Yesterday, we spoke about two new approaches to cancer therapy. Today, we’ll consider other aspects of these new treatments.  No.  We really aren’t.   Because yesterday, we spoke about new tools in our arsenal against cancer.  What we are really going to talk about today is a paradigm shift, something that is sometimes termed ‘precision medicine’.

Instead of attacking lung cancer, breast cancer, kidney cancer, etc.- we are now considering aspects of the tumor itself (and not the organ it attacks) and what these similarities afford us in our ability to treat these various tumors.

We often don’t know why these new treatments work- or why they work better in certain individuals.  That’s why Dr. Dung Le (Johns Hopkins) has been heading up a research group that ascertains how and why certain patients respond better to immunotherapy.   After all, if we are going to be dropping $ 10K per therapy session (and there ARE multiple therapy sessions), it behooves us to know who will respond to the checkpoint inhibitor drugs.

It seems that tumors – those with their own defects- in this case “mismatch repair deficiency”- may be prime candidates for cancer treatment.   Unfortunately, only 4 or 5 % of cancerous growth types manifest such a defect.   But for those that do, then some 40% of those with such defects are prime candidates for pembrolizumab.

Now this new, diagnostic test costs less than $ 200.  Which is one way to insure that the $ 10K dosage we are about to administer is worth it.  But, consider that it is 4% of the tumors- which means we may need to spend about $  4 or $ 5 K  testing everyone’s susceptibility- before we get to the actual costs of treatment.

And, there’s more developments.   Dr. Asher Chanan-Khan heads up a group at the Mayo Clinic (Jacksonville, FL) that has determined that some virulent cancers are best treated with a cocktail.  Just like we do for HIV therapy.  Combining ibrutinib  (an anti-cancer drug approved for leukemia, stopping tumor growth and spread), bendamustine  (long-time approved,  alkylating drug used for leukemia), and an immunotherapy drug such as rituximab (used for arthritis and B cell cancers [like leukemia]) improves ones chances dramatically.

The addition of the immunotherapy adjuvant may be the piece de resistance.  With the results from a new study of some 578 folks, those that received the 3 drug cocktail didn’t die- and the

disease did not progress.  Amazingly, the side effects were no worse with the cocktail compared to the more normal one or two drug regimen. Because these folks’ lives were extended beyond the length of the trial, Chanan-Khan’s group moved 90 of the control group onto the test therapy.

As we find these similarities in tumor characteristics, we are seeing that what were once considered to be  “untreatable” cancers are not.  Because those genetic mutations make it possible for our chemicals, our immunotherapies to properly target them.

Maybe we are finally seeing that progress for which we hoped when Richard Nixon declared “war” on cancer.

Share this: