I’m now 5.5 years post-treatment with immunotherapy for Stage IV melanoma and have had no evidence of disease for over four years. When immunotherapy works, it can be impressive.
For me, my treatment (adoptive cell therapy using tumor infiltrating lymphocytes) used my own white blood cells (130 billion in lab-selected and expanded form) to overwhelm the mutated cancer cells.
It was a one-time treatment (over 3-4 weeks in the hospital) with no further meds or other treatments required.
Immunotherapy has become an important tool in the future of fighting cancer, for sure.
I'm a radiation oncologist specializing in lung cancer. Here's my take:
Immunotherapy is really revolutionizing the treatment of locally advanced and metastatic lung cancer. However, a "revolution" in our world is improving 5-year survival by 10-15% in absolute value. It's not outstanding, but when your baseline is around 10%, improving it by 10% means doubling it. That's why immunotherapy is being adopted so quickly despite its price.
A poster mentioned $100 000 is not a lot if it adds 10 years. It's not as simple. Right now we don't really know if we can stop the treatment. So people often receive the treatment until they progress. If it's 4 years, we're looking at $400k... The cost on society in general will have to be dealt with (and debated) at some point. I doubt insurance companies will continue paying for those treatments "forever", especially considering how prevalent lung cancer is.
Immunotherapy benefits from a great "romantic" story, which helps with its marketing like no other drug. It's your own immune system, your army, waking up and attacking the greatest villain of all; cancer. The alternative, chemotherapy, is often seen as poison. Granted, it has fewer side effects, but it has some, and they can be nasty. Basically, the immune system is in a constant state of equilibrium. You stimulate it too much and it starts attacking your own body. We're seeing some cases of thyroid problems, lung inflammation (pneumonitis), skin problems... Generally speaking though, it's better than most chemos.
Overall, it’s a great treatment but obviously not perfect, crazy expensive to a point that it’s likely not sustainable in the long run. Despite all of the drawbacks, it’s a really exciting time for oncologists as we can finally offer more hope to our lung cancer patients.
This is truly exciting and only just the beginning.
There is a host of bio-tech startups following this initial wave - with two main goals:
1., Improve the treatments to become 100% cures
2., Lower the price
This is very similar to tech and, say, the storage space. Went from 100k for a few GBs to peanuts for TBs on AWS pretty quickly. That's what momentum in a crowded space will do.
Healthcare systems around the globe will have to figure out the effects of this, similar to autonomous driving. And it is not just simple cost of treatment.
What if cancer becomes curable? What to do with all the cancer wards? Specialists in Oncology? Chemo/Radio/Surgery? The spider-web effect here is gigantic.
Sticker price for the drug vs. long term treatment (multiple chemo rounds, surgery, palliative care) if its 100k is NOTHING.
> After a median follow-up of 10.5 months, the estimated rate of overall survival at 12 months was 69.2% in the pembrolizumab-combination group versus 49.4% in the placebo-combination group.
Seriously groundbreaking. This is a once-in-a-decade paper. 
complaints about study funding aside, checkpoint inhibitors really are stunningly effective for some cancers.
it’s the first major advance we’ve had in oncology in maybe 25 years.
AACR meeting in Chicago is the real event. If you're a science junkie, http://webcast.aacr.org/s/2018annual/PL01
My Father is currently on a trial in Australia which combines Immune Therapy with traditional chemo treatment. The results can only be described as a miracle. He has gone from being inoperable stage IV melanoma (with the disease first being spotted in his lung, not his skin) to showing next to no evidence of the disease.
When I read many medical studies in the media, they often sound too good to be true. In this instance it is the real deal.
I hope access to this treatment becomes readily available for the rest of the public.
This is a really significant public health advance.
In the US, cancer is the second leading cause of death, and lung cancer is one of the largest causes of cancer death. Curing this disease, even in a subset of patients, is really amazing
Thanks for sharing. I wish that instead of building destructive weapons, there was more focus was on building cures for the many diseases and fighting hunger and poverty..
I remember reading this recent Financial Times article about how China is innovating in the area of providing immunotherapy and other breakthrough treatments.
[1 non-outlined link]: https://www.ft.com/content/30b5a944-3b57-11e8-b9f9-de94fa33a...
Someone close passed away from lung cancer last year. He received immune therapy (keytruda), and while it may work wonders for others, it comes with drawbacks; My main issue was that it takes 4 to 5 treatments (with weeks between each treatment) before you even really know if it worked or not. This is valuable time that could be used to treat the cancer with chemo (which admittedly has way worse side effects than keytruda, but still).
Went to a talk about immunotherapy last year, toxicity of these class of therapeutics was way better than the best other available treatment. Sadly still too nascent, but don't forget to ask for it if you can.
Bad reporting - fails to explain what Immunotherapy actually is, jargons all over. Can anyone explain in simple terms?
Immunotherapy is not new. My mom went to Greece in 1980’s and received it. It was illegal in the US then. She would go to Mexico for booster shots. I believe it really extended her life w quality. She passed in 1990 but looked good... not a bag of bones like chemo patients.
Odd they don't mention the cuban work on this field.
"Researchers with Cuba’s Center for Molecular Immunology have developed and approved an immunologic cancer therapy that improves survivability for certain types of cancers in some cases; as of January 2017, the drug has begun clinical trials for the treatment in the United States."
>They cost more than $100,000 a year, can have serious side effects and help only some patients, generally fewer than half.
Fuck you and the fuck the US healthcare system. Daddy or mama gets to live a few more years, but it will put the family into lifelong debt. I'll say it again, fuck you.
Cuba has a lung cancer vaccine for $2. Peer reviewed. You don't hear about it. Edit: I don't even know why I go here if this site is so toxic I get downvoted for pointing out something. Enjoy your guys toxic conformation bias
The prohibitively expensive nature of any immunotherapy leaves me profoundly skeptical of its practical usefulness. $100,000/year? That's more than twice the median income in this country.
Is it simply that expensive to get mabs from animals, is drug development disgustingly expensive, or is there unbounded greed in pharmaceutical companies?