Page 8 - Inspire Autumn/Winter Edition 2017

Immunotherapy

Immunotherapy:

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.

8 Inspire 2017