The headlines have been coming all year from some of the biggest names in cancer drug discovery and development — from Merck, Bristol-Myers Squibb and AstraZeneca. And just last month, data from Roche’s advanced bladder cancer study lit up the international medical community, pointing toward what could be the first major breakthrough in over 30 years for this dangerous cancer.
The big story here, of course, and the hope for cancer patients everywhere, is immunotherapy. Also known as biological therapy, or biotherapy, immunotherapies use the patient’s own immune system to fight cancer, either by stimulating the immune system to attack cancer cells or by providing a patient with the biological tools it needs to fight cancer. Merck’s Keytruda, for example, is a humanized monoclonal antibody that blocks, or inhibits, PD-1, a protein that prevents the body’s immune system from attacking melanoma cells, offering a boost to the patient’s immune system. Roche’s new antibody, MPDL3280A, works in a similar way for bladder cancer patients, exposing tumors to an immune system that is hard-wired to destroy them.
For both advanced bladder cancer and melanoma patients, chemotherapy has offered the primary treatment weapon for well over 50 years. Born from the seeds of WWII research, when scientists discovered changes to the bone marrow of Navy personnel exposed to mustard gas — and the pioneering work of Dr. Sidney Farber — chemotherapy is wonderfully efficient at wiping out cancer cells. But, as patients and doctors will tell you, the toxic compounds utilized in this procedure destroy healthy cells in abundance, leading to serious side effects and putting severe strains on the immune system.
And this is one of the great promises for cancer immunotherapies — this new modality might ultimately reduce the incidence of chemotherapy altogether, making cancer treatment far less burdensome on patients and families, while offering better treatment outcomes.
Of course, every medical breakthrough brings a host of commercial challenges, and Nature’s astute May 2013 story on the immunotherapy trend highlights cost concerns; after all, many of these therapies will be used as part of multi-drug cocktails, pushing the price tag of cancer treatment ever higher.
I certainly agree that it’s vital to reduce the costs of drug discovery and development, making cancer drugs more affordable for patients. However, I’m also hopeful that, over time, the rise of immunotherapies could help cut the costs of cancer treatment. While some immunotherapies will be used in combination with chemotherapy, or immediately afterward, clinical success may point toward a day when they are used in lieu of chemotherapy altogether — and this will have big implications for the financial burdens associated with side-effects. For patients, today’s chemotherapy regimens require the use of a wide array of costly medications to help control the impact of side effects, whether nausea, infections, diarrhea, pain or fatigue. And while it’s true that even immunotherapies are not side-effect free, they pale in comparison to traditional chemotherapy and, by fortifying immune systems, bring the promise of creating healthier bodies that beat back the disease, and mitigate side effects, biologically.