Nivolumab & Ipilimumab Immunotherapy Is A Kidney Cancer Game Changer

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Nivolumab & Ipilimumab Immunotherapy Is A Kidney Cancer Game Changer
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Posted by:
Greg Lance – Watkins
Greg_L-W

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Hi,

Immunotherapy cancer drug hailed as ‘game changer’

  • 9 October 2016
 Kidney cancer
Image copyright Science Photo Library

An immunotherapy drug has been described as a potential “game-changer” in promising results presented at the European Cancer Congress.

In a study of head and neck cancer, more patients taking nivolumab survived for longer compared with those who were treated with chemotherapy.

In another study, combining nivolumab with another drug shrank tumours in advanced kidney cancer patients.

Immunotherapy works by harnessing the immune system to destroy cancer cells.

Advanced head and neck cancer has very poor survival rates.

In a trial of more than 350 patients, published in the New England Journal of Medicine, 36% treated with the immunotherapy drug nivolumab were alive after one year compared with 17% who received chemotherapy.

Patients also experienced fewer side effects from immunotherapy.

Double hit

The benefits were more pronounced in patients whose tumours had tested positive for HPV (human papillomavirus). These patients survived an average of 9.1 months with nivolumab and 4.4 months with chemotherapy.

Normally, this group of patients are expected to live less than six months.

Early data from a study of 94 patients with advanced kidney cancer showed that the double hit of nivolumab and ipilimumab resulted in a significant reduction in the size of tumours in 40% of patients.

Of these patients, one in 10 had no sign of cancer remaining.

This compares with 5% of patients showing tumour reduction after standard therapy.

About 12,000 people are diagnosed with kidney cancer in the UK each year and an average of 12 people die from the disease each day.

Image caption Peter Waite was able to continue working as a motor technician while receiving immunotherapy treatment for cancer
Peter Waite, cancer patient

Peter’s journey

“I feel a bit of a fraud having terminal cancer because I haven’t been in pain at all,” says Peter Waite, 64, from Hertfordshire.

“There’s been nothing negative about it for me and I feel a bit embarrassed really.”

Peter started receiving combined immunotherapy (nivolumab and ipilimumab) in a clinical trial in early 2015 after doctors discovered he had a type of renal cancer several years after recovering from kidney and lung cancer.

He was told he probably had three to five years left.

Instead of being treated with chemotherapy, he spent four months receiving both immunotherapy drugs and experienced virtually no side effects, allowing him to continue working as a motor technician throughout his treatment.

Scans of his kidney and lungs show that one of his tumours has shrunk and two others have not shown any further growth.

He is no longer taking the drugs and is being monitored every 12 weeks with scans.

Mr Waite said his daughters have teased him about being a guinea pig – and considered buying him some hay.

“I’m a very upbeat sort of bloke and I’ve been very lucky,” he says.

“I feel very privileged to have had the opportunity to go on the trial.”

As yet, nivolumab has only been approved for treating skin cancer and in June it became one of the fastest medicines ever approved for NHS use, in combination with ipilimumab, for the same cancer.

Nivolumab and ipilimumab both work by interrupting the chemical signals that cancers use to convince the immune system they are healthy tissue.

‘Extend life’

Prof Kevin Harrington of the Institute of Cancer Research and consultant at the Royal Marsden Hospital in London, who led the head and neck cancer trial, said nivolumab could be a real “game changer” for patients with advanced head and neck cancer.

“This trial found that it can greatly extend life among a group of patients who have no existing treatment options, without worsening quality of life.

“Once it has relapsed or spread, head and neck cancer is extremely difficult to treat. So it’s great news that these results indicate we now have a new treatment that can significantly extend life, and I’m keen to see it enter the clinic as soon as possible.”

Prof Paul Workman, chief executive of The Institute of Cancer Research, said nivolumab was one of a new wave of immunotherapies that were beginning to have an impact across cancer treatment.

He added: “We hope regulators can work with the manufacturer to avoid delays in getting this drug to patients who have no effective treatment options left to them.”

To view the original of this article CLICK HERE

Regards,
Greg_L-W.

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What Is Immunotherapy? The Basics on These Cancer Treatments

What Is Immunotherapy? The Basics on These Cancer Treatments
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Posted by:
Greg Lance – Watkins
Greg_L-W

eMail: Greg_L-W@BTconnect.com

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Hi,

What Is Immunotherapy? The Basics on These Cancer Treatments

By DENISE GRADY and ANDREW POLLACKJULY 30, 2016


A nurse prepared an immunotherapy drug
at the University of Texas M.D. Anderson Cancer Center in Houston.

Credit Ilana Panich-Linsman for The New York Times

Some of the most promising advances in cancer research in recent years involve treatments known as immunotherapy. These advances are spurring billions of dollars in investment by drug companies, and are leading to hundreds of clinical trials. Here are answers to some basic questions about this complex and rapidly evolving field.
What is immunotherapy?

