The fight against cancer

New Paths

Immuno-oncology uses the patient’s immune system to attack cancer cells. A promising approach that aims to help more cancer patients in the future.

Chapter 1

Quantum leap

After years of building momentum, immuno-oncology is on the cusp of a surge forward.

”I had a desire to do something meaningful.” This was biologist Laura Helming’s answer when asked about her decision to dedicate herself to the field of immuno-oncology. Her path toward this branch of medicine, which uses the body's own immune system to fight cancer cells, involved a series of intermediate stages. When Helming studied biology as a student, she was particularly interested in genetics and infectious diseases. As the immune system and infectious diseases are inherently linked, the decision to pursue immunology was a logical next step. After working in the area for several years, Helming was given the chance in 2013 to work for Merck KGaA, Darmstadt, Germany in the field of immuno-oncology. She refers to working at the intersection of immunology and oncology and exploring new therapies fight cancer as an ”incredible opportunity.” ”It's a privilege to be able to work as a scientist in this field,” says Helming.

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Chapter 2

A patient’s view

In 2012, Ed Quinn was diagnosed with cancer. In his fight against the disease, he never gave up hope.

Nine months. If things go well, a year. This was how much time Ed Quinn was told he had to live. Though his world collapsed, his family stayed positive. When he saw no way out, they gave him strength and helped him to get back on his feet.

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Chapter 3

Promising approach

Immuno-oncology as an idea is nothing new. But it wasn’t until 2011 that a clinical milestone was reached with the approval of the first immuno-oncological drug  for the treatment of cancer.

Laura Helming is working on the ”immune” part of the term ”immuno-oncology.” Her entry in this field came at an auspicious time. Certainly, the idea of immuno-oncology per se is not new. Bacteria were being injected directly into tumor tissue in the nineteenth

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Chapter 4

Attacking from different angles

Immuno-oncological agents can have varying effects on the immune system. However, not all cancers are equally suited to treatment with these new medications.

The immuno-modulatory effect of compounds – i.e. their impact on the immune system – can take place in a variety of ways. Immuno-oncology agents, for instance, can directly activate the immune system to fight cancer cells.2 Another important approach is to deactivate potential ”brakes” to the immune system that prevent it from attacking the cancer cells.3 An important target are cytotoxic T cells, whose primary role within the immune system is to identify diseased cells and destroy them. However, T cell function can be impaired within cancer and as a result, the T cells do not attack the cancer. The tumor cells, as a consequence, continue to divide and the tumor grows.2 Several immuno-oncology compounds influence this process by preventing inhibitory influences on T cells. Not every cancer or every patient, though, is equally suited to these new drugs. In short: Immuno-oncology may require an exact diagnosis of the tumor tissue to enable the treatment of those patients who will benefit from an immuno-oncology drug.

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Sources

1. Cancer Research Institute, Melanoma, last revised October 2015, retrieved May 20, 2016 from cancerresearch.org

2. Kirkwood, J.M., Butterfield, L.H., Tarhini, A.A., Zarour, H., Kalinski, P., and Ferrone, S. Immunotherapy of cancer in 2012. CA Cancer J Clin. 2012; 62: 309–335

3. Weber, J. S., Immuno-oncology Comes of Age – Introduction, In: Seminars in Oncology, 2014, 41:S1-S2

4. Cancer Research Institute, Sarcoma, last revised May 2016, retrieved May 20, 2016 from cancerresearch.org

5. Cancer Research Insitute, Timeline of Progress, retrieved May 20, 2016 from cancerresearch.org

6. The American Association of Immunologists, César Milstein, Ph.D. (1927–2002), retrieved May 20, 2016 from aai.org

7. Stewart, B., and Wild, C. P. Wild, World Cancer Report 2014, retrieved May 20, 2016 from iarc.fr

8. Genetic Engineering & Biotechnology News, last revised February 1, 2016, retrieved May 20, 2016 from genengnews.com

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