Dr. Wilson Mertens, vice president and medical director of Cancer Services at the Baystate Regional Cancer Program, appeared on last night's Medical Rounds - a collaboration between Baystate Health and Western Mass News. The weekly Medical Rounds is broadcast in the 5:30 p.m. portion of the Tuesday night news and focuses on family health and wellness and breakthrough technology. Each session is followed by an interactive live chat. Last night's session focused on immunotherapy and the state of cancer care in America.
Q: Some doctors are calling immunotherapy “the biggest breakthrough in the treatment of cancer seen in their careers.” What exactly is immunotherapy?
A: When we talk about personalized oncology care today (immunotherapy), it's all about trying to specifically target cancer cells based on some of their molecular characteristics, rather than just a general classification of those cancer cells. I’d say that the biggest breakthrough in the past 30 years really is manufactured antibodies that can either attach themselves to the outside of the cancer cells and shut them off or manipulate their growth, or alter the immune system. There have been a number of these antibodies created and they have made a tremendous difference both in terms of cure rate and cancer control.
Q: Can immunotherapy be used as a treatment for every patient with cancer?
A: It depends on the cancer and on the person. Some of these antibodies have a fair amount of side effects and don’t work in some cancers. But, it’s amazing that the new drugs which really are designed to take the breaks off the immune system, so that the immune system can recognize the presence of cancer cells, can be used against a broad range of cancers. For example, two new antibodies released within the past 18 months have efficacy in terms of melanoma, a major skin cancer, as well as with kidney cancer and lung cancer, with long term disease control even when the cancer has spread.
Q: We hear a lot today about personalized medicine. Is this what they mean about immunotherapy, although the term has been used much longer than the actual breakthrough of immunotherapy? Correct?
A: That’s right. Immunotherapy goes back 130 years when patients were anecdotally found to have control over their cancer after a bacterial infection. We have a number of drugs that are important in the control of cancer, such as interleukin 2 and other agents that are in common use. The new immunotherapy, however, is very different with often relatively little side effects and sustained responses. So, I really think we are in a new era of using the immune system to control cancer.
Q: Are these treatments expensive? And, where are the big costs found in cancer treatment today?
A: It seems as if every new cancer drug on the market costs roughly the same price....around $8,000 to $13,000 a month for treatment. Obviously, this is covered by insurance, but the fact that cancer care costs are skyrocketing is affecting insurance premiums. And, for those Americans who have high deductible plans, this is going to have significant financial impact. I believe the cost of cancer care is going to be one of the major side effects of cancer care in the next few years.