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CURE’s immunotherapy page features the latest cancer news and updates on immunotherapy Through articles, videos, podcasts, and more, CURE brings readers the insights of experts, cancer survivors, patients, and advocates to ensure everyone is up to date in immunotherapy.

Breakthroughs in immunotherapy continue to advance in the treatment landscape for cancer, but patients do not always understand what these therapies are and how they work.

This year, the Cancer Research Institute (CRI) is hosting five Immunotherapy Patient Summits for patients, caregivers and advocates to meet, get valuable information from health care experts and learn more about how new breakthroughs in immunotherapy are changing standards of care for all cancers.

® Talks Cancer,” we spoke with a patient who underwent chimeric antigen receptor (CAR)-T cell therapy in a clinical trial, as well as CRI’s CEO, who offered more information about what these summits consist of and why they’re so helpful.

https://www.cancerresearch.org/?rel=0?rel=0

https://www.cancerresearch.org/?rel=0?rel=0patients/immunotherapy-patient-summit-series

In this week’s episode of “CURE® Talks Cancer,” we delve into immunotherapy breakthroughs and how a new series of patient summits can help individuals learn more.

Learning the Basics of Immunotherapy

While many are aware of the way immunotherapy has revolutionized how we treat cancer today, most don’t know about the trials and tribulations faced by the pioneers behind this new way of thinking.

So, veteran journalist Neil Canavan set out to tell the story of 25 investigators — which included their failures, “dark night” and “aha” moments and their ultimate success – through his book 

A Cure Within: Scientists Unleashing the Immune System to Kill Cancer

This week, we spoke with Canavan about the inspiration for the book, why immunotherapy may be the new “darling of oncology” and why individuals with cancer should give it a read.

We spoke with veteran journalist Neil Canavan about his book, A Cure Within: Scientists Unleashing the Immune System to Kill Cancer. 

Immunotherapy Pioneers

Health-related quality of life among patients with stage 3 melanoma was not significantly affected after receiving postsurgical Keytruda or placebo.

Postsurgical Keytruda Has Little Impact on Quality of Life in Melanoma

Some with metastatic cancers receiving end-of-life-initiated immunotherapy may have a decreased risk of mortality when treated at a high-volume facility, research found. 

Immunotherapy, Academic Centers May Decrease Mortality in Metastatic Cancer

The Food and Drug Administration approved Keytruda plus chemotherapy for patients with locally advanced unresectable or metastatic biliary tract cancer. 

FDA Approves Keytruda Plus Chemo for Locally Advanced, Metastatic Biliary Tract Cancer 

The FDA approved Opdivo for the treatment of patients aged 12 years and older with stage 2B or 2C melanoma that has been surgically removed

FDA Approves Opdivo for Post-Surgical Stage 2B or 2C Melanoma

Certain patients with penile squamous cell carcinoma responded to therapy with an immune checkpoint inhibitor, according to recent research. 

Immunotherapy Shows Promise in Penile Cancer Subset

Thanks to the advent of immunotherapy, average survival for patients with advanced melanoma is drastically better than it was decades ago, explained Dr. Jedd D. Wolchok, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City.

Wolchok explained that when he first started treating patients with melanoma in the year 2000, the average survival for someone with stage 4 disease was about seven months. Now that there are Food and Drug Administration-approved immune checkpoint inhibitors, average survival has increased to over six years.

However, that does not mean that the work is finished for treating these patients, according to Wolchok.

“We still have many people who need other treatments,” Wolchok said in an interview with CURE® And importantly, we also need to balance better risk with benefit to be able to deliver the same type of anti-tumor activity, but perhaps using different doses and schedules, less toxicity.”

When I first started treating melanoma back in the year 2000, the average life expectancy of someone with metastatic melanoma stage 4 disease was about seven months, and it had been stuck at that median number for a really long time, despite a lot of work to try to find better treatments.

 called CheckMate-067, we now know that the median survival for people who were originally treated with a combination of checkpoint blocking antibodies, (Yervoy [ipilimumab]), and (Opdivo [nivolumab]) is now just over six years.

Granted that it took a long time to get there, but the first checkpoint blocking antibody was approved in 2011. So between 2011 and 2021, we've seen the median life expectancy of someone (with) metastatic melanoma go from seven months to just over six years. So I think that's really important context to put this in.

That doesn't mean that our work is over. We still have many people who need other treatments. And importantly, we also need to balance better risk with benefit to be able to deliver the same type of anti-tumor activity, but perhaps using different doses and schedules, less toxicity.

For more news on cancer updates, research and education, don’t forget to 

Thanks to the FDA approval of immunotherapy agents, the average survival for patients for stage 4 melanoma has drastically increased over the past 20 years, an expert explained. 

