Nobel Prize-winning researcher: The future of immunotherapy for cancer treatment

For a long time, immunotherapy was considered nonsense by many people in mainstream cancer medicine. It had been tried for years, starting with a German scientist named Paul Ehrlich in 1906. There’d been a lot of other attempts since then, particularly in the 1960s and 1980s, but none of them really worked. Unfortunately, there was a lot of hype around those efforts each time. So, when they didn’t pan out, the field as a whole got a bad reputation. And as I started looking into immunotherapy research in the early 1990s, people kept telling me, “Don’t do this.” But the U.S. Food and Drug Administration’s approval of ipilimumab, the drug I developed, in 2011 and the discovery of other checkpoint inhibitors by other researchers have proven that immunotherapy is a legitimate cancer treatment option. I think the Nobel Prize was the final seal of approval that this is real, that it’s not just some snake oil. And I believe that immunotherapy is going to continue to grow. Humanizing my immunotherapy research Being the first person on the planet to know something important is really cool. But so is meeting the people your discovery has helped. I don’t know the exact number of people who’ve benefitted from ipilimumab, but I do know there are a lot of folks alive today who wouldn’t be otherwise. The first time I met a patient who’d taken ipilimumab was in 2006. I’d been involved in clinical trials for it by then for several years. One day, I was in my office, and an oncologist I worked with very closely called and said, “Hey. Can...

10-year glioblastoma survivor: Get busy living

Rare. Unusual. Anomaly. All of these words are synonymous with being a long-term glioblastoma survivor. All statistical data suggests that I shouldn’t be here. Only 10% of people with glioblastoma survive five years. However, here I am, 10 years after being diagnosed with the most aggressive form of brain cancer, and I’m not only surviving – I’m thriving. Looking back is surreal. Some things seem like a dream to me, as if I was floating above watching my life unfold beneath me. Other memories are so vivid that I am instantly brought back to the time and place, and I can recollect the smallest details. My glioblastoma diagnosis and recurrence After my glioblastoma diagnosis, I was extremely hopeful, yet realistic. I had every medical advantage for a person diagnosed with brain cancer: one of the best neurosurgeons in the country, Dr. Sujit Prabhu, who removed 99% of the tumor in MD Anderson’s state-of-the-art BrainSuite®; excellent neurological exams; and peak health condition for my age. But I still knew that it was possible, or more than highly likely, that I would have a recurrence. My tumor returned less than a year after my initial diagnosis, and my life changed the moment I stepped out of MD Anderson after my second surgery. Even if it meant multiple recurrences and craniotomies, I would fight as long as possible for my husband, my daughter, my family and my friends. Taking advantage of the gift of time After a few years passed with no more recurrences, I felt foolish for not taking full advantage of being a young, healthy cancer survivor. I decided then...

Can immunotherapy treat glioblastoma? Understanding the latest study

A new study has revived hope for the role of immunotherapy in treating glioblastoma, the most aggressive and deadly form of brain cancer in adults. The study used a type of immunotherapy known as checkpoint inhibitors, which train the immune system’s T cells to fight cancer. Although checkpoint inhibitors have greatly increased overall survival for some types of cancer, such as melanoma, early clinical trials failed – until now – to show any benefit for glioblastoma.   We sat down with John de Groot, M.D., professor and interim chair of Neuro-Oncology, who led the MD Anderson portion of the study, to learn more about the latest progress in immunotherapy for glioblastoma. How did this clinical trial work? The Phase II randomized clinical trial was led by researchers from UCLA and conducted at six other institutions, including here at MD Anderson. We enrolled recurrent glioblastoma patients – people whose tumors had returned after their initial treatment. Nearly all glioblastomas recur, and when this happens, median survival drops to less than a year. The study had two different arms. In one arm, patients received pembrolizumab, an immune checkpoint inhibitor, both before and after surgery. In the other arm, patients only received the drug after surgery. How was this study different from previous clinical trials studying immunotherapy in glioblastoma patients? Most glioblastoma clinical trials only give the new drug at the time of recurrence, usually without surgery. Previous studies of pembrolizumab in glioblastoma that were designed this way haven’t shown a survival benefit. One of the goals of this study was to look at the drug’s effect on tumor biology. In order...

