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Cancer: the saga of immunotherapy

Two immunologists, Eric Vivier and Marc Daëron, explain how the arrival of spectacularly effective molecules disrupts oncology.

Posted today at 07:00 Time to Reading 2 min.

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Illustration of the CAR-T cell membrane receptor, a T lymphocyte produced from the patient's cells and genetically modified to recognize tumor cells and destroy them.
Illustration of the CAR-T cell membrane receptor, a T lymphocyte produced from the patient's cells and genetically modified to recognize tumor cells and destroy them. JACOPIN / BSIP

The book. Anti-PD-1 monoclonal antibodies, CAR-T cells … In recent years, the public and the main stakeholders, cancer patients, have been learning to familiarize themselves with a new class of antitumor treatments, immunotherapies. The latest Nobel Prize in Medicine was awarded to two pioneers in the field: the American James Allison and the Japanese Tasuku Honjo. Their work led to the development of drugs, known as immune checkpoint inhibitors, which changed the fate of patients previously considered incurable.

Patients and families are not the only ones whose existence has been disrupted by the arrival of these drugs acting in one way or another on the immune system. It's also about "The day-to-day life of caregivers, the work axes of researchers and the orientations of the pharmaceutical industry", emphasize the immunologists Eric Vivier and Marc Daëron in Immunotherapy of cancers. History of a medical revolution.

Awesome effects

Beautiful and ambitious idea to devote a whole book on this subject abounding but complex. Step by step, the two researchers tell the story of the anti-cancer immunotherapy saga, which began at the end of the 19th century.e century and caused many disappointments before the spectacular results achieved in recent years.

Despite a set of schemas, the most fundamental part of the book (which describes the different immune cells, their receptors, cooperation between systems …) may seem a bit arid to many readers. Do not hesitate to skip pages. It would be a shame to stall before the story of the most recent discoveries and the last section, which addresses the medical and societal issues of these treatments.

The figures advanced by the authors make you dizzy. "In 2018, more than 3,000 clinical trials include 600,000 patients. Never seen over such a short period, They insist. The interest in the field of immuno-oncology is of such magnitude and so sudden that it becomes complicated to include patients in clinical studies for some key-indications. Another significant figure: at the end of 2017, there were nearly 1,000 treatments or "candidate treatments" for immunotherapy, targeting more than 270 molecules.

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Certainly, there are still many challenges. Immune control inhibitors, for example, have impressive effects in some patients, but most do not benefit. There is also the thorny question of price: about 75,000 euros per year per patient for these same molecules. A cost that hampers their distribution, even more so in developing countries.

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