By Chris Adams

From its initial breakthroughs in the 2000s, immunotherapy has evolved as one of the most important developments in cancer treatment – but there are still substantial promises and challenges.

Dr. Charles Drake, co-director of the Division of Immunology at the John Hopkins Sidney Kimmel Comprehensive Cancer Center, said the treatment – which at its core means using certain parts of a person’s immune system to fight disease – is a vital strategy for some patients, but not effective for others.

“These drugs are really changing the way we take care of cancer,” Drake said.

Some of Drake’s work has been on the use of immunotherapy for kidney cancer. An agent he helped research found that the therapy had a higher response rate – and longer survival, measured in months – than the standard of care.

At the outset, he said, “We were very afraid of this drug.” It had the potential to over-activate the immune system, and so they started treatment gradually. Within months, the first patient had seen his tumor shrink away. While “obviously, this is not everyone,” the case showed what the drugs could do in some patients.

The agent he was researching, called nivolumab, was found to be more effective than the standard of care in treating kidney cancer; it was also better tolerated, meaning patients had a lower rate of adverse reactions. It has since been approved for use in melanoma, kidney cancer, and certain types of lung cancer; researchers are also looking at it for other cancers.

As for immunotherapy itself, Drake led National Press Foundation fellows a tutorial on its basic biology, detailing how immunotherapy actually works on the cell level, how often it does so, and what physicians look for in selecting the patients that might benefit from it.

Of the big four cancers – lung, breast, colorectal and prostate – he said immunotherapy has shown response rates in one.