The development of immunotherapy treatment for cancer patients is progressing rapidly, and more patients are experiencing remarkable responses to these treatments that allow them to lead longer, healthier lives.

In the fight against cancer, immunotherapy and biomarkers are perhaps the strongest new tool in a healthcare practitioner’s arsenal.

Speaking to Medical Chronicle ahead of the European Society for Medical Oncology (ESMO) Summit Africa, held in Cape Town last month, Professor Bernardo Rapoport (medical oncologist and extraordinary professor of Immunology at the University of Pretoria) discussed developments in immunotherapy and designating patient groups. “At present, 95% of treatments in clinical trials or expanded access programmes comprise of chemotherapy, radiation, or surgery, with immunotherapy at just 5%,” said Prof Rapoport. “However, in 15 years those figures could be reversed.”

Recent advances in immunotherapy for melanoma and lung cancer continue to significantly impact the treatment of both common cancers, and influence progress in the treatment of several other cancer types. Immunotherapy drugs are now used to treat many different types of cancer. But immunotherapy is not for everyone.

“It’s unrealistic to expect therapies to bring about the same desired outcome in every instance when patients themselves are unique,” said Professor Simon Nayler (director and pathologist at Drs Gritzman and Thatcher Inc.) before taking a closer look at prescribing immunotherapy and the role of biomarkers. “A deeper understanding of how best to treat individual patients is gained when immunotherapies are complemented with a biomarker diagnostic test,” Prof Nayler explained.

BIOMARKERS KEY TO DETERMINING APPROPRIATE TREATMENT

A biomarker is a measurable biological factor that can tell us about certain aspects of human health. Found in blood, other body fluids, or tissues, it is a sign of a normal or abnormal process, or of a condition or disease. In the context of cancer immunotherapy, biomarkers can provide insights into each patient’s individual cancer – its genetic makeup, its behaviour, and its interactions with the immune system – which doctors can then use to determine the approach most likely to benefit individual patients.

“A biomarker indicates there is a specific target on or in a tumour cell which can be targeted by a specific anti-cancer drug and those tumours with such a biomarker will respond to the drug, while those without will not,” explained Prof Nayler. “Pre-treatment biomarkers predict this response. They may be a protein or molecule either in or on a tumour cell, and this may be established by immunohistochemistry or molecular testing such as polymerase chain reaction (PCR) or gene sequencing (NGS).”

Medicine personalised in this way is already improving outcomes by ensuring that patients receive the right treatment at the right time.