Immunotherapy for cancer: what you need to know


Immunotherapy for cancer: what you need to know

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Over the last couple years, Judy Perkins has lived life according to her bucket list. She went rafting in the Grand Canyon, and hiking in Nepal and Patagonia. She completed a trip around


Florida by sea kayak. Perkins, 52, did all these things because she believed she would die within months of metastatic breast cancer. She was first diagnosed and treated for early-stage


breast cancer — ductal carcinoma in situ — in 2003. She opted for aggressive treatment: a mastectomy, where surgeons removed her entire left breast. She assumed she was cured. Then, a decade


later, she felt a lump on that same side, where her breast had once been. The cancer had recurred, but this time it had spread throughout her chest wall. She had metastatic breast cancer,


and her oncologist gave her three years to live. Over the next two years, Perkins hunted for clinical trials to join and tried every treatment imaginable. She had some success with one drug


but had to stop taking it after developing a dangerously low platelet count. In 2015, just as she felt she'd run out of options, she heard about a clinical trial at the National


Institutes of Health using a new type of therapy, called immunotherapy, to treat cancer. She flew to Bethesda, Md., to undergo treatment — a grueling ordeal that involved (along with five


days of high-dose chemotherapy) having doctors extract her own immune cells, enhance them in a laboratory, then inject them back into her body. She experienced high fevers, chills and bouts


of diarrhea. But within about a week, she realized the treatment was working. “The tumor had been pressing on a nerve that sent pain shooting all the way up and down my chest and back,” she


says. “The pain disappeared so rapidly that 10 days after treatment, I was able to completely stop taking my pain medications.” More than two years later, Perkins is cancer free, and doctors


have told her they don’t expect her cancer to come back. “It’s so strange, because three years ago I was planning my bucket list and thinking about all the books I would read before I


died,” she says. “Now I have a new lease on life. I have probably 20 or 30 years ahead of me. I quit my job as an engineer when I was diagnosed with metastatic cancer. Now I have to think


about what I want to do — go back to nursing school? Volunteer?” Immunotherapy — treatment that uses certain parts of a person’s immune system to fight diseases such as cancer — isn’t a new


concept. “The idea that we could use the body’s own natural defense mechanisms to attack cancer cells has actually been around for quite some time, since the 1960s,” says Len Lichtenfeld,


M.D., deputy chief medical officer of the American Cancer Society. But incredibly, it’s taken a half-century to come to fruition. This revolutionary therapy has quickly become the gold


standard to treat many types of hard-to-treat-cancers, such as lung cancer, melanoma and kidney cancer, says Sumanta Pal, M.D., an associate professor in the department of clinical oncology


at the City of Hope Comprehensive Cancer Center. But while immunotherapy can be a miracle therapy for some, it’s not a panacea for everyone, Pal warns. One preliminary analysis found that


fewer than 10 percent of all cancer patients can benefit from it. In rare cases, it’s even been linked to harm. “There’s a rush now to try immunotherapy with end-stage cancers, but it


doesn’t work for every patient and every cancer type,” Pal says. “That’s why it’s important for patients to understand the pros and cons and have an in-depth conversation with their


oncologist.” Here’s a look at what types of immunotherapy are currently available and what’s in the pipeline for the future. Getty Images CURRENTLY AVAILABLE TREATMENTS There are two main 


types of immunotherapy currently approved to treat certain types of cancers: drugs called checkpoint inhibitors and the less frequently used chimeric antigen receptor (CAR) T-cell therapy.


We break down both below, starting with the drugs. 1. CHECKPOINT INHIBITORS This class of FDA-approved drugs is now being used now for many types of cancer, including melanoma, lung and


kidney cancers. One drug, pembrolizumab, made headlines earlier this year when a study in the _New England Journal of Medicine_ found that when it was combined with chemotherapy, it


dramatically boosted patients' odds of surviving lung cancer. BRAND NAMES: * Keytruda (pembrolizumab) * Opdivo (nivolumab) * Tecentriq (atezolizumab) * Bavencio (avelumab) * Imfinzi


(durvalumab) * Yervoy (ipilimumab)