Immunotherapy

Denise Grady reports in the New York Times,

A new study offers a glint of hope to people in a desperate situation: Patients with melanoma, the most serious form of skin cancer, that has spread to the brain.

A combination of two drugs that activate the immune system shrank brain tumors in many melanoma patients and prolonged life in a study of 94 people at 28 medical centers in the United States. The drugs were ipilimumab (brand name Yervoy) and nivolumab (Opdivo), and they belong to a class called checkpoint inhibitors.

...The results do not apply to people with tumors that originate in the brain, like glioblastoma, the type of brain cancer that Senator John McCain is being treated for. So far, the kind of immunotherapy used in the study has not worked for such tumors, Dr. Tawbi said, but studies of drug combinations are underway to try to help those patients.

The study and an editorial about it were published on Wednesday in The New England Journal of Medicine.

...Immunotherapy caused excitement in 2015 when former President Jimmy Carter said he had received it after melanoma had spread to his liver and brain. He underwent radiation treatment as well.

His most recent scan, in June, showed no cancer, his press secretary, Deanna Congileo, said in an email. Mr. Carter received pembrolizumab (brand name Keytruda), a checkpoint inhibitor that was not used in the new study.

...The drugs have side effects that can be serious and even life-threatening. A little more than half of the patients in the study had significant side effects, and 20 percent quit treatment because of them.

Some suffered from headaches, two had brain swelling, and one died from heart inflammation thought to be caused by the treatment.

...But checkpoint inhibitors work by enabling T-cells — a type of white blood cell — to attack cancer. And T-cells do get into the brain.

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