HJAR May/Jun 2020

50 MAY / JUN 2020 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN ONCOLOGY tolerable to patients. We have come to an era when immune therapies are now finally available as a new treatment option for some patients. Thanks to advancements in mod- ern medicine, cancer immunotherapy has become the fourth pillar of cancer treatment. For much of the last century, scientists researched various aspects of the immune system and how to translate this into treat- ment. It was not until 1987 that the first im- mune checkpoint molecule was discovered, and its function remained unclear until the mid 1990s. Once it was realized to be a crucial step in immune recognition of cancer, clini- cal trials began. Despite decades of research, it was not until 2011 that the first immune checkpoint inhibitor was FDA approved for use in advanced melanoma. Since that time, multiple immune drugs have been approved, and are used in almost every cancer for select patients, some with dramatic and durable responses. The goal of immunotherapy is to utilize the body’s own immune system, or “army”, to fight the enemy. When the immune system realizes how the cancer has been hiding, it is better able to identify the threat and destroy the cancer cells on its own. Ideally, it stops growth of cancer and prevents it from me- tastasizing to other parts of the body, while simultaneously recruiting more immune cells to join the fight. The immune system becomes the drug the cancer has been escap- ing. It can no longer disguise itself as normal once it has been exposed. It is important to note that immunotherapy does not appear to work equally for all pa- tients or all cancer types. Given this, we may combine immunotherapy with other tradi- tional therapies to give our patients the great- est chance of remission. So how does immunotherapy compare to more traditional infusion treatments, such as chemotherapy? Protects Healthy Cells Chemotherapy is known to attack cancer cells, but it can also cause some collateral damage to healthy cells, leading to many of the well-known side effects of chemotherapy. DESPITE a sophisticated immune system, cancer is notorious for evading it. This is due in part to the fact that cancer cells were previously normal body cells that acquired mutations, allowing for uncontrolled growth, which is notably different from normal cellu- lar function. Because cancer cells are closely related to normal tissues, they are able to camouflage their molecular makeup, such that the immune system is unable to recog- nize them as the enemy. Since cancer is intui- tive and adaptable, it often goes unrecognized for long periods of time, allowing the cells to hide and replicate, posing a more significant problem to the individual before the immune system even realizes its presence. For more than one hundred years, we have utilized various treatment modalities to treat cancer, including surgery, radiation, and chemotherapy. It was known even in the 1800s that the immune system was also im- portant for the treatment of cancer, but the intricacies of manipulating it often proved problematic. It has taken years to harness its potential so that effective treatments are HARNESSING THE IMMUNE SYSTEM TO TREAT CANCER PATIENTS For many years, we have known that the immune system is the surveillancemechanismof the body. Its job is to police our tissues to quickly identify and attack any foreignmolecules.