Nobel Prize in Medicine

In case you hadn't heard, the Nobel Prize in Medicine was awarded yesterday. It went to the two cancer researchers who more or less invented Immunotherapy.

The Nobel Prizes are some of the most prestigious in the world. Every year, a committee gives the award for Medicine to one or more researchers who have made discoveries that have changed lives.

This year, there were two winners. they each did work in Immunotherapy. They worked separately, but made similar discoveries on ways that the immune system can be used to kill cancer cells.

Cancer cells are tricky. Our immune system's job is to find invaders (like bacteria and viruses) and kill them, and then remember what they were so they can find them again. But cancer cells aren't really "invaders" -- they don't come from outside our bodies. Instead,they are parts of our bodies -- our own cells -- that have turned off that switch that tells them when to die.

Immunotherapy is an approach to cancer treatment that finds way to get the immune system to treat cancer cells like they were outside invaders.

The first winner, Dr. James Allison (of the MD Anderson Cancer Center) helped to discover a protein called CTLA-4 (or CD152) that stops a type of immune cell called T cells from doing their job. He developed an antibody that worked against CTLA-4. In other words, it blocked the protein that blocked the immune cells.

Eventually, the connection was made between CTLA-4 and cancer. A treatment called Ipilimumab was approved to treat melanoma about 7 years ago. (Notice that "mab" on the end of the name. It's a monoclonal antibody, like Rituxan, or rituximab.)

The second winner is Dr. Tasuku Honjo Kyoto University in Japan. He discovered PD-1, a protein on T cells. "PD" stands for "Programmed Cell Death." All cells die a natural death, and PD-1 plays a role in that (the cells are programmed to die). But it can also keep cells from dying, which is where cancer comes in -- cells don't die and grow uncontrollably.

Like the CTLA-4, treatments were developed that stopped PD-1 from stopping the immune system. Some of the treatments that work as anti-PD-1 are Nivolumab (also known as Opdivo) and Pembrolizumab (also known as Keytruda). Each of them work on a bunch of different types of cancer.

Here's your Follicular Lymphoma connection: Keytruda has been approved as a treatment for Hodgkin's Lymphoma, and there are trials for using it in combinations with other treatments for FL. Opdivo is also being tested in FL patients, in combinations. Early results look promising. The same is true for Ipilimumab (though the results may not be as promising).

None of that research has produced anything that will be available to patients anytime soon, but if you need treatments [not that I'm hoping you do], it's another thing to ask your doctor about, to see if any clinical trials would make sense for your situation.

Immunotherapy is one of those things that gets oncologists and researchers very excited.  At the end of 2013, the journal Science called Immunotherapy the cancer breakthrough of the year. If you want to learn more about Immunotherapy, I suggest you start here.

So just like a sports fan who refers to his favorite team as "us," I feel a little bit of pride in knowing that a couple of "us" won the Nobel Prize. Gives me even more hope for the future.