Recently, two friends with advanced cancer have needed further treatment, because their first-line treatment with Interleukin-2 was no longer stopping the growth of cancer. I am following their progress intently because I could suddenly be in a similar situation following any of my future six-month “routine scans.”
Patients with melanoma or renal cell cancer are fortunate in that new treatments have become available in the past few years, treatments that are often helpful and sometimes curative. All of the new treatments are based on stimulating the body’s natural immune system to find and attack cancer cells. Immune treatments are unlike older treatments using radiation or chemotherapy, which poison all body cells, including cancer cells.
Ipilumumab (Yervoy), Pembroluzimab (Keytruda), and Nivolumab (Opdivo) are examples of recently approved immune-stimulating compounds that often help advanced melanoma and renal cell cancer patients. These compounds are usually administered intravenously at an infusion center, alone or in combination, at two- or three-week intervals.
The body’s immune system is a powerful force in maintaining health. It can also be a dangerous, deadly force when unleashed. The long list of potential serious side effects extends even to organ damage, which can develop rapidly — leading to a serious health emergency. A recent article in the New York Times discusses how health care professionals can be caught off guard when serious side effects develop. Another article reveals that sometimes immune therapy can damage the heart.
Not long ago, a dear friend from my years at Oregon State University was given pembro as part of a research trial for her cancer. After her first couple doses, she suddenly lapsed into a diabetic coma. Under the care of her cancer team, it was found that her immune system had attacked and destroyed her pancreas. She was suddenly and profoundly a type 1 diabetic. Pembro was withdrawn to avoid further organ damage; sadly, her cancer progressed and she died a few months later.
Despite the danger, if I need further treatment with newer immune-boosting drugs, I will proceed. I will stay close to the most experienced immune treatment team available and move forward with caution, hoping to be among those who are helped.