"Immunotherapy marks an entirely different way of treating cancer—by targeting the immune system, not the tumor itself. Oncologists, a grounded-in-reality bunch, say a corner has been turned and we won't be going back.
With much pressure these days to transform biological insights into lifesaving drugs, there's a lesson to be learned from immunotherapy's successes: They emerged from a careful decoding of basic biology that spanned many years. The early steps were taken by cancer immunologist James Allison, now at the University of Texas MD Anderson Cancer Center in Houston. In the late 1980s, French researchers who weren't thinking about cancer at all identified a new protein receptor on the surface of T cells, called cytotoxic T-lymphocyte antigen 4, or CTLA-4. Allison found that CTLA-4 puts the brakes on T cells, preventing them from launching full-out immune attacks. He wondered whether blocking the blocker—the CTLA-4 molecule—would set the immune system free to destroy cancer.
Allison's rationale was untested. He and his colleagues changed the conversation, in the words of one cancer researcher, 'to consider immunosuppression as the focal point, and manipulation of immunosuppression as the target.'
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For physicians accustomed to losing every patient with advanced disease, the numbers bring a hope they couldn't have fathomed a few years ago. For those with metastatic cancer, the odds remain long. Today's immunotherapies don't help everyone, and researchers are largely clueless as to why more don't benefit. They are racing to identify biomarkers that might offer answers and experimenting with ways to make therapies more potent."
Yes, I'm thrilled.
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