Guests/Speakers
Dr. Kellie Smith, associate professor of oncology at the Bloomberg Kimmel Institute for Cancer Immunotherapy at Johns Hopkins Medicine
Immunotherapy: The Breakthrough Changing Lung Cancer Treatment
The lung cancer immunotherapy breakthrough is transforming how doctors fight this deadly disease. Imagine your immune system as a personal bodyguard, trained to hunt down and destroy cancer cells. This revolutionary approach is offering new hope to patients who previously had limited options, providing longer survival with fewer side effects than traditional treatments.
Unlike conventional therapies that attack cancer with external forces like chemotherapy or radiation, immunotherapy supercharges the body’s natural defenses, teaching them to recognize and eliminate cancer cells effectively. It teaches the immune system to recognize and eliminate cancer cells effectively.
“Immunotherapy has completely changed the treatment landscape for lung cancer patients.”
The primary immunotherapy currently used for lung cancer targets the PD-1 or PD-L1 pathway. These treatments use specially synthesized antibodies that block the tumor cells’ ability to shut down T cells, allowing these immune cells to do their job: killing malignant cancer cells.
The Evolution of Immunotherapy for Lung Cancer
The journey toward effective immunotherapy has been decades in the making. Dr. Smith describes it as a series of “hmm moments” rather than sudden breakthroughs. A pivotal moment came in 2010 with the first clinical trial examining the blockade of PD-1, a molecule shown to dampen T-cell responses in mouse models. Researchers observed promising responses in a few lung cancer patients during this early trial, leading to expanded research that revealed a 25% response rate in lung cancer patients.
Today, immunotherapy has revolutionized treatment approaches. “What we’re seeing is there are patients who now don’t even need chemotherapy,” Dr. Smith notes. “A lot of patients are receiving immunotherapy either alone or in combination with chemotherapy as first-line treatment.”
Who Benefits Most from Immunotherapy?
Not all lung cancer patients respond equally to immunotherapy. Dr. Smith explains that patients most likely to benefit typically have:
- Tumors without mutations in the EGFR pathway, ROS1, or ALK
- Lung cancers associated with a history of smoking
- Tumors with a high number of mutations
While biomarkers like PD-L1 expression and tumor mutation burden are sometimes used to predict response, Dr. Smith cautions that these are “highly imperfect” in real-world settings outside clinical trials.
Advantages of Immunotherapy
One significant benefit of immunotherapy is its tolerability compared to traditional treatments.
“Immunotherapy is much better tolerated than traditional chemotherapy,” says Dr. Smith. “My personal goal would be for no one to ever have to go through chemotherapy. If we can develop better methods of activating the immune system without putting patients through chemo, that would be amazing.”
The Future of Lung Cancer Immunotherapy
The field of lung cancer immunotherapy continues to evolve rapidly. Dr. Smith is particularly excited about precision immunotherapy approaches that tailor treatments to specific tumor types.
“Up until 15 years ago, we didn’t view lung cancer as an immunogenic tumor because the survival was so poor,” she explains. “But what we’re seeing is that it actually can be very immunogenic, and we just need to better understand how we can harness the immune system.”
Promising developments include:
- T-cell engagers (a new form of immunotherapy)
- Adoptive cell therapy and CAR T-cells
- Targeting molecules beyond PD-1
- Combination approaches
The Impact of Research Funding
Dr. Smith credits LCFA’s early career researcher grant as crucial to her work. “The grant I received from LCFA was the first grant I ever received as an independent investigator,” she shares. This initial funding allowed her to conduct preliminary studies that led to larger grants and supported clinical trial research that ultimately contributed to FDA approval of immunotherapy for early-stage lung cancers.
Her work has not only advanced lung cancer treatment but has also contributed to progress in treating other types of cancer.
Looking Ahead
“It really is an exciting time for the research community,” Dr. Smith reflects. “Nothing would make me happier than if no one had lung cancer, but second to that, I think nothing would make me happier than if we can turn this into a manageable disease.”
For patients, the evolution of immunotherapy represents a significant shift from the days when lung cancer was considered a death sentence. Today, these innovative treatments are offering longer survival, fewer side effects, and renewed hope.
