The European Cancer Congress 2015

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Immunotherapy: can the hype deliver?

By Michael Walsh

Medicine is an area that suffers from scare stories and over-hyping in the media, with few fields as susceptible as oncology. Front page headlines talking about “cures” or “causes” abound, and there is a “next big thing” almost weekly. However the growing interest around immunotherapy seems to be causing genuine excitement rarely seen across researchers and clinicians.

According to Dr Ignacio Melero, “most of the oncologists and haematologists perceive this field as probably the main area to progress and to achieve better therapeutic efficacy, at the very least for the next five years”. Ignacio will be chairing the Immunotherapy in Cancer track at this year’s European Cancer Congress, and is also a researcher and clinician at the University Clinic of Navarra and the Centre of Applied Medical Research, both in Pamplona, Spain.

Immunotherapy uses the body’s own immune system as a way of fighting a disease, helping it to mount a more successful response. In cancer, immunotherapy involves helping the immune system to recognise and target cancer cells, which so often are able to evade detection and hence destruction.

The last weeks and months have seen immunotherapy hit the headlines around the world, with expectations that this could be a treatment that can deliver on the promise where others have failed. While much of the investment and results have so far come from outside of Europe, Ignacio hopes that the continent can play a bigger role in the development and implementation of new therapies.

He says that while the field is still in its infancy and evidence from trials is still emerging, “the basis for this optimism is quite solid, and we have certainly not found ourselves in the situation to tell this is what is going to be available and nothing beyond here. On the contrary, what we are seeing is the more we dig, the more the jewels we are unearthing.

“The current state of affairs really supports lots of optimism. We are at the beginning of something which looks extremely promising. It’s very difficult to tell how far this will take us. We are seeing spectacular results in some patients who are really beyond any expectations of any successful treatment. We are also seeing a lot of patients with stabilisation of disease which seems durable and quite beneficial in terms of prognosis.”

Unsurprisingly with such an exciting and timely topic, immunotherapy will feature prominently at the congress. It will have its own track and be the focus of a number of different sessions and presentations, as well as being the subject of a talk by Caroline Robert in the opening plenary session on Saturday morning: “Immunotherapy, past, present and future”. Even outside of the immunotherapy track, its place in the treatment of several specific tumour types will be explored in sessions which concentrate on the central nervous system (Sunday evening), melanoma and skin cancer, gynaecological cancer, paediatric oncology (all on Monday), as well as non-prostate genitourinary malignancies (Tuesday morning), where biomarkers, trials, and combination therapies will be discussed.

Building on studies announced at other conferences this year, Ignacio is looking forward to hearing the results of trials using checkpoint inhibitor monoclonal antibodies in various tumours, including head and neck, colorectal, and lung. These compounds release the breaks of the immune system, and he says that “in this meeting, there are going to be clinical studies with sufficient power to tell if these medicines are to be used”.

Although Ignacio is still eager to find out about new compounds that have different mechanisms of action, monoclonal antibody therapies have stolen the limelight. He says that results of large-scale randomised clinical trials on monoclonal antibodies are due to be presented at the congress. “These will provide some of the most exciting news that will be available in this meeting. Obviously at this point in time it’s unknown whether the results will be positive and whether they will meet the high expectations that there are in the oncology community.”

The growing interest around immunotherapy means that it is sure to be one of the main draws at this year’s congress, and Ignacio believes that the atmosphere which has left “even the most sceptical about immunotherapy really falling in love with the field” will leave plenty of others head over heels in Vienna.