7 glioblastoma myths

Glioblastoma is the most common and aggressive primary brain tumor in adults. Although it’s considered a rare cancer, with about 12,000 new diagnoses each year, it’s gained increased visibility recently with the diagnoses of a few high-profile people.  As a neuro-oncologist and the clinical medical director of MD Anderson’s Brain and Spine Center, part of my job is to make sure glioblastoma patients and their families understand this disease and how it will affect them. Unfortunately, as I’ve learned, there are many myths and misconceptions about glioblastoma. Here’s the truth about seven glioblastoma myths I commonly hear. 1. Myth: Cell phones cause glioblastoma. Fact: Cell phones don’t cause brain cancer. Several different studies have failed to find clear evidence of a link between cell phone use and brain cancer. The number of people diagnosed with glioblastoma has remained largely stable over the past decade, while cell phone use has continued to increase. 2. Myth: There’s nothing you can do for an “inoperable” glioblastoma. Fact: A tumor that’s considered “inoperable” at a hospital without specialized brain tumor programs may actually be operable if you seek treatment at a cancer center with the right expertise. Here at MD Anderson, our neurosurgeons successfully operate on many patients who thought their tumors were inoperable. We treat glioblastoma patients every day and have a great deal of experience and expertise in safely removing tumors. This includes glioblastomas involving brain regions responsible for important functions, such as language or movement. Certain brain tumors that cannot be safely surgically removed may qualify for laser interstitial thermal therapy (LITT). This minimally invasive surgical procedure uses thermal heat to destroy...

Losing my brother to glioblastoma inspired me to join the Boot Walk

I was 12 when my 19-year-old brother, Brandon, was diagnosed with glioblastoma, the most common and aggressive form of brain cancer. I remember sitting in the waiting room at MD Anderson with my parents for nine hours during his first surgery, as I filed my nails down to nothing, watched the news and wondered if Brandon was really going to be OK like he said he would be. He fought his 22-month battle with pure grace, dignity and humor. I used to get upset because Brandon was such a selfless person and this was the reward he got? An incurable disease? I know he wouldn’t want us to think that way, so I try to think about the positive things he taught me instead. What I’ve learned from my brother Brandon was always protective and supportive, and he showed me unconditional love as far back as I can remember. I’m told he always loved being my big brother. He was a really good guy who was extremely funny and goofy, genuinely cared about others and had excellent taste. He appreciated people and wanted others to do the same. One time when we were walking through a parking lot, I threw my gum on the ground. Brandon asked me if I liked when I stepped in gum. I looked at him and said, “No.” He told me that if I don’t like it, other people probably don’t like it, and if I was one less human who was throwing their gum on the ground, I was helping. He taught me that I have my own path, and it might be...

Glioblastoma survivor: Family and faith give me hope

I’m a 58-year-old guy who never thought I would be talking about “the C word.” Nevertheless, here I am recollecting the past year contending with glioblastoma, an aggressive brain tumor, in the right temporal lobe of my brain. I’m a proud BOI, which means I was “born on island” in Galveston, Texas, a distinction I carry as a badge of honor. I’m one of seven siblings, I’m married to the love of my life, Denise, and we have three extraordinary sons, a wonderful daughter-in-law and a superhero 3-year-old grandson. They’ve all played a role in my cancer journey. Brain tumor symptoms only my wife noticed I now realize how helpful it is to have partner who knows all your quirks. When Denise mentioned I was missing a “pep in my step” and taking long naps, I didn’t think much of it and blamed it on getting older. She also noticed I had a long blank stare one day, which we later learned was a complex seizure. A few weeks later, we were out shopping, and Denise said straight out, “Let’s go to the emergency room and get you checked out.” We went to The University of Texas Medical Branch (UTMB) Emergency Room, which we knew well since we’d spent most of our adult lives working there. After being triaged, I was wheeled to a room, then a battery of tests began. After the first test, the doctor said, “Tino, you have a tumor about the size of a lemon and it looks like cancer.” Then, after another test, he said, “It’s much bigger, about the size of an avocado.”...