Is there finally a cure for cancer on the horizon?
If you picked up a New York Times, a Washington Post, a Wall Street Journal or the Atlantic Magazine last month, you may have thought there would be such a cure in the very near future.
All of those venerable publications, reporting from the American Association for Cancer Researchers’ annual meeting in New Orleans, cited impressive examples of the human immune system – poked and prodded to varying degrees by a new breed of immunotherapy pharmaceuticals – actually destroying cancer cells and returning patients to apparently healthy lives at a pace never before seen.
Considering the National Cancer Institute projects that over 600,000 lives will be lost to cancer in the U.S. this year, the news about these immunotherapy drugs was splashed across front pages nationwide.
However, Dr. V. Pavan Kancharla, a hematology and oncology specialist with the Cancer Care Centers of Brevard, urges caution.
From his office across from the Sebastian River Medical Center, Kancharla explains that “the response rates [to these new immunotherapy drugs] right now – what we’re seeing – is only about 20 percent.”
“Why are only 20 percent of people benefitting from [these] treatments?” Kancharla asks. “Because there are certain things that are happening in those 20 percent which are not happening in the rest of the 80 percent.”
No one knows yet what those things are.
In other words, according to Kancharla, biological markers need to be found to decide which drugs will work best in which patients. “Immunotherapy,” says the studious-looking oncologist “is still in its infancy. It’s got a long way to go. We’re just scratching the top of the surface right now.”
Moreover, the price tag for immunotherapy, according to Kancharla, “is about $12,000 a month,” so making sure a patient will respond is vital.
Still, the history of cancer treatments – since the days of the ancient Greek physician Hippocrates – has basically been one of medical blunt force trauma.
First mankind tried to slash, gouge or carve cancer out of the body. Then the decision was made to bombard tumors (along with the rest of the body) with lethal doses of radiation or to poison tumors – and any nearby surrounding cells – with toxic chemotherapy drugs.
Immunotherapy – or biotherapy as it’s sometimes called – seeks a different path: harnessing the body’s own immune system to recognize and attack cancer cells.
The Atlantic article, titled “Cancer: The Final Frontier,” calls immunotherapy “a fancy description for treatments designed to get your body to do what it already does for many diseases.”
That might not sound terribly scholarly but it is pretty darned accurate.
Until quite recently the body’s immune system did not fare particularly well against cancer.
That’s in no small part because while a healthy immune system can seek out foreign bodies, (microbes, bacteria and infections), and then attack and destroy them, cancer cells are different.
Cancer cells have gone through changes or mutations but they’re still the body’s own cells and so the immune system often doesn’t treat them as threats.
“What’s actually happening,” Dr. Kancharla explains, “is basically having a cloak. There is a cloak on the top of the tumor cell and our immune system is unable to identify those tumor cells. So, the medications we are trying to develop are [ones] that will unmask that cloak.”
These new immunotherapy drugs, according to the American Cancer Society, help to “train the immune system to attack cancer cells specifically.”
Even the terminology surrounding these new drugs has a kind of Star Wars quality. Names such as “PD-1” or “Programmed cell death protein 1” or “PD-1 inhibitors” mark these chemical compounds as light years away from the scalpels and saws once used to treat cancer.
Among these newer drugs are Keytruda from Merck Pharmaceutical and Opdivo and Yervoy from Bristol-Myers Squibb. All three have helped produce significant and seemingly long-lasting improvements in some cancer patients but by no means in all such patients.
While the Post reports these new drugs “are showing significant and extended effectiveness against a broadening range of cancers,” that may not be the biggest news coming out of New Orleans.
In a possibly more startling development, several major pharmaceutical firms are now working together.
The Times says, “Leading pharmaceutical companies are joining forces in an effort to speed the testing of newer types of cancer drugs to harness the body’s immune system to battle tumors.”
Both Merck and Bristol-Myers have even begun testing their drugs in combination with drugs from other manufacturers.
That’s a very rare phenomenon in the ultra-competitive pharmaceutical world.
These new drugs, according to the Post, are proving especially effective in helping the body fight both head and neck cancers and “an extremely lethal form of skin cancer called Merkel cell carcinoma” and have already been approved by the FDA for use against lung and kidney cancers.
The paper points to the case of former President Jimmy Carter. Last year Carter was diagnosed with an advanced melanoma that had spread to his brain.
A combination of Keytruda and radiation treatments, however, worked so well that the former president no longer requires any treatments at all.
Still, as Kancharla warns, immunotherapy is still nowhere near the point where it can be called an actual “cure” for cancer.
At least not yet.
Still, it’s nearly impossible to point to any one treatment approach in 5,000 years of medical history that holds as much promise for finally defeating cancer as these immunotherapy drugs appear to have.
Dr. V. Pavan Kancharla is with Brevard Cancer Care Centers and is affiliated with the Sebastian River Medical Center. His Sebastian office is at 13050 U.S. 1. The phone number is 772-388-2100.
