The immunologists James Allison, of the US, and Tasuku Honjo, of Japan, were honoured with the 2018 Swedish award in Physiology or Medicine. However, they started navigating promising routes towards cancer immunotherapies almost twenty years ago.
Immunologists like professor José Ramón Regueiro Gónzalez, who serves as a member of the Management Board at Gética (the Spanish group that researches and promotes immune-biological therapies against cancer), felt proud of the prestigious recognition after burdensome years of research. Nevertheless, he pointed out that immunotherapy has been in clinical practice for years.
Immunology is sailing at full steam in 2018. Not only the Allison and Honjo’s prize, but also the Nobel laureate in Chemistry was given to a project about antibodies. Nonetheless, the road map towards healing cancer thanks to immunotherapies was laid down in the 1890s by Emil von Behringand Shibasaburo Kitasato, in Robert Koch’s laboratory.
What does the immune system do for us?
The immune system is like the hull of a boat. Its role is to defend the body against foreign invaders, in the form of rogue microorganisms (bacteria, viruses, fungi), or internal dangers, such as cancer. Although many cancers are probably prevented by immune system surveillance and destruction of abnormal cells, tumours can sometimes outwit it.
Check what “checkpoints” are
Immune checkpoint mechanisms are often activated to suppress the nascent anti-tumour immune response in cancer. By way of explanation, cancer hijacks the mechanism that the immune system has to prevent autoimmunity and damage to healthy cells, like in a sailor revolt -or, better, a body insurrection.
But checkpoint inhibitors such as CTLA-4, PD-1 or PD-L1 inhibitors magnify the body’s natural immune response to cancer. They are the lifeguards in our troubled bodies. And Allison and Honjo are their lieutenants.
Chemotherapy vs. Immunotherapy
A medical oncologist from the Municipal Hospital of Badolana (Spain), Rafael Ibeas Rollán, explained that “while chemotherapy directly affects the growth and proliferation of tumour cells, immuno-oncological drugs harness the body’s natural anti-cancer immune response to attack and destroy the cancer.”
Chemotherapy involves the use of one or more drugs to destroy tumour cells directly or stop cancer growth by inhibiting cancer cells ability to multiply. Immuno-oncological approaches are different and havebeen effective for patients with certain types of cancer that have been resistant to chemotherapy and radiation treatments. They fall into two main categories: passive and active immunotherapy. “Passive immunotherapy facilitates and enhances the body’s existing immune response, whereas active immunotherapy directs the body’s immune cells to recognise, attack and destroy cancer cells; examples include anti-cancer vaccines”, Dr. Ibeas briefly stated.
Stay healthy to avoid cancer
Professor Regueiro also claimed that “the most effective way to tackle cancer is through prevention. What we eat, breath, move and inject has an impact in our health.” And Dr. Ibeas, who provided a clinical point of view, agreed on it. Insisting on prevention, the professor recommended avoiding direct sun exposure, keeping weight within a healthy range, exercising regularly, following a rich and varied diet with an abundance of whole grains and lack of processed foods. “There are several habits that can make the difference”, he asserted.
Although the clinical development of immune checkpoint inhibitors have dramatically improved outcomes for many people with cancer, a beacon of light is still needed in the theoretical field. “We know immunotherapies work, but not how”, Regueiro explained.
James Allison, Tasuku Honjo and their teams are en route to the explanation. “A driving motivation for scientists is simply to push the frontiers of knowledge. I didn’t set out to study cancer, but to understand the biology of T cells, these incredible cells that travel our bodies and work to protect us,” Dr. Allison said in a press release.
Research is moving satisfactorily towards achieving a better understanding of checkpoint pathways. Nonetheless, professor Regueiro concluded that “immunotherapy-related side effects and patient-specific treatments should not be forgotten.”