Cancer Immunotherapy Named ‘Breakthrough of the Year’

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By Robert Levy

Treatments that unleash the body’s own disease-fighting cells against cancer – an approach known as immunotherapy – have been heralded as the “Breakthrough of the Year” by Science magazine.

The accolade reflects the remarkable success of techniques that allow immune system T cells to make a sustained assault on cancer cells. In early-stage clinical trials, these techniques have spurred long-lasting remissions in some patients with advanced cancers.

Gordon Freeman, PhD

Gordon Freeman, PhD

One such technique – which uses an antibody to release the brakes on a T cell attack on cancer cells – has a long pedigree at Dana-Farber. In the early 2000s, Dana-Farber scientists led by Gordon Freeman, PhD, were the first to describe how molecules on cancer cells and T cells interact to turn off a T cell attack. This discovery opened the way to drug agents that, by blocking that interaction, allow T cells to mount their assault.

The mechanism discovered by Freeman and his colleagues involves a protein called PD-L1, which sways from the surface of a few specialized normal cells, and a complementary protein on T cells called PD-1. When PD-L1 latches onto PD-1, the T cell leaves the normal cell alone.

Freeman’s team later found that cancer cells often cloak themselves in PD-L1 (and a related protein, PD-L2) as well – thereby avoiding an immune system attack.

Pharmaceutical companies quickly seized on the finding, developing antibodies that can block PD-1, PD-L1, or PD-L2. Although the clinical trials of these drugs are still in their early stages, the results are highly promising.

One trial for example, tested a PD-1 and a PD-L1 blocker in hundreds of patients with advanced cancers that were no longer being controlled by other therapies. In all, 18 percent of patients with non-small cell lung cancer had their tumors shrink partially or completely, as did 28 percent of patients with melanoma, and 27 percent of those with kidney cancer. The hallmark of many of these remissions was their persistence: two-thirds of the patients who benefited from the drugs were still in remission when investigators checked them a year after treatment. Several other drugs that work by a similar mechanism are currently being tested, with results looking equally promising.

20 Comments:

  1. beta-glucan, as derived from cell walls such as those of spent brewer’s yeast, is mentioned in articles as an agent which improves the body’s immune system. by extension, this suggests including the immune system’s fight against cancer. can D-F comment on beta-glucan regarding such possibilities? if yes, can you provide to me a D-F contact who i may call … and with whom i can discuss this matter. tia.

  2. Im a patient at DF but live in florida, i just read this article abouthttp://blog.dana-farber.org/insight/2013/12/immunotherapy-for-cancer-named-breakthrough-of-the-year/
    my dr is dr meyerhardt and dr clancy. i have had squamous cell colorectal cancer for 3 yrs surgery on rectum, 25 radiations there, in liver again going to begin nano knife radiation soon and its in my lungs would thiswork onmy type of cancer?

    • Thanks for the comment. You should ask your doctors your question. They would be in the best position to answer it. Dr. Meyerhardt’s office phone number is: 617-632-6855.

  3. Why wasn’t this used in 2009 on my husband,Bob Neal at Dana Farber to have given him a chance against non-small cell lung cancer? Maybe he would have had a chance for a few more years.

    • Hi Linda:

      I’m very sorry about your husband. While researchers are making progress, immunotherapy is still very much an experimental treatment that is currently being tested, and most of the clinical trials for this new approach to immunotherapy began only within the past year or so. Until then, the drugs weren’t ready for human testing.

      We all hope that the approach delivers on the promise that it has shown recently.
      –Michael

  4. This is quite a remarkable story… I am an immunotherapy patient and have been so grateful for the opportunity to participate in my clinical trial. I would be remiss, however, if I did not add that the unfailing care of Dr Toni Choueiri and Dr Marios Giannakis and my entire team at DFCI is no less remarkable. I have long felt that Dana Farber is a place where people go to find help and hope … in my therapy and among “my” team I have found both in abundance.

  5. Could this type of treatment work in a primary brain cancer patient? My Uncle was just diagnosed with grade 4 brain cancer. A team of doctors from DF are reviewing his case now.

    • Dear Melissa –

      I’m sorry to hear about your uncle’s recent diagnosis. While researchers are making progress, immunotherapy is still very much an experimental treatment. I encourage you to check Dana-Farber’s clinical trial page as well as clinicaltrials.gov for possible clinical trials using new therapies. If you’re interested in pursuing new therapies, please make sure to speak with your uncle’s physician or oncologist.

      We wish you all the best.