In Recent Decades, Immunotherapy Extended Advanced Melanoma Survival from Months to Years

Patients with myeloma can look forward to advances in research around immunotherapy as they get closer to frontline settings, says Jenny Ahlstrom of the HealthTree Foundation & Myeloma Crowd.

, Ahlstrom discussed her excitement around research on these treatments that use the body’s own immume system to fight cancer, and her hope that patients can access these new treatments soon.

“It's my opinion that immunotherapies, once they start moving up and maybe being used in combination, will provide a whole new realm,” Ahlstrom said.

So, at the recent ASH meeting last December, which is the American Society of Hematology meeting, there's so much excitement around immunotherapies. And the feeling that I got was (that research is) moving these therapies closer to frontline settings.

Because right now these bi-specific antibodies and CAR T-cell therapy and vaccines and things like that are being used kind of later, which is how clinical trials work, right? You start with people who are relapsed and you kind of move things up.

It's my opinion that immunotherapies, once they start moving up and maybe being used in combination, will provide a whole new realm. I mean, we have some new exciting CAR T things coming out in the coming months. And that will hopefully be FDA approved for myeloma, and I think we will start seeing different patterns of care. It's really revolutionary what's happening in myeloma care. It's really impressive.

New advances in research around immunotherapies for patients with myeloma are on the horizon, according to an expert from the HealthTree Foundation & Myeloma Crowd.

Immunotherapy Could 'Provide A Whole New Realm' For Patients with Myeloma

The microorganisms and other genetic material present in the gastrointestinal tract — also known as the gut microbiome – could play an important role in the treatment of certain types of cancers, according to Dr. Jason Luke.

®, Luke, the director of the Cancer Immunotherapeutics Center at UPMC and the University of Pittsburgh, explained that while scientists are just now beginning to understand the impact of the microbiome when it comes to certain types of immune responses seen in some patients, more research is needed to determine how to use this information in future treatment plans.

One of the most interesting areas of research, I think, in oncology over the last few years has been the identification that the contents of the gut or the fecal microbiome can really (have an) impact on the outcomes of patients, especially with immunotherapy to cancer. We're only just beginning to understand this in any meaningful way, but several groups now have reported that certain kinds of bacteria being more present makes it more likely for the immune response to kick in and fight the cancer.

So, the question then becomes, is that a biomarker? Or is that something that we could modulate as if it's like a drug? And those are open questions. There are clinical trials ongoing to try to address this. On a practical level, however, patients really dig this. And they always ask about it. So, what can we do right now?

I think what we can say right now is that we don't know the answer. And we should not be recommending to patients that they take probiotics, because in fact, there's some evidence that actually suggests that probiotics might be worse.

More generally, what we do know is that just like everything else, three meals a day that are heavy on fiber and green vegetables are good for immunotherapy also. So simple stuff is the way to go right now, but this is definitely a space that's evolving and pretty exciting when we think about the future in terms of treatment.

The microorganisms inside a patient's gastrointestinal tract may have a role to play in how immunotherapy can treat certain types of cancer. 

Gut Microbiome May Play an Important Role in Immunotherapy in the Future, But More Research is Needed

Immunotherapy in combination with chemotherapy brings on more side effects during treatment, however, serious side effects in combination treatment remain similar to side effects in chemotherapy alone, according to Nagashree Seetharamu, MD, MBBS.

 Seetharamu, associate professor in Clinical Medicine at Hofstra and Northwell Health, presented on the benefits and challenges for immunotherapy and chemotherapy combination treatment for patients with lung cancer. Seethearamu also sat with CURE to discuss the side effect realities of this combination treatment and why patients must remain vigilant as they undergo the combination therapy.

You have immunotherapy with its own set of side effects. They're not overlapping, meaning that they don't cause the same type of side effects, for the most part, the immunotherapy causes side effects by an overactive immune system. When the immune cells that we are trying to activate or trying to get stronger to attack the cancer cells, may sometimes attack one's own body, that's where the side effects come.

When you do the two together, the side effects are numerically more, but the serious side effects are not that very different in the two groups, patients receiving chemotherapy alone versus patients receiving chemotherapy plus immunotherapy.

The one message I give to patients on immunotherapy, whether by itself or in combination with chemotherapy, is to make a note of anything that is not normal for them from the time they start the treatment. If there is anything new that happens, I don't want them to be guessing whether is it a side effect? Or is it something that I ate yesterday? I would not want them to guess, I want them to give the information to me and let me do the guessing because these side effects with immunotherapy are reversible if it's tackled in a timely fashion.

Immunotherapy in combination with chemotherapy is becoming a popular treatment for patients with lung cancer, but patients need to understand the side effects.

