Using the body's own immune system to destroy cancer has been the holy
grail for cancer researchers for decades. At the St. Jude Crosson Cancer
Institute, the promise of immunotherapies and targeted therapies—designed
to help the immune system recognize and kill cancer cells—has moved
from the lab to the bedside, with often remarkable outcomes.
Just ask Don Kwart.
In 2013, a colonoscopy revealed the 64-year-old had Stage II colon cancer,
and surgery to remove the diseased colon tissue was followed by six months
of chemotherapy. While imaging and blood work showed the treatment was
successful, several months later, the aggressive cancer had returned and
metastasized. More chemotherapy over the next year at first slowed the
cancer’s growth—and then simply stopped working.
In the past, the failure of surgery and chemotherapy would signal the end
of available treatment options. But after genetically profiling Don’s
cancer, David Park, MD, Medical Director of Oncology Services and a board-certified
oncologist with St. Jude Heritage Medical Group, offered a new strategy:
an experimental immunotherapy, called Keytruda.
Keytruda targets activity within a cancer cell, activity which permits
the cancer to protect itself from an immune system response. By “uncloaking”
the cancer cells, Keytruda allows the immune system’s T-cells to
complete their search-and-destroy mission. The FDA had approved it for
melanoma and lung cancer at that time, but not for colon cancer. However,
Dr. Park believed the early data looked promising for cancers with the
same genetic markers as Don’s.
He arranged “compassionate access” with the pharmaceutical
company, allowing Don to immediately begin receiving the investigational
therapy. Don responded to the immunotherapy almost immediately. “For
me, it’s been a miracle drug,” says the father of five and
grandfather of two. “I feel better than I have in years. I should
be the ‘poster child’ for Keytruda.”
Once chemotherapy stops working, life expectancy is typically six to eight
months. For Don, that milestone was over two years ago. And if you want
to talk to him about it, you’ll need to catch him between baseball
games: Don’s son is one of the high school team’s starting
pitchers and Don never misses an inning.
Over a year after Don began therapy, the FDA approved the use of Keytruda
for any tumor with the genetic feature of deficient
mismatch repair (a marker in Don’s cancer)—a first in the history
of cancer therapy.
“Treating tumors based on their genetic or molecular characteristics—instead
of where they are located—is a paradigm change,” explains
Dr. Park, who says the number of immunotherapies and targeted therapies
doubled last year with many more in the pipeline. “By finding the
Achilles’ heel of a tumor, we can maximize the likelihood of success
while avoiding therapies that are unlikely to work.”
At the Crosson Cancer Institute, state-of-the-art molecular profiling of
tumors is now routine for patients with colon, breast, lung, melanoma,
head and neck, pancreas and other cancers—as well as for patients
who have experienced a recurrence.
“Immunotherapies and targeted therapies are moving us much closer
to a cure,” says Dr. Park, explaining that clinical trials involving
immunotherapies alone, or combined with other treatments, are underway
at St. Jude for nearly a dozen different cancers. As the hospital’s
board-certified oncologists aggressively pursue new breakthroughs, St.
Jude has participated in several national research trials.
The Crosson Cancer Institute is a member of Precision Oncology Alliance,
working with other nationally-recognized cancer centers to advance tumor
profiling and research to better diagnose, treat and bring personalized
precision medicine to all cancer patients.
For more information, please contact the St. Jude Crosson Cancer Institute
at (714) 446-5847.