  6. In what way is this different from the gene therapy developed at U Penn that has been so publicized recently in the media? Do you anticipate trying this approach on blood cancers such as CLL?

    • Dear Hector –

      Thank you for your comment and for reading our Insight blog. While we cannot comment on the specifics of other research, gene therapy typically involves inserting functioning, “healthy” genes into cells to correct a genetic error. A recent study has shown that gene therapy using T-cells can be effective against certain blood cancers, including CLL.

      By contrast, the type of immunotherapy described here doesn’t involve changing the genetic programming of immune system cells, but helps unleash the immune system’s natural attack on cancer cells. We encourage you to check Dana-Farber’s clinical trial page as well as clinicaltrials.gov for possible clinical trials using new therapies. Please make sure to speak with a physician or oncologist when considering new treatments.

      We wish you all the best.

  7. Do you know of any clinical trials of immunotherapy going on now in the San Francisco Bay Area? My father-in-law was just diagnosed with terminal pancreatic cancer. Thank you.

    • Dear Theresa —

      I’m sorry to hear about your father-in-law’s recent diagnosis. The National Institutes of Health maintains a list of clinical trials at clinicaltrials.gov, and I would recommend searching that database for any current or future trials for pancreatic cancer. If you’re interested in pursuing new therapies, please make sure to speak with your father-in-law’s physician or oncologist.

      We wish you all the best.

  8. I, too, have been on a clinical trial for immunotherapy and the results have been amazing! My tumor burden has shrunk significantly and the treatment is more than tolerable. In the two years I have been on this study, I have had virtually no side effects! I have been able to live my life fully, and isn’t that what it’s all about? I am so grateful for my oncologist, Dr. Elfiky, for encouraging me to be on this study, and for all the support I’ve gotten from him and the whole Dana Farber team.

  9. Those of us with non-invasive bladder cancer can receive BCG treatment, as you probably know. This is considered to be immunotherapy in the sense that the TB bacteria instilled into the bladder will/might set up an immune response. This seems very simple and unconvincing. Can it be?

  10. Thank you for this important article and these amazing advances. My identical twin sister was diagnosed with stage 4 melanoma in2008. She had countless surgeries amd immunotherapy. These were the worst of times. It had spread to her lungs. But she has been clean for 3 years now. She has young children and each day is a wonderful gift. Although I love hearing the positive news , the survival rates and statistics make me scared. If I ever can participate in a study with my identical twin, we would be happy to help in any advances. I look forward to a world that no one has to hear you have cancer. Until then, thank you Dana Farber! -Amy

  11. My dad was diagnosed with Glioma Astrocytoma Type 3, he is 84 years old. We have gone through 112 standard radiation treatments, 2 cyberknifes, 3 full chemo cycles, 1 biopsy, and 1 resection. We’ve been battling this disease for since Oct. 2 2012, when he was diagnosed via biopsy. Clinically he is better, but we’ve had one bad MRI in Dec. 12 2013, and the doctor, decided to throw in the towel, we are not about to throw in the towel, as he is clinically better, I want to know if there any other options, as he is 84 and most clinical trials only accept patients till 70.

  12. I strongly believe that immunotherapy is the future of cancer treatment. It has clearly helped so many already while just being in the clinical trial stage. My mother had stage 4 colon cancer with metastases to the liver and lungs and was interested in doing an anti-PD1 trial at John’s Hopkins back in September, but she was too sick to make it there. The trial was also full. It would be great if more than a few people could be in a trial; many more people would be helped. Also, getting the word out about trials would be fantastic for the treatment because so many more patients could be helped. It’s fascinating that we can manipulate our own bodies to fight cancer, and I hope to be seeing much more it in the future.

  13. Hello, does this only work on cancer masses? Is it administered during or after chemo? My father just had stage 3 colon cancer removed, with cancer found in one lymph node. He is about to begin chemo, and this is the first I have heard of this ‘treatment.’ He is 78, and I’m wondering if his case would qualify for a trial? Also, it looked very expensive–is this cost for the research institute or the patent’s insurance?
    Thank you

    • Dear Nora –
      I am so sorry to hear about your father’s health trouble. Immunotherapy is not necessarily a specific treatment, but more of an approach to developing treatments based on the concept of using the body’s own defense mechanism, the immune system, to fight cancer. It is the basis of drug development in a number of different cancers. Your father should certainly ask his oncologist about an immunotherapy treatments that are being researched for colon cancer. For more information about clinical trials, how to participate and qualify etc., visit this website. This booklet also covers more information about whether a clinical trial is the right choice, and it includes information on insurance coverage. I hope this is helpful. All the best to you and your father.

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