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Why immunotherapy is revolutionizing cancer treatment

Ben Schmitt
| Tuesday, Feb. 13, 2018, 1:03 p.m.
Immunotherapy treatment enables the body's immune system to attack diseased cells, as depicted in this rendering by the University of Pittsburgh.
University of Pittsburgh
Immunotherapy treatment enables the body's immune system to attack diseased cells, as depicted in this rendering by the University of Pittsburgh.
An artist's rendering depicts the UPMC Immune Transplant and Therapy Center at 5000 Baum Blvd. in Pittsburgh.
Submitted
An artist's rendering depicts the UPMC Immune Transplant and Therapy Center at 5000 Baum Blvd. in Pittsburgh.

UPMC compares the cancer-fighting potential of immuno­therapy to the polio vaccine and revolutionary organ transplant advancements of Dr. Thomas Starzl.

A moonshot perhaps?

The health giant's belief in immunotherapy as a game-changer is strong enough for it to invest $200 million for researching new ways to disrupt cancer growth and reduce the need for immune-suppressing drugs in organ transplantation.

The hospital system announced plans Tuesday to build an Immune Transplant and Therapy Center along Baum Boulevard in Pittsburgh. The center, which is scheduled to open in 2020, will specialize in transplantation, cancer, geriatric disorders and chronic diseases.

"How do you swing for the fences if you are only trying to get on base or bunt?" said Dr. Robert Ferris, director of the UPMC Hillman Cancer Center. "This is us swinging for the fences. It really is unique."

Cancer immunotherapy, which stimulates a patient's immune system to find and destroy its own cancer cells, was once the centerpiece of the federal "moonshot" program to accelerate the search for cures.

It has shown promising results in 15 to 20 percent of cancer patients, sometimes extending lives far beyond what could be expected from the standard treatments of surgery, chemotherapy and radiation while often causing fewer side effects. The Food and Drug Administration approved the first cancer immunotherapy drug, ipilimumab, in 2011.

There are two main types of cancer immunotherapy treatments: checkpoint modulator drugs and cell therapies. The drugs are designed to awaken immune cells within a patient's body to fight cancer. Cell therapies occur when doctors remove immune-boosting T cells from a patient, engineer them to fight cancer cells and infuse them back into a patient's body.

Treatment known as CAR-T therapy was approved by the the U.S. Food and Drug Administration last year for fighting cancer.

"The concept of harnessing one's own immune system to fight cancer has been a paradigm shift in treatment," Dr. Sandip Patel, assistant professor at the University of California San Diego Moores Cancer Center, told the Tribune-Review. "The premise behind cancer immunotherapy is giving your immune system the boost it needs to find and destroy cancer cells."

The immune system is a network of cells and organs working together to defend the body against foreign substances, including viruses, bacteria and cancer cells.

"There have been cases where other treatments have been exhausted and a patient may not expect to live more than a few months," Ferris said. "Immunotherapy treatment might create a Lazarus phemomenon: A body could look like a Christmas tree of tumors, and these things just melt away."

Immunotherapy has worked well in treating melanoma, lung, head and neck, and bladder cancers, Ferris said. It's been less effective in treating prostate and colon cancers.

Overall side effects of immunotherapy can be less severe than the nausea, weakness and hair loss associated with chemotherapy and radiation. However, some side effects can be severe, as immunotherapy sometimes stimulates the immune system to attack its own organs.

"The reason we put up with the side effects is, when immunotherapy works, a patient's cancer can be in remission for years," Patel said.

Cost remains a barrier. Some treatments cost up to $400,000, Patel said.

"We're going to have to figure out a way to make it more cost feasible," he said.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991, bschmitt@tribweb.com or via Twitter at @Bencschmitt.

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