As a busy oncologist and cancer researcher at Montefiore Einstein Center for Cancer Care in New York, I recognize that many people are familiar when the terms chemotherapy and radiation are discussed as treatments for cancer. The notion of the more recently introduced targeted therapies is also becoming more understood. A new approach to treating cancer called immunotherapy is being widely researched by scientists and medical professionals and is also evolving as an exciting new approach to potentially cure very specific forms of cancer. But understanding immunotherapy and how it works is somewhat complicated. If you Google “immunotherapy,” you’ll find “the prevention or treatment of disease with substances that stimulate the immune response.” To better understand how immunotherapy works to block or eliminate cancer, here is some helpful information.
What Causes Cancer?
Cancer is a disease characterized by changes in the “information material” or DNA within specific cells in the body, leading to the production of proteins that are altered in quality or quantity. These altered cells are what makes up cancer, and can multiply rapidly, causing tumor growth and potentially spreading to other body parts, such as lymph nodes, bone and brain through the lymphatic system or blood.
How Does the Body React to These Abnormal Cancer Cells?
Tumor cells can be recognized by our own immune system as foreign and dangerous, and the body will try to control and eliminate these cells. However, it turns out that cancer cells can adapt over time to the immune system attack and develop strategies to evade detection. In essence, cancer cells hijack a critical normal function of the immune system thereby successfully paralyzing attacking immune cells. However, by studying specific cancers, like melanoma, and non-small cell lung cancer, scientists realized there could be a way to block or otherwise prevent the cancer cells from evading the immune system’s response.
What Does Immunotherapy Do?
Immunotherapy allows the body’s defense system to go to work killing off the foreign cancer cells. Immunotherapies can take the form of a vaccination to boost the body’s immune system or a targeted therapy designed to release the block created by the tumor cells and reactivate the body’s fighting cells. There are several immunotherapies already approved for use in a range of cancers and many more currently being researched. Researchers are continuing to study when to introduce immunotherapy during cancer treatment. Immunotherapy is a very exciting and dynamic area that holds much promise, especially for difficult to treat or advanced forms of cancer.
The best way to illustrate how immunotherapy works is for me to tell you about a patient in my practice. John, a former smoker, is 46-years-old, worked as a welder and lives in the Bronx, New York, with his wife, a homemaker, and their two teenage sons. Last year, John came to my office with severe pain throughout his ribcage. He was quickly diagnosed with the most aggressive type of lung cancer. In spite of standard of care treatment with chemotherapy, radiation and then a second combination of chemotherapy, his tumors increased, spread to his brain and continued to ravage his body. Throughout his care, we tested his tumor extensively in search of an alteration in his cancer cells that we could successfully target but to no avail. It was not until he lay close to death that we discovered within his tumor an extremely high amount of the biomarker, PD-L1, which is the protein that can turn off the attaching immune system. This provided a clue that a new immunotherapy could potentially jumpstart his immune system to attack the rapidly growing cancer and turn off the spread of the disease that was resistant to chemotherapy and radiation. And it worked beyond our highest expectations – John made a remarkable recovery, with most of his tumors melting away and his symptoms completely disappearing three months into his immunotherapy treatment. Today, he feels nearly 100 percent recovered and is considering returning to work. For those of us on his medical team, John’s cancer journey and recovery clearly shows why immunotherapy is a game changer in our field.
Where Can I Learn More About the Use of Immunotherapies in Cancer?
There are many online resources available from leading professional, government and patient advocacy and education organizations. Here are links to three organizations with highly useful information about immunotherapies: