– The future of cancer treatment, part one.
This week we take a look at some promising new cancer treatments…
We have something like 14 million cells in our body, but only one in three of us, and over many years, gets cancer (defined by the uncontrolled division of cells which grow to form tumor). At the cellular level, cancer is extremely rare, and this is because we have mechanisms that block mutated cells progressing towards disease.
We study these mechanisms in melanomas, which are cancers that begin in melanocytes – the cells the produce the pigment melanin, which colours skin, hair and eyes. So melanomas are usually (but not always) skin cancers.
Dr. Stegall’s comments: We actually have far more than 14 million cells in our bodies. Current estimates range from 30 trillion to 100 trillion. Thus, it is understandable why some of those cells might not work properly and ultimately mutate into cancer cells. The body’s mechanism for identifying these abnormal cells and eliminating them before they cause a problem is remarkable. However, some mutated cells “slip through the cracks” and that is why we are approaching a lifetime risk of 1 in 2 people getting cancer.
Precision Medicine: Interpreting the Story of Genes
There is an exciting new movement in cancer research — often referred to as exceptional responder investigation — that appears to be transforming past disappointments into progress.
The history of oncology is full of “unique cases” — anecdotes doctors tell one another about the single patient who had an impressive response to a treatment that failed many others. Until recently, these puzzling phenomena usually didn’t get much attention, since there was no way of telling why a therapy helped certain people but not others.
If, for example, a new drug tested in a clinical trial worked remarkably well for one patient and ten others got no benefit, the therapy traditionally would have been written off as ineffective. And most likely the doctors who led the trial would have moved on to investigate another drug instead.
But in the past couple of years, researchers have been returning to failed trials to dust off data about those few exceptional responders. And increasingly, they are able to solve these mysteries thanks to powerful new sequencing technologies that make it possible to inspect the DNA of these patients’ tumors and find out what makes their cancers unique.
Dr. Stegall’s comments: I feel that it is very important to study these “outliers,” as there is probably a common denominator for their exceptional responses to treatment. We simply haven’t identified what that is yet. Until then, I encourage patients to gather all pertinent information regarding their diagnosis and prognosis, and especially in the case of a poor prognosis, plan on being the exception to the rule.
Memorial Sloan Kettering’s Jedd Wolchok Describes Stunning Success of Cancer Immunotherapy
Memorial Sloan Kettering medical oncologist Jedd Wolchok is featured in the May issue of Scientific American and on its website describing the new generation of cancer therapies that unleash the immune system to attack tumors. This new approach, which Memorial Sloan Kettering physician-scientists played a major role in developing, is producing stunning results when combined with standard anticancer therapies.
“I believe it is finally time to start thinking realistically about long-term remissions, even cures, because we can now combine standard therapies that target the tumor with immunotherapies that boost a patient’s own defenses,” Dr. Wolchok writes
Dr. Stegall’s comments: As we have discussed previously, immunotherapy is a hot topic in cancer research and treatment today. Helping the immune system work for us, rather than against us, is a key component in successfully fighting cancer.