Immune checkpoint inhibitors, like Opdivo and Keytruda, are drugs that unleash the body’s own immune system against cancer. In fact, a poll of top medical oncologists showed that 37 of 50 cancer specialists cited these drugs as “game changers.” “Immune checkpoint inhibitors were found to be useful in such immune sensitive malignancies as melanoma, renal cell carcinoma and Hodgkin’s disease,” said my former professor Dr. Robert Mayer of the Dana-Farber Cancer Institute in Boston. “It has now shown major promise in more difficult cancers, such as squamous cell carcinoma or adenocarcinoma of the lung, and even a subset of colon cancer, gastric cancer, and esophageal cancer.” Each and every month it seems that more cancers are added to the list-like metastatic breast cancer and multiple myeloma.
2. TWO THIRDS OF ALL CANCERS MAY JUST BE DUE TO “BAD LUCK”
Dr. Bert Vogelstein, an internationally recognized medical geneticist from Johns Hopkins, analyzed the mutation rate of stem cells in 31 different tissues. Dr. Vogelstein and colleagues concluded that two thirds of all cancers were the result of random mutations-with the environment and lifestyle playing a much smaller role than previously thought. Dr. Vogelstein went on to conclude that much more effort needs to be placed on screening and detection-catching cancer early. But his “controversial study” remained at odds with the Federal government’s efforts to limit screening for major cancers like breast cancer and prostate cancer.
3. EMERGING ROLE OF STEREOTACTIC RADIOSURGERY IN LUNG CANCER
Stereotactic radiosurgery, like that delivered by Cyber Knife, was shown to be equivalent to open surgery for all lung cancer patients with early stage cancer. Previous studies showed that Cyber Knife was the best way to treat patients who were considered “medically inoperable.” That is to say, medically inoperable patients were unable to undergo surgery because of their multiple medical problems, like COPD or heart disease. But in 2015, a number of studies have shown equivalent results with stereotactic radiosurgery compared to lobectomy, a major surgery. In fact, stereotactic radiosurgery was even better than wedge resection. The exciting possibility in the coming year is combining stereotactic radiosurgery with immune checkpoint inhibitors, not only for lung cancer patients, but for patients with other cancers.
As 2015 is coming to an end, I wish my staff, my colleagues, and most of all my patients a Happy New Year. There is now real hope for cancer patients 2016.