Immunotherapy drugs can be more effective against cancer when combined with other therapies, such as radiation therapy, targeted drugs, or other immunotherapy agents. Clinical trials that are currently underway are testing such combinations in a variety of cancers.
It might seem that immunotherapy and chemotherapy make an unpromising pair. Chemotherapy, after all, is known to lower the immune system response, so combining it with an immune-stimulating agent might appear to be counterproductive.
That was the thinking — until a clinical trial in patients with metastatic non-small cell lung cancer (NSCLC) showed that the use of the immunotherapy drug pembrolizumab and chemotherapy together substantially increased how long patients survived before the disease worsened. The U.S. Food and Drug Administration approved the combination in 2017 as a frontline treatment for people newly diagnosed with NSCLC.
The results in NSCLC have prompted scientists to launch clinical trials of immunotherapy-chemotherapy combinations for patients with colon cancer or advanced triple-negative breast cancer, says F. Stephen Hodi, MD, director of the Center for Immuno-Oncology at Dana-Farber.
What explains immunotherapy-plus-chemotherapy’s effectiveness against NSCLC and, potentially, other cancers? Scientists aren’t sure, but they have some theories that are being explored.
First, while it’s true that chemotherapy suppresses patients’ immunity, the immune system includes a range of different types of cells, including regulatory T cells (or Tregs), whose job is to rein in the immune response. When chemotherapy reduces the number of circulating Tregs, it may actually invigorate some aspects of the immune system, says Dana-Farber’s Osama Rahma, MD, of the Center for Immuno-Oncology and a specialist in gastrointestinal cancers.
Some scientists theorize that the die-off of cancer cells produced by chemotherapy causes a release of antigens, which are proteins that identify cells as foreign. The antigen release may help trigger an immune response to the cancer. Other researchers have suggested that chemotherapy produces changes in the tumor microenvironment — the tissue that supports tumor growth — such that the immune system can more readily attack the cancer. Testing these theories may help scientists improve the effectiveness of current combinations of chemotherapy and immunotherapy and extend them to other types of cancer.
Hello- is immunotherapy recommended for breast cancer patients? My original diagnosis was in 2014 Stage IIIA and spread to the lymph nodes. I was recently told that my breast cancer metastasized and the ct scan shows that it is in my bones, liver and lungs. I am PR positive (5%) and Her2 negative. Thank you!
Hi Winona,
Thank you for reading and apologies for the delay in response. Unfortunately, we cannot provide personalized medical advice through this blog. Breast cancer investigators are tackling cancer on multiple fronts, including immunotherapy. You can find more information about breast cancer research and treatment on our website: https://www.dana-farber.org/breast-oncology-program/clinical-research-and-trials/
Wishing you the best,
DFCI
Where I will get the details of the clinical trials? May be the answer lies in the clinical trial protocols!
Hi Satish,
Thank you for reading. You can find current clinical trials offered through Dana-Farber here: http://www.dana-farber.org/Research/Clinical-Trials.aspx You can also search for clinical trials here: https://clinicaltrials.gov/
However, the website isn’t constantly updated, and data is constantly changing. You can always make an appointment to discuss treatment options with a doctor, who will have a better understanding of clinical trials that are being offered. Here is where you can find information on making an appointment: https://www.dana-farber.org/request-an-appointment/
Wishing you all the best,
DFCI
What about Immunotherapy combined with Alecensa?
I am still alive , years after they gave me a 25 percent chance of living 4 months … With a combination of Radiation and Keytruda
Are there currently trials for this combination with multiple myeloma
Hi Debra,
Thank you for reading and reaching out to us. You can find current clinical trials offered through Dana-Farber here: http://www.dana-farber.org/Research/Clinical-Trials.aspx You can also search for clinical trials here: https://clinicaltrials.gov/
However, the website isn’t constantly updated, and data is constantly changing. You can always make an appointment to discuss treatment options with a doctor, who will have a better understanding of clinical trials that are being offered. Here is where you can learn more about making an appointment at Dana-Farber: https://www.dana-farber.org/request-an-appointment/
We are wishing you all the best,
DFCI
Have cancer and rececent scan showed it in the liver. Was told I only have months to live. Are there any clinical trials I could take part in.
978-618-4601
Hi Barb,
Thank you for reading and reaching out to us. You can find current clinical trials offered through Dana-Farber here: http://www.dana-farber.org/Research/Clinical-Trials.aspx You can also search for clinical trials here: https://clinicaltrials.gov/
However, the website isn’t constantly updated, and data is constantly changing. You can always make an appointment to discuss treatment options with a doctor, who will have a better understanding of clinical trials that are being offered. Here is where you can learn more about making an appointment at Dana-Farber: https://www.dana-farber.org/request-an-appointment/
We are wishing you all the best,
DFCI