Tuesday, June 4, 2013

Progress on Cancer Therapeutics

The NY Times has an article on Cancer Therapeutics, following the annual ASCO Conference in Chicago. Regrettably the focus is on immune system therapeutics almost exclusively. In fact there is a quote:

The new drugs work by disabling a brake on the immune system called the programmed death 1 receptor, or PD-1. And although the data presented at the meeting was from the earliest stage of testing only, the drugs were the center of attention here, with some doctors predicting that cancer treatment was about to shift. “If you look five years out, most of this meeting will be about immunotherapy,” said Dr. Mario Sznol, a professor of medical oncology at Yale. 

 This is akin to Rosenberg some twenty five years ago, a dream that the immune system alone will be the means to the end. Somehow this article fails to account for the pathway blockers such as those blocking BRAF and MEK.

The article continues:

Harnessing the immune system is appealing for several reasons. It might be applicable to many different types of cancer. It might produce longer lasting remissions than can be achieved by chemotherapy or the newer targeted drugs. And it seems somehow more natural and holistic. 

This is a classic statement of those seeking the Holy Grail. In reality one suspects that we will be identifying and targeting mutation after mutation and not just allowing the immune system to respond. After all the PD-1 inhibitor just enable another path to work on T cell attack. This is the second of many possible but T cells are most likely not the sine qua non.

I am still intrigued by TVEC and the viral attack. Perhaps what we will see is a typical combine approach. However there are many approaches and the Press all too often send out hope to patients well ahead of reality. The PD-1 Trials were Phase 1 Trials after all!

We have summarized the results in a recent White Paper for reference.