Nine years later, against all odds, Mr. Telford is still alive. What saved him was an experimental immunotherapy drug—a medication that unleashes the body’s own immune system to attack cancer. His remarkable survival caught the attention of researchers, who began to realize that the way immunotherapy drugs were affecting tumors was unlike almost anything seen with conventional treatments.
Today Mr. Telford is among a growing group of super-survivors who are transforming the world of oncology. In both total numbers and duration of survival, they are charting new territory. And they are reviving hopes that the long-maligned idea of enlisting the power of the immune system against cancer may help to turn the tide against some of the most lethal and resistant forms of the disease.
“It’s the most exciting thing I’ve ever seen,” says David Lane, scientific director of New York’s Ludwig Institute for Cancer Research. “It’s the long-term survival of people who have advanced disease. This is very unusual.”
Cancer immunotherapy comes in several forms. The drugs sparking the most interest are called checkpoint inhibitors. They work by releasing the natural brakes on the immune system, enabling its foot soldiers, called T cells, to attack tumors.
Immunotherapy is still in its early stages, and more rigorous studies are needed. Researchers and drug makers are striving to overcome huge obstacles to a lasting cure. For one, most patients don’t respond the way the super-survivors have, and researchers are just beginning to understand why. Another mystery is why some patients relapse while remaining on therapy while others go into prolonged remission after undergoing just one course of treatment.
Most experts believe it will take combinations of immunotherapy drugs—or combinations of immunotherapy with other cancer treatments—to optimize their impact. But finding safe and effective combinations is a daunting undertaking.
While side effects of the new drugs are relatively mild for some patients, others have developed potentially devastating complications caused by an out-of-control immune system. Some patients have died as a result. Researchers are devising ways to minimize such problems.
“It’s extremely exciting that so many patients are responding” to checkpoint inhibitors, says Bert Vogelstein, director of the Ludwig Center at Johns Hopkins Kimmel Cancer Center in Baltimore. “But the reality is that most are not.”
