Investigates a ‘sea change’ for cancer treatment
pies are known as checkpoint inhibitors. They act as a form of “border control”, enabling the body to differentiate between normal and “foreign” tumour cells and kill off the latter. They target “checkpoints” — molecules on certain immune cells that need to be unblocked, or blocked, to spark an immune response. Basic immunotherapy drugs are administered via a drip every two to three weeks.
The more advanced form of immunotherapy is cell therapy. This involves taking cells from patients via a blood sample and manipulating them genetically to ensure they can “bind” on to the tumour when reinserted in the body. There is, however, a risk of “over-cooking” the dose and overstimulating the immune system, causing auto-immune diseases such as irritable bowel disease or colitis. The challenge is in determining which patients are likely to do well. “How do we pick the patients that are most likely to benefit, and not waste resources?,” one oncologist said. “We don’t know the answer yet.”
The future
NEW immunotherapies are being announced on an almost monthly basis. Last November atezolizumab, the first for patients with bladder cancer, was made available immediately on the Cancer Drugs Fund. It was said to be the first new effective treatment in 30 years. Nivolumab was made available for patients with head and neck cancer, having earlier been made available for lung cancer after chemotherapy.
At Charing Cross hospital researchers are the first to discover that pembrolizumab can cure women from cancerous forms of gestational trophoblastic disease that arise in the womb after pregnancy. Three in four women taking part in a trial went into remission.
Professor Michael Seckl, consultant medical oncologist at Charing Cross, said: “There are a small number of women whose [GTD] cancers are resistant to conventional therapies and as a result have a fatal outcome. Immunotherapy may be a life-saving treatment and can be used as an alternative to the much more toxic high-dose chemotherapy that is currently used. These are landmark findings that have implications on how we treat the disease in the UK and around the world.”
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