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The Basics of Cancer Immunotherapy
This book provides patients and their physicians (especially “non-oncologist” health care providers) with a clear and concise introduction to cancer immunotherapy, which, unlike traditional forms of cancer therapy, acts by boosting the patient’s own immune system to fight cancer. The unique features of cancer immunotherapy make its management, monitoring and side-effects different from those of traditional cancer therapy. Especially novel are the side effects of cancer immunotherapy, necessitating greater awareness for both patients and physicians in order to minimize complications of therapy. The patient-friendly, concise, easy-to-understand, and up-to-date knowledge presented in this book will inform patients about the benefits and risks of cancer immunotherapy, and help them and their care providers to understand how immunotherapy would control their unique disease. Researchers and academic professionals in the field of cancer immunotherapy will also find clear and useful information to help them communicate with patients or address unresolved problems. Some key features of the book
Expertise. All editors and authors are scientists and oncologists specializing in cancer immunotherapy, and are involved in scientific discovery from the early stage of immune-checkpoint inhibitors to today’s daily patient care. Their insights, expertise and experience guarantee the high quality and authority in the science, medicine and practice of cancer immunotherapy.
Patient-friendly. This book is written for cancer patients in order to meet their needs when considering immunotherapy. As an educational tool, this book will help the reader balance the risks and benefits based on both science and clinical facts, and therefore to make the best choice in receiving or withdrawing from immunotherapy.
Disease Specificity. Cancer is a complicated disease involving multiple stages and pathology. Its response to immunotherapy is individualized and varies depending on cancer types. The authors’ expertise in treating different types of cancers, including melanoma, lung, kidney, bladder, and lymphoma, provides disease-specific insights in applying immunotherapy to each disease.
Expertise. All editors and authors are scientists and oncologists specializing in cancer immunotherapy, and are involved in scientific discovery from the early stage of immune-checkpoint inhibitors to today’s daily patient care. Their insights, expertise and experience guarantee the high quality and authority in the science, medicine and practice of cancer immunotherapy.
Patient-friendly. This book is written for cancer patients in order to meet their needs when considering immunotherapy. As an educational tool, this book will help the reader balance the risks and benefits based on both science and clinical facts, and therefore to make the best choice in receiving or withdrawing from immunotherapy.
Disease Specificity. Cancer is a complicated disease involving multiple stages and pathology. Its response to immunotherapy is individualized and varies depending on cancer types. The authors’ expertise in treating different types of cancers, including melanoma, lung, kidney, bladder, and lymphoma, provides disease-specific insights in applying immunotherapy to each disease.
170 pages, Paperback
Published January 12, 2018
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Displaying 1 - 3 of 3 reviews
October 31, 2023
Amazing!
December 21, 2019
I admit that I have been somewhat skeptical of immunotherapy from the start. How can a healthy cell be considered a therapeutic target? Everyone, including the authors of this book, have been touting it as nothing short of a miracle. Here is a snippet: "These next-generation immunotherapy drugs are re-shaping the way we think about and treat cancer, and herald the coming of a new era in the history of oncology." (p.104)
I think the best counter to this argument can be found in the book itself. In the absolute best case scenario (in melanoma with a high somatic mutation rate), Ipilimumab (anti-CTLA4) improves recurrence-free survival from 17.1 months to 26.1 months. That is less than 10 months... Of the patients allocated to ipilimumab, 52% discontinued therapy due to adverse effects (p.45).
Nivolumab (anti-PD1) in lung cancer improves median survival from 9.2 months to 14.9 months (p.61)... Another study found it improved it to 9.7 months from 5.8 compared to chemotherapy... Pembrolizumab (anti-PD1) in NSCLC improved median progression-free survival from 6.0 months to 10.3 months (p.65). Tumor vaccines like T-VEC also seem like a dud: melanoma median survival with T-VEC was 23.3 versus 18.9 receiving GM-CSF (p.50). There are also many references to an improvement in "response rate", or other nebulous end-points.
Keep in mind immunotherapies are shown to work the best in melanoma and lung cancer, the rest of the book details uses in other types of malignancies which show even worse numbers. There was a chapter for "Other Malignancies", which showed responses like esophageal cancer: median overall survival of 5.3 months with nivolumab vs 4.14 months with placebo (p.129). Does this sound revolutionary to you?
I think the only exception was non-hodgkins lymphoma, where CAR-T showed 54% complete remission (p.107). But, keep in mind that lymphoma is already curable in many cases with the chemotherapy we have today.
