Doctors find first success with immune therapy against cervical cancer, Chicago conference told
By MARILYNN MARCHIONE Associated Press June 4, 2014 1:54PM
In this August 2011 photo provided by Arrica Wallace, Wallace poses with her husband, Matthew, and sons Marccus and Mason in Mexico during a vacation, two weeks after her first round of chemotherapy. Arrica Wallace was 35 when her cervical cancer was discovered in 2011. It spread widely, with one tumor so large that it blocked half of her windpipe. The strongest chemotherapy and radiation failed to help, and doctors gave her less than a year to live. But her doctor heard about an immune therapy trial at the Cancer Institute and got her enrolled. "It's been 22 months since treatment and 17 months of completely clean scans" that show no sign of cancer, Arrica Wallace said. (AP Photo/Courtesy Arrica Wallace)
Updated: June 4, 2014 2:54PM
Doctors are reporting their first success using immune therapy against cervical cancer, a disease caused by the virus HPV.
In a pilot study at the National Cancer Institute, the tumors of two out of nine women completely disappeared — and those women remain cancer-free more than a year later, doctors reported at a conference this week in Chicago of the American Society of Clinical Oncology.
That’s far better than any other treatment has achieved in such cases.
The cervical cancer experiment was the first time an immune therapy has worked so dramatically against a cancer caused by a virus — HPV, the human papilloma virus.
Doctors are trying it now against throat, anal and other cancers caused by HPV, the human papillomavirus, and think it holds promise for cancers caused by other viruses, too.
This is “very, very exciting,” said Dr. Don Dizon of Massachusetts General Hospital, a women’s cancer specialist with no role in the study.
At the same conference, doctors also reported extending gains recently made with immune therapies against leukemia and the skin cancer melanoma to bladder, lung and other tumor types.
One of the women in the cervical cancer trial whose tumors disappeared is Arrica Wallace, of Manhattan, Kansas, west of Topeka. She was 35 when her cancer was discovered in 2011. It spread widely, with one tumor so large that it blocked half of her windpipe. The strongest chemotherapy and radiation failed to help, and doctors gave her less than a year to live.
But with sons 8 and 12 years old, “I couldn’t give up,” Wallace said.
Her doctor heard about the immune therapy trial at the Cancer Institute. She enrolled in the study, and researchers removed one of her tumors, isolated special immune system cells that were attacking it, multiplied them in the lab and gave billions of them back to her in a one-time infusion. They also gave her drugs to boost her immune response — “like Gatorade for the cells,” she said.
“It’s been 22 months since treatment and 17 months of completely clean scans” that show no sign of cancer, Wallace said.
Researchers have made great strides recently in the hunt for ways to boost the body’s natural ability to fight cancer. The most success so far has been against the skin cancer melanoma and certain kinds of leukemia.
The second woman to have a complete response has been cancer-free for 15 months so far, said a study leader, Dr. Christian Hinrichs of the Cancer Institute.
“There’s no way to know,” though, whether the results will be permanent, Hinrichs said.
A third woman had tumor shrinkage that lasted only three months. The other six women did not respond to treatment and researchers are trying to determine why.
The cervical cancer treatment in the institute’s pilot study involved sampling a woman’s tumor, isolating special immune system cells that were attacking it, multiplying them in the lab and giving them back to the patient in a one-time infusion.
Doctors are trying the treatment on several dozen more women with advanced cervical cancer. And it could someday be offered at many cancer centers the way bone marrow and stem cell transplants are now.
Researchers also are testing the treatment against throat, anal and other cancers caused by HPV but do not have results yet.
Many private companies are pursuing other treatments that are given like drugs aimed at the immune system.
Also discussed at the American Society of Clinical Oncology conference:
◆ Bristol-Myers Squibb Co.’s Yervoy, the first immune therapy to improve survival of advanced, inoperable melanoma, also helped prevent recurrence when given to people with earlier stage disease at regular intervals after surgery, a study of nearly 1,000 patients found. But severe side effects caused half to quit treatment, and five people died from it. Doctors think a lower dose might minimize these problems. The drug also costs more than $100,000 for initial treatment, so long-term cost is a concern.
◆ Nivolumab, an experimental therapy from Bristol-Myers, extended survival by 3 1/2 years on average when given with Yervoy to people with very advanced melanoma, far better than any previous treatments. Nine of 53 patients treated had complete remissions.
◆ Merck & Co.’s experimental therapy pembrolizumab gave one-year survival rates of about 69 percent in a study of 411 patients with very advanced melanoma, including many previously treated with Yervoy.
◆ Genentech’s experimental immune therapy for bladder cancer shrank tumors in 13 of 30 patients with advanced bladder cancer for which there are hardly any treatment options now. All signs of cancer disappeared in two patients.
Immune therapy struggled for years with just occasional small gains, but “now we have cruise missiles” giving better kill rates against many tumor types, said Dr. Steven O’Day of the University of Southern California.
Others tempered their enthusiasm, noting that some promising approaches produced more limited gains once they were more fully researched.
“Let’s not forget the history” of what seems like progress with a new approach, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. “It doesn’t always work out the way it appears to be heading.”
National Cancer Institute: http://tinyurl.com/o5p6ahb