Page 8 - Inspire Autumn/Winter Edition 2017
P. 8



        Fact or Fiction?                                        Nivolumab (known by the brand name Opdivo) and another
                                                                immunotherapy drug, pembrolizumab (brand name
                                                                Keytruda), target PD-1, a protein on immune system cells
        Laura Bagnall is a busy mum of three who’s living with   called T-cells. PD-1 normally helps keep these cells from
        stage IV lung cancer.                                   attacking other cells in the body. By blocking PD-1, these
                                                                drugs boost the immune response against cancer cells. This
        In fact, she has advanced stage squamous non-small      can shrink some tumours or slow their growth.
        cell lung cancer (NSCLC). About 30% of all cases of
        NSCLC are of this type. It develops in the flat cells   Immunotherapy offers fresh hope for patients whose
        that cover the surface of the airways, and tends to     options are limited – like Laura. Despite her prognosis, she
        grow near the centre of the lung. It is typically treated   wasn’t giving up without a fight. She asked about
        with courses of chemotherapy.                           immunotherapy and tests revealed that her tumours
                                                                express the ‘right’ kind of protein, indicating she might
        Following her diagnosis, Laura received various         benefit from nivolumab.
        conventional chemotherapies, including, as a third
        line, a combination therapy. Eventually, even this third   But there was a problem. The drug has only very recently
        treatment stopped working and, early in 2016, she was   been made available for lung cancer patients in England via
        told she had just three months to live.                 the Cancer Drugs Fund (CDF). It was not available to them
                                                                in 2016. The only way that Laura, who lives in West Sussex,
        Yet, 18 months later, she’s working, following football   could receive nivolumab was via EAMS (the Early Access to
        with a passion – and, most days, out running as she     Medicines Scheme). Others in a similar situation have not
        steps up her training for the London Marathon.          been so lucky.

        So just how did this dramatic change come about? In a   She said: “The scheme was due to close, but my oncologist
        word, immunotherapy: the use of drugs that stimulate    pulled out all the stops and got me onto it with just one day
        the body’s immune system to recognise and destroy       to spare. That was the turning point and after three months
        cancer cells more effectively. It can be used to treat   I was feeling well.
        some forms of NSCLC.

        For many years, scientists have tried to find ways to
        harness the body’s own immune system to attack cancer
        cells. After all, our immune system exists to fight off threats
        to our health – so why does it not attack cancer cells?

        The answer is that some cancer cells can ‘mask’ themselves
        from the immune system to prevent it from recognising
        them as a threat. Immunotherapy works by stripping away
        this ‘mask’ to make cancer cells visible to the immune
        system, thereby allowing it to attack and destroy them.

        A key part of the immune system is its ability to keep itself
        from attacking normal cells in the body.

               My oncologist pulled out all
               the stops and got me onto it
                with just one day to spare.

        To do this, it uses “checkpoints” – molecules on immune
        cells that need to be turned on (or off) to start an immune
        response. Cancer cells may ‘mask’ themselves from these
        checkpoints to avoid being attacked by the immune system.                         Laura running a 10k at Hyde park.

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