The impression I get is that the larger, easy to pick fruits have been picked: anti-PDL, anti-PD, anti-CTLA, and maybe CAR-T therapy. There are many trials currently underway, but the vast majority of them focus on combination therapies. It seems like the field has reached somewhat of a cul-de-sac. I feel bad for everyone who invested their careers in this... Sure, it may offer hope to patients, and I understand their pain. I think it is a cruel and false hope, though, a very thin line between this type of hyping and a scam in my opinion...
I would welcome the author's thoughts on this, or anyone else who is knowledgeable about the subject. Am I being too harsh?
I think the best counter to this argument can be found in the book itself. In the absolute best case scenario (in melanoma with a high somatic mutation rate), Ipilimumab (anti-CTLA4) improves recurrence-free survival from 17.1 months to 26.1 months. That is less than 10 months... Of the patients allocated to ipilimumab, 52% discontinued therapy due to adverse effects (p.45).
Nivolumab (anti-PD1) in lung cancer improves median survival from 9.2 months to 14.9 months (p.61)... Another study found it improved it to 9.7 months from 5.8 compared to chemotherapy... Pembrolizumab (anti-PD1) in NSCLC improved median progression-free survival from 6.0 months to 10.3 months (p.65). Tumor vaccines like T-VEC also seem like a dud: melanoma median survival with T-VEC was 23.3 versus 18.9 receiving GM-CSF (p.50). There are also many references to an improvement in "response rate", or other nebulous end-points.
Keep in mind immunotherapies are shown to work the best in melanoma and lung cancer, the rest of the book details uses in other types of malignancies which show even worse numbers. There was a chapter for "Other Malignancies", which showed responses like esophageal cancer: median overall survival of 5.3 months with nivolumab vs 4.14 months with placebo (p.129). Does this sound revolutionary to you?
I think the only exception was non-hodgkins lymphoma, where CAR-T showed 54% complete remission (p.107). But, keep in mind that lymphoma is already curable in many cases with the chemotherapy we have today.
The impression I get is that the larger, easy to pick fruits have been picked: anti-PDL, anti-PD, anti-CTLA, and maybe CAR-T therapy. There are many trials currently underway, but the vast majority of them focus on combination therapies. It seems like the field has reached somewhat of a cul-de-sac. I feel bad for everyone who invested their careers in this... Sure, it may offer hope to patients, and I understand their pain. I think it is a cruel and false hope, though, a very thin line between this type of hyping and a scam in my opinion...
I would welcome the author's thoughts on this, or anyone else who is knowledgeable about the subject. Am I being too harsh?
July 16, 2020
I found this a good introduction to cancer immunotherapy principles and therapeutics, circa 2018. The authors were realistic about the fact that current immunotherapeutics are only addressing one component in the tumor microenvironment (at most two), and hint at our still overwhelming ignorance of that complex battlefield of pro- and anti-tumor factors. Their elucidation of the side effects unique to immunotherapy should prove helpful to clinicians and patients alike.
The authors are very clear about the fact that cancer is an illness which admits of a great deal of heterogeneity. Perhaps no therapy has better responded to this nature than CAR-T, to which they provide an excellent introduction.
I think someday we will look back on this period in oncology research as the time when we began to tip the balance in the patient’s favor through the mastery of the multiplicity of factors which make up the tumor microenvironment. The ground is ripe for ongoing original research and copious bioengineering work, to make biomarkers available to clinicians, to scale up immunotherapies, to refine algorithms for therapies like CAR-T, and to model our ever-clarifying understanding of the tumor-microenvironment.
My only complaint is that, as neither a clinician nor a researcher, I found the insertion of clinical trial data difficult to follow, in the midst of an otherwise very readable text. This data would benefit from organization into a database searchable by both therapy and cancer type.
The authors are very clear about the fact that cancer is an illness which admits of a great deal of heterogeneity. Perhaps no therapy has better responded to this nature than CAR-T, to which they provide an excellent introduction.
I think someday we will look back on this period in oncology research as the time when we began to tip the balance in the patient’s favor through the mastery of the multiplicity of factors which make up the tumor microenvironment. The ground is ripe for ongoing original research and copious bioengineering work, to make biomarkers available to clinicians, to scale up immunotherapies, to refine algorithms for therapies like CAR-T, and to model our ever-clarifying understanding of the tumor-microenvironment.
My only complaint is that, as neither a clinician nor a researcher, I found the insertion of clinical trial data difficult to follow, in the midst of an otherwise very readable text. This data would benefit from organization into a database searchable by both therapy and cancer type.
Displaying 1 - 3 of 3 reviews