Monday, January 7, 2019

Immunotherapy: New Hope For Treating Cancer

He has been dubbed "The Texas T Cell Mechanic."  For the last 30 years, he has relentlessly studied this particular cell from every angle.  His dogged pursuit of knowledge has produced breakthroughs in the treatment of cancer.  This researcher's name is Dr. Jim Allison, a pioneer in immunotherapy.

The innovator was recognized in December with the Nobel Prize in Physiology and Medicine for his discovery of a cancer treatment that frees a patient's immune system to attack cancerous tumors.  The Nobel committee lauded his research efforts as a "landmark in our fight against cancer."

Editor's Note: Dr. Allison shared the award with Tasuku Honjo, M.D., Ph.D., of Kyoto University in Japan.

Dr. Allison's journey from the South Texas town of Alice to the Nobel ceremony in Stockholm, Sweden, began 70 years ago.  He acquired his interest in medicine observing his father, who was the country doctor in Alice, population 19,100.  His mother died of cancer when he was 10-years old.

Those experiences shaped his passion for medicine, which began at the University of Texas, where he earned a degree in microbiology and then a doctorate in biological sciences.  After college, he pursued his fervor for research in the cancer field, eventually concentrating on T-Cells.

T-Cells, a type of white blood cell, play a key role in the body's immune system.  The cells act as soldiers, patrolling the body, attacking old cells that have reached their expiration date.  But the cells also stalk intruders, such as bacteria, fungi, parasites and viruses, destroying these hostile invaders.

The T-Cell warriors face a formidable task policing an estimated 30 trillion cells in the average human body. And T-Cells are just one of 200 cells living in our body.  Isolating and studying T-Cells was once viewed by experts as nearly an impossible mission.  But Dr. Allison persevered.

Through years of painstaking research, Dr. Allison discovered that T-Cells do not kill every bad guy.  In fact, he found T-Cells have a braking mechanism that restricts it from attacking every cell in the body, the fit ones as well as the diseased cells.  But the brakes allow cancer cells to flourish.

A determined man, Dr. Allison wanted to learn how to ease off the brakes on T-Cells to allow the cells to demolish cancer cells.  The researcher uncovered a protein CTLA-4, found on the surface of T-Cells, which act as the cell's brakes.  Then he zeroed in on how to manipulate the brakes.

Toiling late hours in the lab, he developed an antibody to block CTLA-4, thus removing the brakes and unleashing the T-Cells to attack the marauding cancer cells.  His work paid off with the development of the drug Ipilimumab, the first in a category of drugs known as checkpoint inhibitors.

Dr. Allison, who published a paper on his ingenious finding in 1995, points out that it took "way too long" for the Federal Food and Drug Administration to finally approve the drug in 2011 to treat late-stage melanoma.  There results were unprecedented.

Twenty percent of the patients who took the drug lived for at least three years and many patients survived 10 years and beyond. He remains humble about his achievements, calling it an "emotional privilege to meet cancer patients" who have been successfully treated with the inhibitors.

His pioneering research sparked fellow scientists to study other immune system brakes, which paved the way to the development of drugs to treat other cancers, such as lung, kidney, bladder, gastric, liver, cervical, colorectal, head and neck as well as Hodgkin's lymphoma.

These discoveries have opened a whole new field of immunotherapy, using the body's immune system to battle cancers. Until now, there were basically three ways for doctors to tackle cancer: surgery, chemotherapy and radiation.  Now doctors have a fourth option with fewer side effects.

Even more promising, Dr. Allison believes the T-Cells will continue working long after the treatment has ended.  "The immune cells remain in the body.  If the cancer comes back, the immune cells will attack it," he was quoted on the MD Anderson website.

Dr. Allison's success led to his appointment as director at the Parker Institute for Cancer Immunotherapy at the University of Texas-MD Anderson Cancer Center in Houston.  He captains a team dedicated to expanding the uses of immunotherapy to not only treat but one day cure cancer.

By disabling the T-Cell brakes, Dr. Allison has toppled one more barrier in the war on cancer. As his career illustrates, breakthroughs often take decades.  But with an estimated 609,000 cancer deaths last year alone in the U.S., time is not an ally for those suffering with the disease.

More research and experimentation urgently needs to be done.  But the FDA also must dispense with regulatory red tape to speed up approval of drugs.  Allowing potential life saving drugs to languish in research laboratories robs cancer victims of an opportunity to extend their lives.  

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