Nautilus

The Rise of Cancer Immunotherapy

Every time Jim meets a patient, he cries,” Padmanee said to The New York Times in 2016. “Well not every time,” Jim added. Jim Allison and Padmanee Sharma work together at the MD Anderson Cancer Center in Houston, Texas, having met in 2005 and married in 2014. A decade before they met, Allison and his lab team made a seminal discovery that led to a revolution in cancer medicine. The hype is deserved; cancer physicians agree that Allison’s idea is a game-changer, and it now sits alongside surgery, radiation, and chemotherapy as a mainstream option for the treatment of some types of cancer.

Take one example. In 2004, 22-year-old Sharon Belvin was diagnosed with stage IV melanoma—skin cancer that had already spread to her lungs—and was given a 50/50 chance of surviving the next six months. Chemotherapy didn’t work for her and her prospects looked bleak. “I’ve never felt that kind of pain,” she later recalled, “ ... you are lost, I mean you’re lost, you’re absolutely out of control, lost.” All other options exhausted, she signed up to an experimental clinical trial testing a new drug based on Allison’s idea. After just four injections over three months the tumor in her left lung shrunk by over 60 percent. Over the next few months, her tumors kept shrinking and eventually, after two and a half years of living with an intense fear of dying, she was told that she was in remission—her cancer could no longer be detected. The treatment doesn’t work for everyone but, Allison says, “We’re going to cure certain types of cancers. We’ve got a shot at it now.”

Jim AllisonGerbil / Wikimedia

Once she had recovered, Sharon Belvin was the first patient Allison met. Her parents and husband were also there—and everybody was crying. Belvin hugged Allison tight. “There’s no words to describe what it feels like,” she has said, “ ... what it feels like when you have handed someone back their life.” Both the Talmud and the Koran teach that when a person saves a life, it is as if they have saved a whole world. About two years after they met, Belvin sent Allison a photo of her first baby, and a couple of years after that, she sent him a photo of her second.

Not just a one-off success, this major new medicine has saved or prolonged thousands of lives. But it came about not from any attempt to treat a particular type of cancer, or any disease for that matter. Rather, we owe its existence to curiosity-driven research—a tinkering with cells and molecules—to fathom how the immune system works, and we’re only just beginning to understand its potential benefits.

Cancer was once thought to be but the idea remained controversial for over three decades. This was because of the possibility that the immune reactions observed in the experiments in question had been caused not by the tumors in the animal subjects but by the chemicals used to induce the tumors. Eventually, several lines of evidence established that our immune system can and does fight cancer: immune cells were found to infiltrate tumors, and when isolated in the lab, these cells could kill tumor cells. In addition, mice engineered to lack a proper immune system were found to be especially susceptible to cancer.

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