Immune System Boosting Cancer Drugs Seen Extending Lives

Building on the success of Bristol-Myers’ Yervoy drug for melanoma that reached the market in 2011, drugmakers are devising more potent immune therapies or combining treatments for maximum effectiveness. They are also testing the new medicines in more types of cancers, including lung and breast.

If the new generation of immune therapies lives up to its promise, “this is going to be a paradigm shift for treating cancer,” said Merck senior vice president Gary Gilliland in an interview. “We are pretty good at shrinking tumors, but not good at getting rid of them. Immune therapy is a way to begin to approach that.”

Strengthening the immune system’s ability to identify and kill cancer cells can broaden the attack on cancer so it will fight any dangerous malignancy.

Stop Cancer from turning off T-cells

The new drugs are designed to prevent flicking what is essentially an off switch, called PD-1, for immune system T-cells, the body’s key defenders against attacks from dangerous germs, infections or other biological bad guys.
“Tumors have this Harry Potter cloak of invisibility,” Merck’s Gilliland said. The new class of drugs “lifts the cloaking device and allows the immune system to attack.”

Yervoy from Bristol-Myers was the first drug proven to extend survival in advanced melanoma, the most deadly form of skin cancer.

Data presented in September on the medicine showed it doubled the number of patients that survived four years to 19 percent. Now, the New York-based drugmaker is seeing positive early results from nivolumab, a new experimental immune therapy for skin, lung and kidney tumors.

In June of last year, Bristol-Myers reported that nivolumab shrank tumors in people with advanced lung, kidney and skin cancer in 18 percent to 28 percent of patients who had failed on other treatments.

So far, nivolumab is leading the next wave of immune-boosting cancer medicines with six final-stage trials in 3,300 patients with lung cancer, kidney tumors and melanoma.

In November, doctors at a melanoma research conference presented early data showing lambrolizumab shrank tumors in 51 percent of patients with advanced skin tumors. Merck has also begun studies of its drug in cancers of the lung, head and neck, and breast.

The enthusiasm is understandable because immune drugs hold the promise of producing long-lasting remissions, said Michael Gordon, director of research at Pinnacle Oncology Hematology, in Scottsdale, Arizona, who has been involved in testing the Roche drug.

Cancer doctors “are accustomed to moving from one therapy to another” as tumors rapidly develop resistance,” he said in a telephone interview. “It is generating tremendous excitement to have a drug class that might well be able to provide long term control of metastatic cancer.”

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