Cancer’s Brave New World is Looking for Recruits

I made the call. That was the first step. No one answered, of course.
So I called again today. And now that I’m beyond the fear, I’ll call again tomorrow.
It’s for a local clinical trial. The gist: Doctors will biopsy my tumor and study the cancer cell for its mutations, looking for doors and windows that my immune system can penetrate to kill it. They’ll give me drugs to amp up my immune system so it’s angry and vicious and looking for cancer blood.
At the Cancer Research Institute Immunotherapy Patient Summit I went to last weekend, they said only 3 to 6 percent of people eligible for clinical trials pursue them. In the past, that was no big deal. A Phase 1 trial, the first of three the FDA normally requires before giving a drug approval, might have only needed a dozen or so people to figure out the dosage needed to kill a cancer.
Today, though, they’re looking for teems of people. And instead of targeting just one type of cancer, these drugs are targeting the immune system which goes after any cancer in the body, so virtually anyone with metastatic cancer – meaning it’s spread to other parts of the body – is eligible.
Making the call means pushing past the fear of the unknown. My oncologist has a Chinese food menu of options for me that are tried and true – not to cure it, but that will contain it. When one stops working, we go to column B and choose the next one. But a clinical trial? That’s no man’s land. Unchartered territory. The great unknown.
Brian Brewer of the Cancer Research Institute assures me that the research is there. That these drugs can be so powerfully effective, they’re gaining FDA approval halfway through Phase 2 testing.
But it doesn’t mean they don’t have side effects. Immunotherapy works by supercharging your body’s killer T-cells, while removing cancer’s cloaking mechanism so the T-cells can find it and decimate it. It seems the body already knows how to kill cancer, it’s just that cancer is doing a great job of hiding from it.
A supercharged immune system, though, can at times go after healthy cells. And there can be life-threatening consequences if you don’t stay on top of it. Most of those side effects can be treated with steroids until the body calms down and the immune system finds its rhythm, researchers and patients on these drugs said at the conference. Still, it’s scary.
And even when these drugs work, researchers are learning those capricious cancer cells find new ways to cloak themselves, rendering the meds ineffective.
Researchers aren’t giving up, though. They’re taking blood draws and sucking out those new cancer cells, taking them apart again, seeing how they’ve changed, devising new ways of targeting them and injecting those new, vulnerable, modified cancer cells back into a person’s body so their immune system can find it again and kill it.
It’s all pretty incredible. And the more I learn, the greater my resolve, the lesser my fear, the stronger I become.
At this point, I don’t know who is more at risk: The clinical trial coordinator who seems to be ignoring my calls or the smug cancer cells who mock my T-cell, giggling and chortling as they say “No one’s home,” when my T-cell knocks.
Just wait. That’s all I have to say.