'Cancer Moonshot' Panel: Focus on Immune Therapies

Cancer research should focus on getting more tailored data from individual patients — and provide that information to them and their doctors in a useful way, experts said Wednesday. And because a new approach called immunotherapy seems to work so spectacularly for some patients, researchers and doctors should create networks to focus on that approach, a panel of cancer experts working on the Obama administration's "cancer moonshot" initiative said in a new report. I
mmunotherapies include techniques that manipulate the body's own immune defenses against tumor cells, including direct changes to patient's individual cells, drugs that boost immune activity and engineered antibodies trained to recognize particular tumors.

They include the new class of drugs that appear to have made former President Jimmy Carter's melanoma disappear, such as Keytruda and Opdivo, which block the mechanisms that tumors use to hide from immune cells. "Immunotherapy is important. We need to understand it better," said Dr. Douglas Lowy, acting director of the National Cancer Institute. "It is an extremely exciting area of medicine and science today but even now it only benefits a subset of patients," added Tyler Jacks, director of the Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology and a panel co-chair. "We must learn why some patients who have melanoma (such as President Carter) or lung cancer respond to checkpoint blockade immunotherapy, whereas patients with many other types of adult cancers, including ovarian, breast, pancreatic, brain, and prostate cancer—as well as most pediatric cancers—have brief responses or do not respond at all," the report reads.

"Current immunotherapy treatments represent only the tip of the iceberg of what is possible," it adds. The report repeats much of what's already been said about the "Cancer Moonshot," spearheaded by Vice President Joe Biden and vulnerable to the funding decisions of a deadlocked and partisan Congress. It focuses on 10 areas that might help the program achieve its goal of making 10 years worth of progress in half that time. There's also a new approach to the old-fashioned bone marrow stem cell transplant. Called chimeric antigen receptor T-cell, or CAR-T, these treatments use a patient's own immune system T-cells, engineered to better recognize cancer cells.

But they require destruction of the patient's existing immune system and that can kill the patient before it cures. One of the main changes proposed by the panel would be to offer tailored tumor profiling to more cancer patients. Right now, patients usually need to be treated at a big cancer center and take part in a major clinical trial to get an individual genetic sequence done. The panel's report proposes offering this service to cancer patients everywhere. "Many patients are eager to provide their data, and gathering this information in a linked network of databases would enable more precise knowledge about what works, in whom, and in which types of cancer," the report reads. And this data could help researchers with a third goal -- creating a big, 3-D atlas of cancer.

It ideally would show how cancer starts in the first place and the mechanisms by which it grows and spreads. Cancer is the No. 2 killer in the U.S. It has replaced heart disease as the No. 1 cause of death in 21 states and it will kill nearly 600,000 people this year, the American Cancer Society says. About 1.68 million Americans will be diagnosed with some form of cancer this year. President Barack Obama launched the "moonshot" initiative in February, asking for close to $1 billion in extra spending over the next two years.