ABSTRACT: MEDICAL DISPATCHES about new immunotherapy cancer treatments. In the last hundred years, progress in the treatment of cancer has come mostly from radiation and chemotherapy. Previously fatal blood-cell cancers, such as childhood leukemia and Hodgkin’s disease, are now curable.
But solid tumors, which grow in the lungs, the colon, and the breast, have stubbornly resisted treatment once they spread beyond their initial site.
In 1971, the Nixon Administration declared a “war on cancer,” promising Americans that within ten years the disease would be beaten. At the time, many researchers believed that cancer was caused by a virus that speeded up a cell’s metabolism, resulting in uncontrollable growth of the cell.
After all, they had discovered some hundred viruses that caused cancer in amphibians, birds, and mammals. In the early seventies, interferon, a drug that had been developed from a protein released by white blood cells during a viral infection, was widely thought to be a possible cure for cancer.
Over the next decade, other proteins produced by the body as part of its immune response were made into drugs, most notably one called interleukin-2.
In 1988, Armand Hammer, the ninety-year-old oil-company magnate who chaired Ronald Reagan’s cancer panel, sought to raise a billion dollars, with the aim of curing cancer by his hundredth birthday. He touted interleukin-2 as an immune booster that could achieve the goal.
But most solid tumors were impervious to it, too. In the past fifteen years, as tumors have been found to contain genetic mutations that cause them to grow unrestrained, the focus of research has shifted to cancer’s genome. Targeted therapies, which are designed to disarm these mutations, are now at the forefront of care. The first successful targeted therapy was Gleevec, which caused rapid remissions in chronic myelogenous leukemia, with few and mild side effects.
Herceptin, a targeted therapy that attacks HER-2, a protein that is found in some twenty to thirty per cent of breast-cancer cases, has also been effective.
Harold Varmus, a Nobel laureate and the director of the National Cancer Institute, told the writer that until very recently, “except for monoclonal antibodies, every therapy that exploited the immune system was pretty abysmal. There weren’t any good ideas about why immune therapy failed.”
But now patients who did not respond to available therapies have shown dramatic and unexpected responses to a new series of treatments that unleash the immune system. Tells about the work of Jim Allison, the director of the tumor-immunology program at Memorial Sloan-Kettering.
Discusses tests conducted by Allison on a treatments that stimulate the immune system by suppressing a protein called cytotoxic T-lymphocyte antigen-4, or CTLA-4. Writer interviews cancer patients who have used immunotherapy treatments.
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