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Samuel Lagercrantz: Immunotherapy against cancer is still in its early stages

For more than 100 years, researchers have tried to target the body’s own immune system to fight cancer cells. They have occasionally been laughed at and ridiculed by the medical establishment. However, from our perspective today, we can sum it up with the saying: He who laughs last laughs best, writes Samuel Lagercrantz in an editorial.

No more than 10 years ago, most cancer patients were subjects for chemotherapy, radiation or surgery, which obviously are important treatments that can prolong or save lifes, but in many cases, they are also followed by pain and severe side effects.

In the last decade, another strategy against cancer has been introduced on a large scale – immunotherapy, which is not a new field of research though.

For more than 100 years, researchers have tried to target the body’s own immune system to fight cancer cells. They have occasionally been laughed at and ridiculed by the medical establishment, as the American author Charles Graeber describes in his recommendable book The Breakthrough - Immunotherapy and the Race to Cure Cancer (2019).

In some cases, the criticism was justified, as researchers, obsessed with the idea of making the immune system fight cancer, would perform experiments, which would hardly meet the present requirements for a modern ethics test.

However, from our perspective today, we can sum it up with the saying: He who laughs last laughs best.

Research in the 1990s laid the foundation for the most successful form of immunotherapy to date, checkpoint blockade, as James Alison in the United States and Tasuku Honjo in Japan began to investigate mechanisms that allowed cancer cells to deceive the body’s immune response. The two scientists each found a way to release the cancer cells’ “brakes” on the immune system. The rest is history.

In 2011, the first checkpoint inhibitor against malignant melanoma was approved. To their
amazement, doctors could now see tumours and metastases disappear from patients’ X-rays from one visit to the doctor to the next. Since then, immunotherapy has been approved for more types of cancers, and in 2018, James Allison and Tasuku Honjo received the Nobel
Prize for their discoveries.

At Life Science Sweden, we often write about checkpoint inhibitors as it is an exciting development, which, despite the progress, is still in its early stages. Research and development are ongoing to ensure that more patients will respond to this type of treatment.

In this issue we take a deep look into another form of immunotherapy. CAR-T therapy is a cell therapy in which white blood cells are removed from the patient’s bloodstream, and a new gene, which prompts the blood cells to attack cancer cells, is inserted into the blood cells in a laboratory. The immune cells are then returned to the body to battle the cancer.

The development of this form of immunotherapy has not come as far as that of the checkpoint inhibitors. About 90 people have received this treatment in Sweden so far, Gunilla
Enblad, Chair of the national working group for CAR-T treatment, says to Life Science Sweden.

However, this therapy represents a treatment principle that is revolutionary in the true sense of the word, and in the future, it will probably also be used as a treatment for diseases other than cancer. There are hopes that the method can be used against several autoimmune
diseases and also against viral infections such as sars-cov-2.

Artikeln är en del av vårt tema om News in English.

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