“Cancer care was either surgery to cut it out, radiation to burn it or chemotherapy to poison it.” That is how Dr. Michael Zinner, chief executive and executive medical director at Miami Cancer Institute, summed up most of the last century when he spoke to Fox News Digital in 2023.
Then came targeted therapies, roughly 20 to 25 years ago, followed by personalized care. Immunotherapy, Zinner said, was the next great development. It had been in the works for 40 to 50 years, “and finally it has now blossomed.” Some experts now call it the fourth pillar of cancer treatment.
How it works
In cancer patients the immune system is generally dormant, said Julian Adams, chief science officer of Stand Up To Cancer. Immunotherapy, he said, “awakens the body’s immune system, which then targets cancer.”
Dr. Marc Siegel of NYU Langone Medical Center described the problem as one of disguise: cancer makes itself invisible to an immune system that hunts foreign invaders. He named two main routes to undo that. Checkpoint inhibitors block the proteins that keep immune cells from attacking, so, as Siegel put it, they “stop the cancer from doing its disappearing act.” The second route targets mutated or abnormal proteins on the tumor surface, which includes CAR-T therapy. In that approach, doctors remove a patient’s T cells, alter them in a lab to fight cancer harder, and return them to the body. Cancer vaccines are also emerging, Adams said, for patients in remission or after surgery, to keep the disease from coming back.
What the trials show
One trial gave a promising immunotherapy drug to rectal cancer patients. “All 18 patients in the trial had their cancer disappear, without the need for the standard treatments of radiation, surgery or chemotherapy,” Adams said. The cancer had not returned in any of them, some of whom had been cancer-free for up to two years. Stand Up To Cancer also backed work on a CAR T-cell therapy for children and young adults with B-cell acute lymphoblastic leukemia.
Results vary by tumor. Melanoma, lung and bladder cancers are “very responsive,” Adams said, while pancreatic and colon cancers stay “cold” and respond poorly. For kidney cancer and melanoma, immunotherapy has replaced chemotherapy in some cases. In lung cancer, a combination often works best. Chemotherapy tends to bring nausea and diarrhea, while immunotherapy can cause autoimmune side effects. Both, Adams said, can be managed with supportive care.
One patient’s course
Anthony Hall, 71, of Ohio, was diagnosed with stage 3 lung cancer in 2022. He had chemotherapy and radiation over eight weeks, with 12 treatments and minimal side effects, then began the drug Imfinzi in November 2022. His daughter, Erin LeMaster, said he had no side effects besides occasional fatigue: no hair loss, no food aversion, no skin sensitivity. Scans every three months showed a response, until an October scan found growth in the original mass. His oncologist will not continue that drug. Hall was waiting on biopsy results and would likely need more chemotherapy and radiation, perhaps surgery.
Zinner noted that cellular therapy is still designed almost entirely for blood cancers such as multiple myeloma, lymphoma and leukemia. The field is moving toward solid tumors like breast, pancreatic and colon cancer. “We’re not quite there yet, but we’re moving in that direction.” Adams, pointing out that immunotherapy is only about 15 years old, expects more advances. Patients weighing treatment should talk to their doctor about which option fits their cancer.
