The area of immune-oncology, which has taken the field of cancer research and cancer treatment by storm over the last few years, is not new.
The image to the right is of Paul Ehrlich, a German physician and scientist who worked in the fields of hematology, immunology, and antimicrobial chemotherapy, between 1870 and 1910. Around 1900, he had suggested that the body should have the ability to recognize cancer as being different from normal cells, and thereby limit the development of cancer in human beings. Moreover, in an analogy to vaccination, he attempted to generate immunity to cancer by injecting weakened cancer cells, and suggested that we may be able to use the immune system to fight cancer, to treat cancer, and potentially prevent cancer.
In 1908, Ehrlich was awarded the Nobel Prize for Physiology of Medicine for providing a theoretical basis for immunology.
Ehrlich's were a prophetic series of statements and in essence, he was right . . . but it took a long time for his predictions about the use of the immune system in the treatment and control of cancer to reach fruition. Through a long process of basic science & clinical development in academia and industry and government labs, we now have the tools to use the immune system very effectively to treat some cancers.
In 2013, Science Magazine described Cancer Immunotherapy as the Breakthrough of the Year. This was based on the recent science that has taught us how cancers avoid detection by the immune system, and grow, despite the presence of immune cells to fight cancer cells-- and how we might be able to stimulate those immune cells to fight back.
In 2016, the American Society for Clinical Oncology named cancer immunotherapy the "Clinical Advance of the Year", based on the kinds of clinical experiences that are being seen today, using the immune system to fight cancer more effectively.
Below we share some of our favorite stories detailing these experiences, and we hope to add many more to come.
In May 2010, Emily was diagnosed with acute lymphoblastic leukemia (ALL) when she was just five years old. Acute lymphoblastic leukemia is the most common childhood cancer and is curable in approximately 90% of children. The standard treatment protocol consists of 26 months of chemotherapy which meant that Emily would receive chemotherapy until she was seven years old. However, 16 months into treatment, Emily relapsed.
In one last effort to beat the disease, Emily was enrolled in a highly experimental phase I clinical trial using a novel immunotherapy called T-Cell Therapy at Children's Hospital of Philadelphia (CHOP).
Emily was the first pediatric patient enrolled in the trial.. and became the first child in the world to have her immune system trained to fight cancer. The process involved collecting her T-cells (a type of white blood cell), genetically reprogramming them to recognize and attack cancer cells, and infusing the modified cells back into Emily's blood. When the modified T-cells were infused back into Emily she became very sick and spent several weeks in the pediatric intensive care unit on a ventilator. At one point her doctor said she had only a 1 in 1000 chance of surviving the night; however, she fought very hard while her amazing and caring medical team worked around the clock trying to make her better. .. Not only did Emily survive that night, but a few weeks later she was declared cancer free – the T-cell therapy had worked..
Researchers have stopped a study of a new lung cancer drug, saying it's so effective they want to offer it to all the patients in the trial. The drug, Keytruda, is the same drug that former president Jimmy Carter says helped stall advanced melanoma that had spread to his brain.
Keytruda was being tested for the first time in 305 lung cancer patients who had not been treated at all yet. The researchers wanted to see how it worked against the standard chemotherapy cocktails. The novel immunotherapy treatment worked at least as well if not better than the chemo, so the researchers have stopped the study to give everyone a chance to take Keytruda.
"I suspect the findings were significant enough that this will be a practice-changing finding," Dr. Pasi Janne, lung cancer specialist at Harvard Medical School and the Dana-Farber Cancer Institute, told NBC News."It helped patients live longer overall and helped them live longer without their tumors growing or spreading," Merck said.
The FDA has given speedy approval to several new drugs in a class called checkpoint inhibitors, including Keytruda… They treat cancer by stopping tumor cells from cloaking themselves against the normal, healthy immune system response. "Immunotherapy is a whole new way of treating cancer, including lung cancer," said Janne, who was not involved in the study. "Having seen patients benefit who failed existing therapies, now doing well on these new therapies, is fantastic."