Immunotherapy repels cancer for former US President Jimmy Carter

Former President Jimmy Carter had stage 4 melanoma cancer, after three months of immunotherapy, there was no trace of the disease.

In August 2015, at the age of 91, former President Jimmy Carter was diagnosed with stage 4 melanoma, metastasized to the liver and brain.

If you get sick many years ago, Carter's chances of survival are almost zero. However, thanks to a new approach called immunotherapy combined with chemotherapy, radiotherapy, the cancer of former US President was repelled.

According to Cancer Research, to treat Carter, the doctor first removed tumors with radiation therapy. Next, the patient was given pembrolizumab (trade name Keytruda) , a PD-1 key check inhibitor to help the immune system completely eliminate cancer cells.

In December 2015, three months after starting treatment according to immunotherapy, the patient's body no longer traces cancer. Carter's case shows that immunotherapy is not only effective for children with cancer but also for older patients.

Using the body's own immune system to identify and destroy cancer cells, immunotherapy is considered a breakthrough in cancer treatment. The therapy was won by two scientists, Professor James P. Allison (USA), and pioneer Tasuku Honjo (Japan). In fact, the idea of ​​using anti-cancer immune systems has been around for a long time, but in the 1990s it was just beginning to be put into clinical treatment.

To understand the mechanism of immune therapy, first of all, it is necessary to talk about T cells. According to the American Cancer Treatment Center, T cells and other immune cells are likened to the police force of the muscle. can. When strange cells invade, they receive notifications through a series of signals and immediately intervene, just as the police are notified via radio.

Meeting strange cells, T cells will "scrutinize" proteins on the cell surface, similar to checking identity cards. If proteins show cells are healthy and healthy, T cells accept to leave. Conversely, if proteins are exposed as infected cells that carry the disease , T cells immediately issue an attack order. At this time, the immune system enhances a type of molecule called an immune control latch to prevent immune cells from attacking normal body cells.

However, cancer cells know how to bypass the immune system. By transmitting signals to immune checkpoints such as CTLA-4 and PD-1, cancer cells impersonate healthy cells, making T cells unable to activate attacks. The immune checker accidentally becomes a brake, inhibiting T cell activity, preventing it from killing cancer cells.

In order to repel cancer, it is necessary to support the immune system to distinguish between healthy cells and cancer cells. In order for the immune system to do this, it is necessary to block "underground communication" between cancer cells and check. Researchers have developed inhibitory latch inhibitors. The appearance of inhibitors of the check pin helps release the brakes, enabling immune cells to perform their tasks properly.

Inhibitor closes the "implicit" cut off point between cancer cells and immunosuppression.(Photo: CTCA).

Key block inhibitors from Allison and Professor Honjo's studies show clear efficacy in patients with lung cancer, kidney cancer, melanoma and lymphoma.

Focusing on the immune system instead of tumors, this therapy works for many different types of cancer and causes less damage to the patient's body than chemotherapy or radiation therapy.

Several types of check inhibitors have been approved by the US Food and Drug Administration, such as ipilimumab (Yervoy), pembrolizumab (Keytruda), nivolumab (Opdivo), atezolizumab (Tecentriq).

However, immunotherapy still has limitations. For example, a blockade inhibitory reaction may exist for many years and work with many types of cancer but is not effective for every patient. According to Dr. Pham Nguyen Quy, a cancer resident doctor at Kyoto University Hospital (Japan), quite a few patients who use the check inhibitor still do not activate the immune system.The cause may be that the immune system is "inert" or too weak.

Besides, the cost of immune therapy is extremely expensive, not to mention many cases still need to combine with radiotherapy, chemotherapy to increase efficiency. Sharing with the PV, Dr. Quy said that at the time of birth, the nivolumab key inhibitor was criticized by many scholars and called the name "Japan's economic recession" . Many people are concerned about whether the budget will be able to stand when the Ministry of Health of this country approves the use of nivolumab for the majority of lung cancer patients.

In the US, immunotherapy costs up to $ 200,000 per year. In Vietnam, the cost of immunotherapy is not currently covered by health insurance, so patients have to pay 100%. The price for each vial is over 62 million dong.

In addition, doctors recommend that in addition to immunological drugs that have been clinically tested and certified, there are many "self-proclaiming" methods . Even drugs like nivolumab can trigger excessive immunity, leading to "self- infliction " and autoimmune conditions such as pneumonia, enteritis, dermatitis, adrenal insufficiency, type 1 diabetes, and acting serious progress. For this reason, immune drugs must be used under the supervision of specialists and need interdisciplinary coordination to cope with many forms of illness when missed by being "fired into the ghost."