New and innovative treatments emerge each year in the fight against cancer, and MU Health Care physicians and researchers have set their sights on one promising method, immunotherapy, to develop new strategies and improve outcomes for patients everywhere. Eric Kimchi, MD, a surgical oncologist at Ellis Fischel Cancer Center, explains how immunotherapy works with the body’s natural defenses to take out cancerous tissues.
How cancer spreads
Your body repairs and replaces millions of cells every day. With such a high turnover rate, mistakes are unavoidable. But, says Kimchi, “those cells are usually removed from your system because there’s something wrong about them that our body recognizes, just like your body would recognize if it were infected with a virus.” White blood cells attack the altered cell and keep it from replicating.
Occasionally, an altered cell is able to disguise itself from the immune system. “This happens through a sequence of events where the cancer cells meet up with immune cells, target the immune cells’ receptors that recognize cancerous cells and systematically turn them off,” Kimchi says. Without the immune response, those cells replicate out of control, forming tumors.
Restoring the immune response
Here’s where immunotherapy comes in. “The key is, can we reverse that process?” Kimchi asks. “And can we reverse it selectively? Because our immune system is playing an important role in defending us from outside threats, but it also plays an important role in protecting our normal cells. We try to design immune therapies to find specific identifiers on the cells that we think are cancer cells and then activate only that subset of the immune system so that the immune cells will attack the cancer cells.”
If the drug doesn’t work selectively, the immune system could start attacking healthy cells, which could lead to dangerous reactions. Most immunotherapy drugs available now are nonselective, but researchers and physicians are working hard to target cancerous cells. “The more specific we can make the treatments, then the better and more safely we can treat our patients,” Kimchi says.
MU research opens doors
Kimchi and others at MU Health Care are building on decades of immunotherapy research to make highly targeted immune therapy drugs. “We look at the mechanism through which the immune system is turned off and how we can turn it back on and other things we can do to elicit immune responses: how to use the tumor's own qualities to turn the immune system on,” he says.
The surgical oncology team has secured grants from the National Institutes of Health to focus on treatment of liver cancer using immunotherapy. “It’s one of the most lethal cancers and one of the most common worldwide,” he says. “Incidence of liver cancer is growing rapidly in the United States. That’s through hepatitis C infections and through the development of fatty liver disease, which may be related to our diet and the rise in obesity.” MU doctors study the unique traits of liver cancer cells in hopes of identifying drugs that will help the body’s immune system recognize rogue liver cells as a threat.
The future of cancer treatment
While it’s unlikely that a “silver bullet” treatment will be discovered that can destroy all types of cancer, Kimchi believes the field immunotherapy will continue to produce ever more effective, life-saving drugs. “Just recently,” he says, “the FDA approved an immunotherapeutic drug based on its effectiveness at targeting the genetics seen within cancer cells, regardless of the type of cancer. This is how immunotherapy is a game changer in that it crosses the boundaries of different cancers, and it's broadly applicable.”
As for patients at Ellis Fischel, Kimchi says, “We have a unique, multidisciplinary approach. We assess every single patient for individualized, personalized medicine. If immunotherapy is the correct approach, then that’s what we pursue. But regardless of the disease and what the ultimate treatment is, we develop a specific plan, as a group, for each person in our care.”