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December 2019 (Vol. 4 Issue 10)

Cancer: it’s the immune system, stupid
About the author: 
Bryan Hubbard

Cancer: it’s the immune system, stupid image

It’s suddenly dawning on medicine that cancer is often the result of a compromised immune system (so destroying it further with chemo may not be the best treatment option). Immunotherapy is the new approach that’s having an amazing effect—doubling the survival rate—while cancer is more likely to appear in people with an impaired immune system, several new studies have found.

Immunotherapy—which uses a new breed of drugs to harness the healing powers of the immune system—is doubling survival in people with advanced and aggressive head and neck cancers that aren’t responding to conventional treatments.

The new therapy is so successful that the researchers stopped the trial early so that the others given the placebo (or dummy) treatment could start immunotherapy. The study involved 361 patients who had not responded to chemotherapy. Their cancers—metastatic head and neck squamous cell carcinoma—are fast-growing and are usually fatal.

However, after 12 months of immunotherapy, 36 per cent of the patients were still alive compared to 17 per cent of those receiving chemotherapy. The therapy also doubled the number of patients whose tumours shrank, and whose cancer had not spread.

Sadly, it’s not for everyone. A ‘significant proportion’ of lung cancer patients also have a malfunctioning immune system, which makes them ineligible for immunotherapy. Up to 25 per cent of patients have autoimmune disease, and for these, immunotherapy would be toxic.

In a separate study, researchers have discovered that cancer is far more common in people with an impaired immune system. The rate of cancer was 42 per cent higher among people registered in the United States Immune Deficiency Network (USIDNET), which is tracking the health of patients diagnosed with an impaired immune system. The registrants were most likely to suffer from lymphoma, or cancer of the lymphatic system; the rate was 10 times higher in men and eight times higher in women than in the general population.


References

(Sources: immunotherapy: proceedings of the American Association for Cancer Research, Chicago, June 6, 2016; lung cancer study: UT Southwestern Medical Centre website; immune system study: website of Roswell Park Cancer Institute)

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