For many years, cancer therapy has been tackled with a more or less universal approach. The drawback of this approach to therapy is the wide range of different responses to a given therapy. The concept of personalized medicine, tailoring treatment to a patient’s specific characteristics, has been envisioned and desired for many years. It is now being studied and implemented to increase successful responses to therapy, including cancer therapy.
Pembrolizumab, a newer drug, harnesses T cells to tackle cancer. For certain lung cancer patients, this means having twice the lifespan than that accorded by chemotherapy!
For patients battling lung cancer, the majority are of the non-small-cell lung carcinoma (NSCLC) subtype. Among these, a subgroup of tumors produce a protein, PD-L1, which enables escape from attack by the patient’s immune system (see here). Specifically, PD-L1 binds to PD-1 receptors on T cells, thereby preventing T cells from activating, proliferating, and/or producing cytokines, so that T cells do not mount an attack towards the PD-L1-positive tumor cells.
The success of rituximab as an antibody drug targeting B-cells has led to the development of obinutuzumab – a similar, third-generation drug
Chronic lymphocytic leukemia (CLL) is a B-cell disease that is currently incurable. Combining targeted drugs has improved overall survival. However, not all patients benefit, because B-cells can harness any of several mechanisms to gain unrestricted proliferative capacity (see here).
Therapeutic CAR T cells administered to leukemia patients in a clinical trial offer long remissions associated with T cells that persist out to at least 4 years
About 50% of stem cell transplant patients develop GVHD. A clinical trial using a modified stem cell graft reduced this hazard to 9%.