Nobel Prize in Medicine awarded to researchers who exploit the immune system to fight against cancer

The Nobel Prize in Physiology or Medicine 2018 was awarded jointly to two immunologists for developing a new class of effective cancer treatments that releases the body's immune system.

Congratulations to James P. Allison, Professor at the MD Anderson Cancer Center at the University of Texas, and Tasuku Honjo, Professor at Kyoto University, Japan, for winning this year's Nobel Prize in Medicine and for having collected the million dollars that accompanies this award. The researchers, who worked independently of each other, were honored for their pioneering work on "immune treatment at checkpoints," a new approach that harnesses the body's immune system to fight cancer.

Allison and Honjo have studied the proteins that prevent the body's primary immune cells, called T cells, from attacking tumor cells. Their work, which dates back to the 1990s in both cases, has resulted in therapies that are used today to treat various types of cancers, often with very positive results.

"Allison and Honjo have shown how different strategies to inhibit the immune system's brakes can be used in the treatment of cancer," wrote the Nobel Assembly of the Swedish Karolinska Institute in a statement. "The two winners' fundamental discoveries are a turning point in our fight against cancer."

Our immune system goes into action when it detects foreign substances, such as viruses, bacteria and other threats. A special type of white blood cell called T-cells is a key element of this system. T cells are able to attach to these foreign substances, triggering a large-scale immune response. Various messenger proteins are also involved in this process, some acting as accelerators, further strengthening the immune response, others acting as brakes, preventing an exaggerated autoimmune response that can destroy healthy tissues and cells.

Cancer is a serious problem for the immune system, which is not always able to identify tumors as a substance worthy of attack. It is here that intervene the work of Allison and Honjo.

In the 1990s, while working at the University of California at Berkeley, Allison studied a protein known as CTLA-4. This protein slows down the immune response, also called negative immune regulation. Allison has developed an antibody that releases this brake, allowing the immune system to effectively fight cancer cells. Lab work in mice has progressed in human patients, leading to remarkably effective treatments for advanced melanoma, a type of skin cancer, by 2010.

Honjo's work in the 1990s was quite similar, but he focused on PD-1, another protein that influences the action of T cells. In 2012, therapies built around the removal of this protein helped effectively treat several types of cancer. Long-term remission and outright elimination of cancer have been documented in many patients with metastatic cancer, a condition previously considered impossible to treat.

"After initial studies showing the effects of blocking CTLA-4 and PD-1, clinical development has been dramatic," said the Nobel Assembly. "We now know that treatment, often called" immune treatment at checkpoints, "has fundamentally changed the results for some groups of patients with advanced cancer."

Unfortunately, control point therapies are known to produce undesirable side effects caused by an overactive immune response and subsequent autoimmune reactions. Fortunately, these side effects are manageable and research is underway to further reduce them.

"This work has led to a remarkably effective, sometimes curative, therapy for patients with advanced cancer that we were previously unable to help."

Of the two approaches, PD-1 appears to be more robust, with positive results observed in the treatment of lung cancer, kidney cancer, lymphoma and melanoma. Smartly, combined therapies involving both PD-1 and CTLA-4 have also been developed. In addition, the pioneering work of Allison and Honjo has inspired the next generation of immunologists, who are looking for new ways to use the body's immune system to fight cancer.

"This work has led to a remarkably effective, sometimes curative, therapy for patients with advanced cancer that we were previously unable to help," said Ned Sharpless, director of NCI in an NIH. declaration. "Their discoveries have marked the era of cancer immunotherapy, which, along with surgery, radiation therapy, and cytotoxic chemotherapy, represents a" fourth modality "for cancer treatment – a better understanding of biology. Underlying the immune system and cancer could help many more patients. "