A cancer treatment that has recently received a lot of attention in medical reports and even to the public by TV ads. Some great results have been achieved in some patients, but in my opinion there is still much to be done. We are still too much involved with treating the disease and often forgetting the host with the disease. Many believe cancer immunotherapy is a new modality, but as you will see later in this and future posts, the concept has been around for quite some time.
In 2005, I published an editorial entitled “Host Immunity Ignored in Clinical Oncology: A Medical Opinion.” At that time, I emphasized the importance of host immunity cancer survival. Cancer immunotherapy was still considered experimental and was not part of the Big Three Cancer Treatments: (1) Surgery, (2) Chemotherapy, and (3) Radiation; all of which are in themselves immunosuppressive and damage the host’s immune system.
There is now much attention on cancer immunotherapy, but this attention is on patients that have metastatic Stage IV disease. Why don’t we support the immune system early in the disease and in the early stages of standard of care therapy? After completion of therapy, why don’t we evaluate the patient’s host immunity? If there is specific depressed lymphocyte immunity to the patients own tumor; why don’t we then offer an autologous vaccine to that patient in the adjuvant setting?
This vaccine may be what is needed to delay or prevent recurrence. We have done that in a group of patients that had depressed lymphocyte immunity to their own tumor after standard of care therapy. Those patients were vaccinated with an autologous vaccine containing their modified cancer cells, proteins, and biologic adjuvants targeted to their own tumor. The results were published in 2012 and showed the vaccine improved disease specific survival in the vaccinated patients. This vaccine was for breast cancer, but this technology will probably be beneficial solid epithelial tumor.
Our vaccine stimulates the adaptive immune system, while most of the newer therapies are passive immunity. We will explain in later posts, but these are monoclonal antibodies given by infusion to a certain tumor target. Checkpoint inhibitor drugs are similar and are targeted to immunosuppressed elements in the tumor microenvironment. These are great and help patients with metastatic disease. The point is why don’t we try harder to prevent metastatic disease and eliminate the need for expensive other cancer immunotherapies? This would be cost effective and much better for the cancer patient and their families.
In upcoming posts, I will explain the types of cancer immunotherapy in more detail, and also other measures that can be done to support the immune system during therapy. We will emphasize things neglected, what you should look out for and how you might improve your odds. I will quote some passages from our papers on the subject. Hope you enjoy and get something from this post; and we eagerly await your comments and questions.
Robert L. Elliott, M.D., Ph.D., DSc. &
Catherine C. Baucom, M.D., Ph.D