I wanted to repost this list of FDA approvals of immunotherapeutics that blogger, Brad Loncar has published (***). I made a word cloud of his results and, as expected, Keytruda (pembrolizumab) and Opivid (nivolumab) had the greatest hits for therapies. In recent years the PD-1 inhibitor, Keytruda, has galvanized the immunotherapy field. Keytruda has been found to show indications in advanced non-small cell lung cancer, advanced melanoma, head and neck squamous cell carcinoma, Hodgkin lymphoma, and advanced urothelia bladder cancer. Hopefully, more malignancies can be targeted by Keytruda, along with other drugs.
Anyone who works in the realm of biomedical research at one point or another has been asked this question, “When will we have a cure for cancer?” Sometimes this question can be annoying, because many people believe that cancer will be cured with one silver bullet. However, one cannot be too annoyed with the question, because it is a fairly honest question. We have been researching, reporting about, and experiencing the ups and downs of cancer for ages. After President Nixon declared war on cancer in 1971, many politicians have promised a cure for this deadly malady. Since a large portion of biomedical research is funded through various governmental funding agencies, the people, as taxpayers, have a right to ask this question.
This blog update based on an article published by Eva Kiesler and Meredith Begley (***), which lists five reasons for continued optimism in cancer research. Here, I will touch on three of these reasons that I find very interesting and exciting.
Precision Medicine: In 2015, President Obama announced a $215 million genetic research plan to genetically map one million people, to research the genetic causes of various cancers, and to gauge new drugs and treatments. Of course many of these ideas set forth this initiative may change under the current administration, which has not been very friendly towards science in general. Of course there is some good mixed with the bad in the field of Precision Medicine. Some of the good can be realized in: understanding the genetic background of new diagnoses, detecting diseases at earlier stages, and developing personalized treatments. However, there are several drawbacks to this field of study that resonate with critics. The biggest criticism is what happens if all of this genetic information falls into the wrong hands. Would someone be denied insurance coverage or a job based on his/her genetic background? Time will only tell how Precision Medicine will help or hinder cancer research, especially under this new administration.
Immunotherapy: Over the past couple of years, immunotherapy has become a very “sexy” field in cancer research. Generally put, immunotherapy uses a patient’s own immune system to fight his/her cancer. It has been long believed that the “cure” for cancer lies in immunology, because cancer basically evades the surveillance mechanism of the immune system. PD-1 inhibitors represent the first class of immunotherapies, but plenty of others inhibitors are quickly catching up to PD-1 inhibitors. Recently, epacdodostat [Indoleamine 2, 3-odioxygenase (IDO) inhibitor], produced by Incyte Corporation, has had great success in combination with PD-1 inhibitors for treating non-small cell lung cancer and kidney cancer. Many people inside and outside of the laboratory have high hopes for immunotherapy, especially through combination treatment.
Cell-based Therapies: A few years ago, chimeric antigen receptor (CAR) T cells jumped on the scene as an intriguing way to attack cancer cells. This technology makes “killer” T-cells from a patient’s own blood cells. A patient’s T cells are collected; the cells are genetically modified to attack a specific types of proteins expressed on cancer cells; and then these genetically-modified cells are re-introduced into the patient. A major concern with this technology is that one has to modify the T-cells for targets that are expressed on cancer cells and not on healthy cells. In many cases, similar proteins can be expressed on both cancer and normal cells. Since this technology is very personalized, it will take very specialized laboratories to manufacture these cells. Typically, when you get into this extreme level of specialized medicine, the price tag is not cheap. Currently, Novartis and Kite Pharma are two companies that are in the lead for getting this therapy approved by the FDA for treating acute lymphoblastic leukemia and B-cell non-Hodgkin lymphoma, respectively.
Although we have not eliminated various types of cancer, I think that we are well on our way. Here, I touched on three exciting areas of cancer research that may provide some answers in the field of oncology. I think that we are in a very exciting moment of cancer research but time will tell how effective these new therapies will be.