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 you come down to the outpatient clinic for a minute?” I said, “Why? I’m busy.” And he said, “Just come.” So, I said, “OK.”
There, he introduced me to a 23-year-old patient who’d been diagnosed with stage IV melanoma the year before. She’d had 31 metastases in her liver and another in her brain, and been told she only had about six months left to live. Then she got a single round of treatment with the drug I developed, and her tumors just completely melted away.
The day I met this woman was the first time she’d come back in for a follow-up visit, and her oncologist had told her there were no signs of cancer left in her body. He asked her if she wanted to meet the man who’d made that possible. She did, and we ended up becoming really good friends. She’s 15 years out from being treated now, and married with two kids — living a rich, vibrant life.
What it means to meet cancer patients who’ve benefited from my immunotherapy research
Since then, I’ve met other patients who’ve been given ipilimumab, including one woman who came up to me at a conference a couple of years ago and said, “Jim, I don’t know whether to kiss you or kick you.”
That took me aback, until she explained. It turned out she’d been given my drug two and a half years earlier and had every adverse reaction possible. I was really sorry she’d had such a hard time. But on the other hand, here she still was to tell the tale — and her health was perfect — which is pretty unusual after a pancreatic cancer diagnosis. So, that’s progress.
Every time I meet a patient who’s benefitted directly from my research, it’s very touching. It really brings home that what started off as a fundamental science project and then became these clinical trials has real-life implications.
What’s next for immunotherapy
Today, I’m a couple of levels removed from the lab, so my students are the ones having the big fun now. But the future of my research is building on what we already know. And immunotherapy has already been approved to treat bladder cancer, kidney cancer, head and neck cancers, lung cancer and Hodgkin lymphoma. The list goes on and on.
There are still some pretty lethal types of cancer that we haven’t made much of a dent in yet, such as glioblastoma. But I think if we work intelligently, we’re going to be able to make a lot of progress against that and others. That’s why it’s still such a thrill to see new data and think about what we could do with it.
Immunotherapy is really adaptable. The three pillars of cancer treatment are surgery, radiation and chemotherapy. What’s unique about immunotherapy is that it can be given in tandem with any or all of those. So, when I first started looking at it, I anticipated there would be a lot of combinations tried. And I believe that one day, immunotherapy is going to be a part of every successful combination that’s used to treat cancer.
James "Jim" Allison, Ph.D., is chair of Immunology and executive director of the Immunotherapy platform at MD Anderson. He was awarded the 2018 Nobel Prize in Physiology or Medicine for launching an effective new way to attack cancer by treating the immune system rather than the tumor.
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