This is the Future: Immuno-Oncology is Redefining Cancer Treatment

On June 15, we hosted a “White Out Cancer” event on AstraZeneca’s Gaithersburg, MD, campus encouraging our employees to join the cancer community and #WearWhite to raise awareness of immunotherapy, also called Immuno-Oncology (IO). This marked the fourth year we’ve hosted an onsite event to support Cancer Immunotherapy Month.
 

Employees coming together to show support  

Jane Chung, Franchise Head, Immuno-Oncology, sharing AstraZeneca’s dedication to advancing IO research

Employees sharing why they #WearWhite  

In further collaboration with the Cancer Research Institute (CRI), we asked Jill O’Donnell-Tormey, PhD, CEO and Director of Scientific Affairs at CRI, to share her expert knowledge about immuno-oncology (IO). As CEO of the first organization to devote itself to what is today considered the most promising advance in cancer treatment, Dr. O’Donnell-Tormey offers a unique perspective informed by three decades of experience funding and interacting with CRI’s global network of research and clinical experts. 

What is IO and how does it work?

Dr. O’Donnell-Tormey: IO is a different approach to cancer treatment that works by augmenting the immune system’s natural ability to see and eliminate cancer cells much in the same way it protects us against infection from viruses and bacteria. As a living, dynamic system, the immune system is able to detect cancer anywhere in the body, which is especially important in treating patients with cancers that have spread or metastasized to other organs.

Recent clinical successes have resulted in Food and Drug Administration (FDA) approval of IO therapies, both alone and in combination with other treatments, for nearly 20 types of cancer, including advanced solid tumor and blood cancers as well as cancers with a specific genetic defect resulting in a high frequency of mutation, regardless of tissue type. In bladder cancer, melanoma, and certain types of lung cancer, IO therapies have received FDA approval as first-line treatment, replacing or, in the case of combination approvals, improving conventional treatments like chemotherapy. IO therapies are also FDA-approved to treat some patients for whom prior treatments were ineffective, and clinical trials are ongoing to test the benefits of IO agents in many other types of cancer.

We used to think of cancer as a death sentence—but thanks to modern medicine, we may be rethinking things. IO has played an important role in redefining the way we think about cancer treatment.

How is IO different from other cancer treatments, and what should I expect if I take an IO?

Dr. O’Donnell-Tormey: Immunotherapy is very different from other cancer treatments in terms of mechanisms of action, response time, the potential for durable response, and side effects. IO therapy works with the immune system itself, unlike chemotherapy, which directly kills all rapidly dividing cells, including cancer and certain normal cells; or radiation, which targets and directly kills cancer cells and sometimes surrounding healthy cells; or small molecules that interfere with specific mechanisms required for cancer cells to grow. Immunotherapy has the potential to provide lasting protection against cancer after treatment (as the immune system has “memory”), lowering the risk of recurrence.

Generally, side effects from IO therapies are different than those seen with chemotherapies and don't result in hair loss. Side effects with most IO therapies can range from rashes and fever to severe flu-like symptoms, inflammation of the lungs (pneumonitis), auto-immunity (where the immune system begins to attack normal cells), diarrhea, damage to nerve cells, and other immune-related adverse events (irAEs), some of which could become serious or life-threatening. If caught early, many of these irAEs can be treated with administration of steroids or other treatments without diminishing the anti-tumor effect. Depending on the severity of the side effects, treatment may need to be temporarily paused or permanently discontinued. It is important that patients inform their doctors immediately of any symptoms while receiving treatment.

Are all IO therapies the same? What should I consider when researching the right treatment for me?

Dr. O’Donnell-Tormey: No, they are not all the same. There are diverse IO drugs that target various steps in the anti-tumor immune response, including activation, elimination, and suppression. There are also different classes of IO with different mechanisms of action, including checkpoint blockade, cell therapy, monoclonal antibodies, vaccines, and immunomodulators like cytokines, pattern recognition receptors, and others. Different IO therapies have been shown to work more effectively than others in certain cancers or subsets of cancers. For example, a certain type of CAR-T cell therapy has achieved an 83 percent response rate in B-cell acute lymphoblastic leukemia (a type of blood cancer) and a 50 percent response in diffuse large B cell lymphoma, but is not yet effective in treating solid tumors that arise in the lung, bladder, kidney, colon, brain, and other organs.

Another consideration is whether patients should receive one drug or a combination of drugs and/or conventional therapy, a strategy that has proven more effective in some cancers, including non-small cell lung cancer and melanoma. Scientists believe the key to determining which patients are likely to respond to treatment, or which treatments are more likely to work than others, is to consider the patient’s unique situation – their environment, lifestyle, and treatment history – as well as the genetic makeup and gene expression of the patient’s tumor.

When should I talk to my doctor about IO treatment?

Dr. O’Donnell-Tormey: This field is moving rapidly, and IO treatments are being approved in different types of cancer more and more frequently. With the science moving so quickly, it’s important to ask your doctor about IO options when you are first diagnosed and begin to consider your treatment plan. An IO drug might already be approved for your type and stage of cancer, including as first-line standard of care or for second- and third-line therapy or later. IO therapy might also be available to you via a clinical trial, though most (but not all) trials require that you first have received prior therapy or an established standard of care. Some trials allow you to receive IO therapy while simultaneously receiving a standard of care treatment. The important thing to remember is that IO therapies are beginning to be approved for treatment at earlier points in a patient’s cancer journey. So patients should bring up IO options with their doctors as early as possible if their doctor doesn’t mention it first.

For more information about IO, visit Cancer Research Institute.

 

US-20900 Last Updated 6/18