The US Food and Drug Administration granted its first approval to an immunotherapy regimen for breast cancer. The drug, Genentech’s Tecentriq, was approved for use in combination with Abraxane chemotherapy for patients who have a type of advanced triple negative breast cancer.
For women with metastatic triple negative breast cancer (TNBC), the future ranges from bleak to nonexistent. But now the FDA has granted accelerated approval to a new immunotherapy drug, named Tecentriq, that promises to brighten the future for many of those women.
What is triple negative breast cancer?
- The cells in most breast cancers contain receptors for estrogen, progesterone, or another hormone known as HER/2neu.
- The presence of cancerous cells receptive to these hormones means that the cancer may be vulnerable to hormone-based chemotherapy.
- But 15% of breast cancers do not contain any cells that are receptive to the three crucial hormones.
- Hence the label of “triple negative” breast cancer.
What is immunotherapy?
The term immunotherapy refers to a broad category of treatment modalities that enlist the body’s own immune system to combat disease. The human immune system naturally produces white cells that patrol the blood stream and attack alien invaders such as virus and bacteria.
Cancer cells can trick the immune system
- Cancer cells often baffle the immune system because they start out camouflaged as the body’s own cells.
- They then begin to multiply uncontrollably.
- When cancer cells are rapidly replicating, they’re also mutating in ways to continually evade the immune system’s efforts to destroy them.
How does this new immunotherapy drug work?
- In cases of TNBC, a protein known as PD-L1 is produced by the cancer cells.
- PD-L1 then sends out a deceptive signal that the immune system mistakenly interprets as: “Hey, don’t attack me, I’m on your side”. That’s where Tecentriq enters the scene.
- Tecentriq deactivates the PD-L1 protein, which in turn shuts down the false flag signal.
- The cancerous cells are then vulnerable to attack via an injectable chemotherapy nanoparticle known as Abraxane.
The FDA’s approval was based on the results of an international multi-center, randomized double-blind Phase 3 study. The project included 902 patients spread across 41 countries in Europe, the US, Canada, Asia, Latin America, and Australia.
One particular result from the study triggered the FDA’s decision to fast-track approval of the Tecentriq/Abraxane combination. That result came from the group of patients whose TNBC tumors were producing the PD-L1 protein.
The FDA was impressed by a metric known as “progression-free survival”
Progression-free survival is the amount of time during which a patient’s cancer does not get worse. The survival time for the TNBC patients receiving Tecentriq/Abraxane was 7.4 months, as compared to 4.8 months for those getting Abraxane with a placebo.
“This is the first time immunotherapy has worked in such a difficult to treat cancer,” said Dr. Peter Schmid of Queen Mary University in London, who was the study’s lead author.
Before Dr. Schmid’s study yielded results, a Florida woman used immunotherapy to beat terminal stage IV breast cancer
Dr. Schmid’s claim of exclusivity might be viewed a bit skeptically by Florida resident Judy Perkins. By 2013, Perkins’ terminal stage IV breast cancer had metastasized throughout her torso. In 2015, Perkins enlisted in an experimental clinical immunotherapy trial conducted by the Cancer Institute at the National Institutes of Health.
Perkins’ doctors searched through the 37 trillion cells in her body. They isolated just 11 cancer fighting blood cells, known as tumor-infiltrating lymphocytes, or TILs. Then those 11 tiny warrior cells were replicated until they numbered 90 billion.
When all those cancer killing cells were repatriated into Perkin’s bloodstream, her cancer was obliterated. She has been in remission ever since.
Immunotherapy seems to be the future of cancer treatment
Dr. Schmid’s study was just a small step, and Perkins’ case is an anomaly. Of the 47 people who joined her in that experimental clinical trial, only 7 achieved some sort of remission.
But immunotherapy continues to hold out great promise for effective treatment of cancer. As the rate of scientific discovery continues to ever accelerate, it may not be long before our own cells can be successfully trained to eliminate the incursion of cancer within our bodies. Let me know what you think. Thaïs
As one of the nation’s leading OB-GYNs, Dr. Thaïs Aliabadi offers the very best in gynecological and obstetric care. Together with her warm professional team, Dr. Aliabadi supports women through all phases of life. She fosters a special one-on-one relationship between patient and doctor. We invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863-6700.
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