When it comes to cancer, experts say that there’s still a wealth of information that the medical community has yet to uncover. Oncologists with the Cancer Treatment Centers of America (CTCA) are busy learning more about the body’s immune system and the genetics of cancer to advance the field of immunotherapy.
Dr. Bruce Gershenhorn, the CTCA’s medical director of the lung cancer center in Illinois, explained in Conquer magazine exactly how immunotherapy drugs work. According to Gershenhorn, the concept of immunotherapy has been researched since the 1890s. Finally, in 2010, the first FDA-accepted immunotherapy medication was released. Yervoy (ipilimumab) was approved to treat patients with advanced melanoma. Today, immunotherapy drugs are used for lung, bladder, kidney, head and neck cancers and Hodgkin lymphoma.
Immunotherapy medications, which are also called checkpoint inhibitors, use the immune system to destroy cancer. Normally, the body doesn’t attack malignant cells because they hide their identity with PD-L1 proteins. Immunotherapy drugs block this protein so that the T cells attack the cancer.
Chemotherapy and radiation target all dividing cells whether they are good or bad. The immune system has the ability to target the unwelcome cells exclusively and eliminate the side effects that are associated with conventional treatments. This makes immunotherapy unique and very promising for cancer patients.
Experts like Dr. Maurie Markman, the president of medicine and science for the CTCA, are still working to understand cancer genomes and the mechanisms behind immunotherapy medications. The big question for researchers is why these new treatments work for some people but not others. Many patients experience favorable results initially, but the treatment eventually stops working. According to one CTCA expert, approximately half of patients don’t respond to immunotherapy.
Markham believes that T-cell exhaustion could inhibit the immune response. If the white blood cells are busy in another part of the body, they might be unable to reach the cancer cells. To counter this, researchers are testing co-stimulators that could boost the production of T cells so that the body can successfully target cancer cells.
According to CTCA nutritional expert Carolyn Lammersfeld, malnutrition inhibits the immune system’s performance. She says that undernourishment and overnourishment are common among cancer patients. Their weakened immune systems are further compromised since 80 percent of cancer patients receive multiple treatment modalities. Lammersfeld recommends that patients moderate their food consumption, take several smaller meals, stay hydrated and engage in light to moderate exercise.
There are other theories. Several studies showed that cancer mutates in response to immune attacks, which prevents immunotherapy from producing optimal results. Neoantigens, a type of cancer-related molecule that attracts T cells, aren’t always produced in the numbers that are needed to provoke the immune system. Additionally, JAK1 and JAK2 proteins resist specific immunotherapy medications. Cancer cells evolve constantly, which is a wild card in immunotherapy.
Genetic mutations disrupt the body’s interferon-gamma signaling system that activates cancer-fighting cytokines. These molecules interact with the immune system by requesting T cells as backup in the attack. If cancer cells mutate, the immune system’s effect is reduced, and the chance of a relapse increases.
Despite genetic challenges, immunotherapy is a promising solution for patients who have had little success with conventional treatments. Clinical trials, such as the Targeted Agent and Profiling Utilization Registry (TAPUR) that’s overseen by the Cancer Treatment Centers of America, give patients a chance to access cutting-edge alternatives to chemotherapy and radiation.
Cancer Treatment Centers of America is a private for-profit health care network headquartered in Boca Raton, Florida. The company specializes in conventional cancer treatments, precision genomic medicine and integrative therapies that reduce treatment symptoms and improve patients’ quality of life.
The company was founded in 1988 by Richard J. Stephenson who was disappointed by the lack of treatment options that were available to his mother. The first treatment center was built near Chicago. Since 2005, four additional hospitals have opened in Atlanta, Philadelphia, Tulsa and Phoenix. Through this regional hospital system, the CTCA serves patients in the Midwest, Southeast and Southwest and on both coasts.