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Immunotherapy and AI: Advancing Our View of Cancer Treatment

   

Most allergy sufferers know that receiving a series of allergy shots can prevent sniffling, sneezing, and red eyes. But not everyone is aware of how it actually works. The shots contain a very small amount of the allergen, the thing that is causing the problem. While the allergen introduced into the system isn’t enough to cause sickness, it does set off an alarm telling the body’s immune system it’s time to get to work. Over time, the doses get larger and eventually help the body develop a tolerance to the allergen. In other words, the body becomes immune to the invader.

This concept is a form of immunotherapy - a type of treatment now being adopted to battle many other diseases. Cancer researchers and clinicians in particular are beginning to deploy these treatments to leverage the natural defense powers of the body to fight back against cancer cells.  

 

What is immunotherapy?

Immunotherapy is a course of treatment that uses substances that occur naturally in the body to enhance the effectiveness of the immune system - a network of organs and cells in the body that provides a defense against disease. These treatments seek out abnormal cells, like viruses, allergies, and cancer cells, and attempt to destroy them.

The process involves providing patients with substances called biological response modifiers (BRMs). The body normally produces these substances, but the introduction of additional BRMs boosts the body’s natural ability to fight diseases.

There are both active and passive forms of immunotherapy. In the active form, BRMs stimulate the body’s natural immune system responses to work harder and more efficiently. In passive immunotherapy, BRMs provide man-made proteins to supplement a patient’s immune system and help it work more effectively.

With many of the most common cancer treatments, patients often experience intense side effects like hair loss, pain, loss of appetite, and exhaustion among many others. There’s hope that immunotherapy can be an effective alternative or supplement to traditional treatments and help mitigate these often-debilitating side effects by using the patient’s own biology to fight the disease.

 

The impact of immunotherapy in cancer

The disease starts when cells mutate and begin to grow out of control. The immune system doesn’t always recognize the change in these cells as foreign to the body. Even when it does recognize a problem, the response of the immune system may not be strong enough to destroy the now cancerous cells. This limits the body’s ability to fight cancer, as seen in many people with healthy immune systems who still suffer from the disease.

Immunotherapies for cancer are more often referred to as immuno-oncology treatments and there are four main categories¹.

  • Monoclonal antibodies: Man-made proteins are introduced into the patient’s body which can be effective since they can be designed to attack specific parts of the cancer cell.
  • Immune checkpoint inhibitors: Checkpoints in the immune system prevent it from killing healthy cells. Cancer cells can take advantage of this by disguising themselves as healthy. Immune checkpoint inhibitors “take the brakes off” the immune system helping it to recognize and attack cancer cells.
  • Cancer vaccines: These BRMs are introduced to start an immune response against certain types of cancer.
  • Non-specific immunotherapies: These are general booster treatments for the immune system helping it perform more effectively against cancer.

Oncologists continue to look for ways to combine immunotherapy with more traditional treatments for cancer, like chemotherapy, radiation and surgery. Combination therapies have long interested researchers since one form of treatment is often not enough to battle complex diseases like cancer.

To fully understand and realize the benefits of combination therapy, we have to be able to answer this important question: Why do certain treatments work for one patient but not for another? While it is generally accepted that combination treatments can be the most effective way to certain types of cancer, the challenge lies in selecting the most promising combination for each specific patient.

 

Deciphering Combination Therapies with AI

This is where artificial intelligence can make a significant impact. AI provides us the opportunity to drive and deliver precision medicine- care that is targeted based on an individual biology - by uncovering which combination therapies work for which patients.

But in order to optimize a treatment strategy, it is essential to understand why a patient is responding to a certain treatment, or how he or she is likely to respond based on genetics. Ignoring the biology results in a trial and error approach of single and combination therapies and wastes precious time, time patients don’t have.  

Answering these why and how types of questions allows us to move beyond general population trends to understand the biology of the patient, the treatment, and how various interventions may change health outcomes.  No patient is average, especially when considering the millions of mutations that are possible with cancer. The complexity of disease and biological systems requires sophisticated technology that continues to grow smarter, to decipher the underlying cause and effect relationships in way that positively impact patient lives.

Cancer treatment has come a long way and the promise of adding immunotherapy to the arsenal is exciting. And yet, there is still so much that we still don't know about how cancers evolve and progress. We now have the technology to cull through vast amounts of data to discover the drivers behind diseases and the precise care needed based on an individual's biology. The time has come to start using these novel therapies and powerful tools collaboratively to win the fight against cancer once and for all. 

 

[1] Types of cancer immunotherapy, American Cancer Society web site

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