Looking Out for Side Effects in Immunotherapy Combination Treatment

The key to successful chemotherapy responses may involve combining the treatment with checkpoint inhibitors. Even as treatments for cancer evolve, chemotherapy has been the standard-of-care for patients with small cell 

 (SCLC) for the past 20 years. With the addition of certain drugs, such as checkpoint inhibitors, researchers have found new ways to alleviate chemotherapy-induced side effects, such as myelosuppression, one study suggested.

“In 30 or 40 years from now chemotherapy may have gone away, but it’s not going away anytime soon, and there are certain tumor types such as small cell lung cancer and triple-negative breast cancer where chemotherapy remains the foundation of treatment for advanced disease,” said Dr. Lowell Hart. “So that’s not going to change anytime soon.”

During the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, Hart, the Scientific Director for Clinical Research at Florida Cancer Specialists,

discussed the future of chemotherapy and the latest advancements in 

With new ways to treat chemotherapy-induced side effects, it seems that chemotherapy, combined with checkpoint inhibitors, is here to stay for the foreseeable future, according to one expert.

Conference

With Addition of Checkpoint Inhibitors, Chemotherapy 'Not Going Away Anytime Soon'

Tumor mutation burden (TMB) is an independent predictor of inflammation that may be a predictive marker of developing depression in patients with 

“What tumor mutation burden is, essentially, is just a marker of how many mutations are in a person’s cancer,” McFarland, who is from the Department of Psychiatry and Behavioral Sciences at Memorial Sloan Kettering, explained. “What TMB is taking advantage of is our body’s innate immune system that responds to cancer as a foreign thing.” TMB up-regulates inflammation and fights against the cancer, which is fundamentally what 

 does in patients with lung cancer, he added.

“At the same time there is a lot of data to say that inflammation is predictive of developing 

,” said McFarland. “The idea behind this study was because you have TMB as an up-regulator of inflammation around cancer, does that inflammation, which is also associated with depression, lead to depression in this scenario of people who have cancer?”

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, McFarland discussed the study findings and explains the link between a high tumor mutation burden, inflammation and developing depression in patients with both small cell and non-small cell lung cancer.

Tumor mutation burden may be an independent predictor of developing depression in patients with lung cancer, according to Dr. Daniel McFarland.

Tumor Mutation Burden May Be Predictive of Depression in Patients With Lung Cancer

New frontline treatments like Keytruda (pembrolizumab), immune synergizing agents and PD-1 antibodies are demonstrating positive results for patients with non—muscle invasive bladder cancer when they fail to respond to Bacillus Calmette-Guérin (BCG) 

, according to Arjun V. Balar, M.D. However, immunotherapy is most likely to be augmented, rather than replaced, by such treatments.

At the 2019 Genitourinary Cancers Symposium, Balar — who is director of the genitourinary medical oncology program at NYU Langone’s Perlmutter Cancer Center – discussed advances in bladder cancer treatment and what they mean for the future of BCG – the main intravesical immunotherapy for early stage 

“BCG has a long-standing history in the treatment of non—muscle invasive bladder cancer. I believe that it will actually have a firm role for decades to come largely because it is still very active.”

An expert discusses the future of immunotherapy in light of new frontline treatments like Keytruda that have been demonstrating positive results for patients with non–muscle invasive bladder cancer.

The Future of Immunotherapy for Bladder Cancer

Immunotherapy has different side effects than more traditional cancer treatments, such as chemotherapy, explained Jarushka Naidoo, M.B.B.Ch., an assistant professor of oncology at the Sidney Kimmel Cancer center at Johns Hopkins University.

Patients should remember that immunotherapy works by stimulating the immune system to fight the cancer. So, taking these agents could result in inflammation anywhere in the body, as well as some more general symptoms, such as fatigue, nausea and skin rash. While most side effects can be mitigated with steroids, there are some that Naidoo said are important to look out for, including inflammation of the heart and of the brain. If a patient thinks that they are experiencing these symptoms, they should contact their health care team immediately.

Immunotherapy can cause some side effects that patients and practitioners should look out for.

Immunotherapy Side Effects: Know the Risks

While the immunotherapy duo Yervoy (ipilimumab) and Opdivo (nivolumab) works well for many patients with kidney cancer, the regimen is not for everyone, explained Sumanta K. Pal, M.D., associate clinical professor in the Department of Medical Oncology and Therapeutics Research and co-director of the Kidney Cancer Program at City of Hope.

This therapy may not be best for patients with good-risk disease or who have autoimmune conditions or concerns. Instead, these patients will often do better on tyrosine kinase inhibitor (TKI) drugs, such as Cabometyx (cabozantinib), according to Pal.

Yervoy plus Opdivo is a good combination for many patients with kidney cancer, though some individuals should steer clear of the regimen.

Immunotherapy

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