Immune Drugs Show Promise Against More Cancers
The problem was getting the drugs to attack only tumor cells and not healthy tissue.
Finally, all the hard work in this field over the years appears to be paying off, Lichtenfeld and Schilsky say.
In 2011, the FDA approved the first "checkpoint inhibitor" drug, Yervoy (ipilimumab), for melanoma that couldn’t be removed surgically or had spread to other parts of the body.
Yervoy, Keytruda and Opdivo are all so-called checkpoint inhibitors. They work by blocking immune cell molecules called “checkpoint proteins.”
These proteins are like the brakes on the immune system. They keep the immune system from going overboard and attacking normal tissue, as happens in autoimmune diseases like rheumatoid arthritis and lupus. Tumors can fool checkpoint proteins into thinking that they are normal tissue, so they fly under the immune system’s radar.
“The immune system was designed by nature to recognize foreign things in the body,” Schilsky says. “Every cancer is a foreign object. It’s only a question of how foreign it appears to be so that the immune system can recognize it.”
All three drugs have side effects, but Opdivo and Keytruda appear to have fewer than Yervoy, Schilsky says. Side effects for Opdivo included rash, itching, cough, and retaining fluid, according to the FDA. Keytruda side effects included fatigue, cough, nausea, joint pain, constipation, and diarrhea, the agency says.
Lichtenfeld says experts still have a lot more to learn about the safety and effectiveness of immunotherapy drugs, though.
When Keytruda was approved, the FDA said it helped shrink tumors in 24% of patients. The effect lasted at least 1.4 to 8.5 months, but lasted longer than that in most people, the agency said.
Opdivo helped shrink melanoma tumors in 32% of patients, and the effect lasted more than 6 months in about a third of those people.
The drugs are also expensive. Schilsky says they can cost $10,000 to $20,000 a dose and are given every other week.
And even though the drugs are promising for other conditions, the cost might prevent them from being prescribed off-label, meaning used for treatment before being FDA-approved for that purpose. Insurance companies are not likely to pay for that use, Schilsky says.
Immune Drugs Show Promise Against More Cancers
Research Paying Off at Last? continued...
The problem was getting the drugs to attack only tumor cells and not healthy tissue.
Finally, all the hard work in this field over the years appears to be paying off, Lichtenfeld and Schilsky say.
In 2011, the FDA approved the first "checkpoint inhibitor" drug, Yervoy (ipilimumab), for melanoma that couldn’t be removed surgically or had spread to other parts of the body.
Yervoy, Keytruda and Opdivo are all so-called checkpoint inhibitors. They work by blocking immune cell molecules called “checkpoint proteins.”
These proteins are like the brakes on the immune system. They keep the immune system from going overboard and attacking normal tissue, as happens in autoimmune diseases like rheumatoid arthritis and lupus. Tumors can fool checkpoint proteins into thinking that they are normal tissue, so they fly under the immune system’s radar.
“The immune system was designed by nature to recognize foreign things in the body,” Schilsky says. “Every cancer is a foreign object. It’s only a question of how foreign it appears to be so that the immune system can recognize it.”
All three drugs have side effects, but Opdivo and Keytruda appear to have fewer than Yervoy, Schilsky says. Side effects for Opdivo included rash, itching, cough, and retaining fluid, according to the FDA. Keytruda side effects included fatigue, cough, nausea, joint pain, constipation, and diarrhea, the agency says.
Lichtenfeld says experts still have a lot more to learn about the safety and effectiveness of immunotherapy drugs, though.
When Keytruda was approved, the FDA said it helped shrink tumors in 24% of patients. The effect lasted at least 1.4 to 8.5 months, but lasted longer than that in most people, the agency said.
Opdivo helped shrink melanoma tumors in 32% of patients, and the effect lasted more than 6 months in about a third of those people.
The drugs are also expensive. Schilsky says they can cost $10,000 to $20,000 a dose and are given every other week.
And even though the drugs are promising for other conditions, the cost might prevent them from being prescribed off-label, meaning used for treatment before being FDA-approved for that purpose. Insurance companies are not likely to pay for that use, Schilsky says.
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