Immunotherapy has led to many lives saved from cancer -- but has the reality of the revolutionary treatment kept up with the promise?
“Without this, many, many, many more patients would have died,” says Allison Betof Warner, MD, PhD, an oncology fellow soon to be on thefaculty at Memorial Sloan Kettering Cancer Center in New York City. “It’s a complete game changer for the diseases for which it works.”
The answer, scientists realized after decades of research, is that cancers can manipulate the body’s immune system. Sometimes, tumors trick the immune system into stepping on the brakes instead of attacking when faced with cancer cells. The checkpoint drugs took off in the early years of this decade, beginning with the approval of Yervoy for melanoma in 2011. The second type of blockade, including drugs like Keytruda and Opdivo, provided more than double the benefit of the first drug, Yervoy.
Regardless of their results on the therapy, patients and insurance companies are charged a lot of money for these immune therapies. According to one 2015, for instance, Opdivo costs just over $100,000 for a typical patient. With a 20% copay, that will run a patient $20,000. And side effects happen nearly as often in people who get little benefit from the drugs as those who benefit long-term, Awad says.
“We shouldn’t assume that we’re done with understanding the basic science,” says Sharma, whose husband and colleague, James Allison, shared a Nobel Prize last year for work that led to the development of the first checkpoint inhibitor, Yervoy.
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