol drugs such as statins.
These tests are hoping to prove that immunotherapy is not only safe but also a better way to fight certain cancers.
Scientists are trying to make some of the most impressive drugs while some have been developed. Pharmaceutical companies are funding many of these studies in the hope of bringing to market a revolutionary type of medication. And regulatory agencies focus on safety and efficacy.
There are almost 7 million people worldwide who die of cancer every year. A handful of them can do tests and see the miraculous results. Others have no choice but to wait.
Access to treatment
30 years ago, this kind of treatment was “only a dream,” said Rosenberg. While scientists have always been attracted to the idea of turning the body’s own defenses against cancer, there is the fact that tumors arise from healthy cells, so that the immune system does not see them as foreign. That’s why the first generation of drugs of immune antibodies against tumors did not make much impact as doctors expected.
Still, it does not mean that the immune defenses are “useless” when it comes to cancer. Cytotoxic immune cells were found infiltrate itself in malignant cells when doctors cut the tumors. However, the immune system cannot compete with fast-growing cancers.
Rosenberg showed that could delay the development of tumors by activating cells known as T cells to work more efficiently than immunotherapy immune cells. However, T cells approach worked only about 15% to 20% of the time.
“We used to think that T cell therapy was the safest in the world,” Turtle said. “But that’s probably because it did not work very well.” Most cancer patients still had to rely on surgery, chemotherapy and radiation. Then in 1996, James Allison, from the University of California, discovered how immune cells could be trained to identify and attack cancer cells.
The ‘killer’ T cells are actually prevented from targeting and destroying cancer cells, but through the release of this security system, drugs called angiotensin it allowed immune cells to attack the cancer cells.
However, try a new strategy of this type involves significant challenges. Immunotherapy is largely an ultra-personalized medicine, and requires ultra-custom essays.
The medical dilemma
Some doctors are resisting the recommendation of clinical trials, even for promising treatments such as immunotherapy. On a practical level, most do not have the time to keep up with the thousands of studies conducted by pharmaceutical companies and the government, so they may not know what to recommend.
Many of them are also unwilling to take responsibility for putting their patients on an unproven treatment costs they are also prohibitive; three to five times more expensive to care for a patient in a clinical trial because there is more testing and monitoring of side effects.
Also, the more time they spend doctors with patients in a clinical trial, the less time they have to see other patients whose care is reimbursed by other insurers.
Researchers, drug companies and the Food and Drug Administration (FDA) want to ensure that any changes in patients can rightly be attributed to the drug being tested and not another thing that patients have taken before.
This raises an important question that remains unanswered: how can a patient cling on hope of receiving help from an untested drug with scientific and financial requirements of researchers and pharmaceutical companies?
“It’s hard,” said Dr. Michael Neuss, medical director of the Vanderbilt-Ingram Cancer Center. “There are conflicting goals and a lot of tension in that discussion. I’ve been doing this for a long time, and I’m not sure if there is a right way.”
The way to follow
As with any major advance in medicine, costs will be considerable. For now, the treatment of a patient in a clinical trial with immune-based drugs, either funded by the government or by a pharmaceutical company, costs about $ 200,000 a year. That may be a drop in the ocean compared to some of the new cancer drugs which can cost double or triple while only extend life for a few months.
But it is difficult to sustain for the treatment of the nearly 14 million people in the United States living with cancer.
For now, people with certain nodes or blood cancers are benefiting the most. These cancer cells of leukemia and lymphoma have a distinctive feature that scientists can already train immune cells to attack.
However, researchers are thinking about moving immune-based treatments for the largest group of cancer patients, people who have the disease in their breast, colon, lung or pancreas.
Riddell suspects that if the immune systems of patients are activated in the right way and early enough, they may be able to avoid chemotherapy and radiation completely. Even for pancreatic cancer, there is hope that someday immunotherapy could reduce not only chemotherapy, but also the need for extensive surgery.