The director of the University of Louisville’s James Graham Brown Cancer Center has a lofty goal — to make cancer a disease of the past.
“I think we are close to that happening,” Dr. Jason Chesney told a packed house at Holsopple Brewing in Lyndon Wednesday night. “If I had said that five or 10 years ago, I would have been lying to you.”
But he’s hopeful today because of successes — at his center and elsewhere — with immunotherapy, which harnesses the power of the body’s own immune system to fight cancer.
With the progress that’s been made with immunotherapy, “we’re going to see a 25% reduction in the number of deaths in the United States from cancer in the next five years,” he said, drawing applause and cheers from the crowd. “… It’s all come about from basic research and clinical research that’s happening.”
Chesney was the featured speaker at Beer with a Scientist, an educational series that brings people together in a casual setting to learn about various subjects, from aging to climate change to superbugs.
Chesney introduced the crowd to various types of immunotherapy, including checkpoint inhibitors, which are drugs that help the immune system respond more strongly to a tumor, according to the National Cancer Institute.
He primed the crowd by discussing how the body’s immune system normally works, describing how cytotoxic T cells go after virally infected cells. Without the T cells, viruses that cause things like the common cold could take over the entire body and lead to death, he said.
“The immune system was not set up to cure you of cancer; it was set up to take care of infections,” with the help of T cells, Chesney said.
These T cells “are the cells that we want to get mad, or for lack of a better term, pissed off at your cancer cells,” he said. “That’s the whole goal here.”
Ideally, “the T cell recognizes proteins on the surface of cancer cells and it says, ‘Oh, there’s something wrong with this protein. This is foreign,’ and then it says, ‘I’ve got to kill that cell,’ ” Chesney said.
However, cancer cells are “very good” at evading T cells, and T cells are easily tricked, Chesney said. With immunotherapy, “we have multiple approaches that we use to try to get those T cells — egg them on — to kill the cancer cells.”
That includes using antibodies to block “brakes” on the T cells, he said.
“These antibodies are like a big wood board being put in front of the brake in your car, so that’s essentially what we’re doing,” Chesney said. “We’re blocking your ability to stick your foot on the brake and it allows the car to go crazy, and that’s what we’re doing with these T cells. We’re allowing the T cells to continue to get activated.”
It is possible to over-activate the T cells, however. “We can give these drugs very safely today without significant side effects,” he said. “But they can be lethal if not managed appropriately,” or lead to other problems, such as skin rashes and liver inflammation.
Also, immunotherapy doesn’t work for every patient.
Nevertheless, immunotherapy can be so successful at fighting some cancers that “I think that someday we won’t have to do surgery anymore,” Chesney said. For example, “it’s pretty remarkable what we’re seeing in melanoma,” a type of skin cancer.
Recalling a particular trial, he said, “We went from everyone we saw who had metastatic melanoma dying to the majority living.”
The U.S. Food and Drug Administration has approved immunotherapy for other conditions, too, such as head and neck cancer, liver cancer, kidney cancer and cervical cancer, Chesney said.
But researchers at the Brown Cancer Center are hopeful for even more advancements. Some of the approaches being tried locally include taking the patient’s own T cells out and expanding them or genetically modifying them and then putting them back into the patient.
“We’re not done,” Chesney said. “We know that we’re going to have to continue to innovate and move the needle to get us to the point where 100% of patients who get cancer don’t die of cancer. That’s our goal.”