Immunotherapy refers to any treatment that uses the immune system to fight diseases, including cancer. Unlike chemotherapy, which kills cancer cells, immunotherapy acts on the cells of the immune system, to help them attack the cancer.

What are the types of immunotherapy?

Drugs called checkpoint inhibitors are the most widely used form of immunotherapy for cancer. They block a mechanism that cancer cells use to shut down the immune system. This frees killer T-cells — a critically important part of the immune system — to attack the tumor. Four checkpoint inhibitors have been approved by the Food and Drug Administration and are on the market. They are given intravenously.

Another form of immunotherapy, called cell therapy, involves removing immune cells from the patient, altering them genetically to help them fight cancer, then multiplying them in the laboratory and dripping them, like a transfusion, back into the patient. This type of treatment is manufactured individually for each patient, and is still experimental.

Bispecific antibodies are an alternative to cell therapy, one that does not require individualizing treatment for each patient. These antibodies are proteins that can attach to both a cancer cell and a T-cell, that way bringing them close together so the T-cell can attack the cancer. One such drug, called Blincyto, has been approved to treat a rare type of leukemia.

Vaccines, another form of immunotherapy, have had considerably less success than the others. Unlike childhood vaccines, which are aimed at preventing diseases like measles and mumps, cancer vaccines are aimed at treating the disease once the person has it. The idea is to prompt the immune system to attack the cancer by presenting it with some piece of the cancer.

The only vaccine approved specifically to treat cancer in the United States is Provenge, for prostate cancer. Another vaccine, BCG, which was developed to prevent tuberculosis, has long been used to treat bladder cancer. As a weakened TB bacterium, BCG appears to provoke a general immune system reaction that then works against the cancer. Researchers hope that other vaccines may yet be made to work by combining them with checkpoint inhibitors.

Which types of cancer are treated with immunotherapy?

Checkpoint inhibitors have been approved to treat advanced melanoma, Hodgkin’s lymphoma and cancers of the lung, kidney and bladder. The drugs are being tested in many other types of cancer.

So far, cell therapy has been used mostly for blood cancers like leukemia and lymphoma.

Which cancer drugs are checkpoint inhibitors?

The four on the market are:
Yervoy (ipilimumab) and Opdivo (nivolumab), made by Bristol-Myers Squibb;
Keytruda (pembrolizumab), by Merck;
Tecentriq (atezolizumab), by Genentech.

How well does immunotherapy work?

Though immunotherapy has been stunningly successful in some cases, it still works in only a minority of patients. Generally, 20 percent to 40 percent of patients are helped by checkpoint inhibitors — although the rate can be higher among those with melanoma. Some patients with advanced disease have had remissions that have lasted for years. In some cases, combining two checkpoint inhibitors increases the effectiveness. But for some people the drugs do not work at all, or they help just temporarily.

Cell therapy can produce complete remissions in 25 percent to 90 percent of patients with lymphoma or leukemia, depending on the type of cancer. In some cases the remissions can last for years, but in others relapses occur within a year.

What are the side effects?

Checkpoint inhibitors can cause severe problems that are, essentially, autoimmune illnesses, in which the immune system attacks healthy tissue as well as cancer. One result is inflammation. In the lungs it can cause breathing trouble; in the intestine it can cause diarrhea. Joint and muscle pain, and rheumatoid arthritis can also occur, and the immune system can also attack vital glands like the thyroid and pituitary. These reactions are dangerous, but can often be controlled with steroid medicines like prednisone.

Cell therapy can also lead to severe and potentially fatal reactions resulting from the overstimulation of the immune system. The reactions can usually be controlled, but patients may need to be treated in an intensive care unit.
What does immunotherapy cost?

Does insurance cover it?

Checkpoint inhibitors can cost $150,000 a year. Many insurers will pay if the drug has been approved for the type of cancer the patient has. But sometimes there are high co-payments. Patients in clinical trials may get the drugs free.

Manufacturers have not said yet how much they will charge for cell therapies, assuming they win approval and reach the market. But experts expect the price to be as high as a few hundred thousand dollars.

Where can I get immunotherapy?

Any oncologist can prescribe the checkpoint inhibitors that are on the market. Patients with cancers for which the drugs have not been approved may find insurers reluctant to pay, but may be able to get the drugs for free by volunteering for clinical trials.

Cell therapies are available only through clinical trials now. Most of the study sites are major medical centers.

How can I find out about clinical trials in immunotherapy?

Information is available on the Cancer Research Institute website, or by calling 1-855-216-0127 (Monday through Friday, 8:30 a.m. to 6 p.m. E.T.). Another source is ClinicalTrials.gov.

To view the original CLICK HERE

Regards,
Greg_L-W.

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