Keytruda – immunotherapy for cancer

Keytruda – medicine which completely changes the approach to cancer treatment.

Due to the recent research in Israel, led by Dr. Raanan Berger, Head of Cancer Institute, Chaim Sheba Medical center, Keytruda was approved in Israel for treatment of 12 types of cancer including lung cancer, ovarian cancer, tumors of the head and neck, stomach cancer, bladder cancer etc.

Using Keytruda for melanoma treatment

Research let by Prof. Jacob Schachter, Head of “Ella”Institute, melanoma treatment and research, Chaim Sheba Medical center, Tel Hashomer, successfully resulted in melanoma treatment. The drug, which has helped 50% of patients with metastatic melanoma with minimum side effects (in September 2014), was approved by the Ministry of Food and Drug Administration of America (FDA), under the accelerated procedure. Many experts suggest that this drug can lead to a real breakthrough in the treatment of cancer.

Unlike previous medicines, in this case the experts focused on innovative therapies without trying to destroy the tumor using hazardous chemicals which lead to serious side effects and manipulate delicate and complex natural immunity of organism – to stimulate it so that it could attack and destroy cancer cells itself. If a new mechanism of action called the immunological treatment will confirm physicians’ suggestions the world may take a revolution in the treatment of cancer in the next few years.

According to Prof. Schachter: “The new drug creates a real potential for the treatment of one of the deadliest cancers with few side effects and good tolerability. Furthermore, it is entirely changes the approach to the treatment of cancer because of its mechanism of action is also effective against other types of cancer. Now, of course, immunological therapies that help the body’s immune system to destroy the tumor cell itself, are the Holy Grail of oncology treatment. At this stage, we can imagine only curative potential combinations of these agents, each of which acts on different mechanisms, some of which are already in advanced stages of development. ”

Malignant melanoma usually develops in the skin. The disease can also occur rarely in other organs such as eyeball, oral mucosa or nail.

Currently, Israel is the country with the highest incidence of melanoma in the world. In the first place of the list are Australia, New Zealand, the United States and Britain. According to the International Agency for Cancer Research the mortality from this disease in Israel among men is in eighth place in the world, and among women in tenth place.

“Treatment of metastatic melanoma a few years ago were very limited,” says Professor Schachter. “There was chemotherapy but its effectiveness was close to zero. There was also a certain type of immunological treatment, which had serious side effects and was practiced by very small number of sites in the world. These drugs are able to help only 5% of patients. ”

In the last decade, the use of biologics represents a significant leap forward in terms of the effectiveness of treatment of some types of tumors, but it does not provide the optimal solution. “The main problem is that the effectiveness of biological products passes very quickly,” says Prof. Schechter. “Some of them give very good results at first, but after a few months of treatment, the tumor gets used to them.”

Unlike chemotherapy for the destruction of cancer cells via chemical agents, immunological treatment destroys the tumor itself, but it can cope healthy cells of our immune system. This is proof that cancer cells in our body are constantly and immediately destroyed by the immune system. Therefore, our body can destroy these cells. But for some reason it sometimes loses this ability. Immunological therapies are designed to work with the immune system to ensure that it did not lose its protective ability.

Every second of our cells is not subject to the ordinary laws of the body. One of the functions of the immune system is to identify these cells and eliminate them. This process occurs on a daily basis in all of people. But sometimes things go wrong. Possible causes – genetic or environmental – can contribute to the formation of abnormal cells that have a little more resistance. The immune system recognizes the new cage and tries to destroy it, but the cells respond appropriately to survive. The process of the tumor cells under the control of the immune system in the form of mutual equilibrium and can last for many years. This means that the person is already malignancy, but cancer cells were not revealed.  Eventually, these cells are able to develop resistance to the overall immune system, and then develop the disease. This means that when a patient calls the doctor, his immune system has lost the ability to take control of this type of cancer.

For many years researchers could not crack a secret mechanism that causes the immune system to destroy harmful cells. It was very difficult to understand why a system that destroys these cells constantly and successfully fights bacteria and viruses suddenly stop doing it. In an attempt to regain its lost power, the researchers sought to strengthen it by various means. To a large extent they succeeded, but due to serious side effects.

The problem is not in the system itself, the problem is the stability of the cancer. A condition in which a tumor develops does not mean that the system has ceased to function, as previously thought, but rather a condition in which the cancer effectively avoids it. The great revolution of new drugs, some of which are still under development, in that they help the immune system in various ways to catch cancer cells that try to slip past her.

One of the elements that play an important role in this process is a natural restraint mechanism that prevents the immune system from attacks on their own bodies and their destruction. According to Professor Schachter: “To make immune system to destroy the bad cells, it is necessary to remove these ” brakes” . Various molecules, whose function is significantly inhibited the activity of immune cells. Neutralizing these molecules removes the most significant barrier. ”

The drug Keytruda is the second drug that knows how to disable the “brake” of the natural immune system. “There are other elements that help cancer cells to survive in the body, but the” brakes ” are a critical element,” – says prof. Schachter. “Once you get rid of them the system begins to act like a maniac. New drug Keytruda has fewer side effects than the previous one and it is very fast. A few weeks later the swelling decreases and patients return to normal life. ”

According to the FDA, 69 percent survival rate of patients receiving the drug, accounted for at least one year after the disease was found, and 62 percent – a year and a half. This is a real revolution. As a result of the treatment of hundreds of patients over the past two years, the Israeli research institutions in the Sheba Medical Center and Hadassah have much evidence of success of the new method of treatment.

“There are dozens of success stories of the most seriously ill patients who have exhausted all conventional methods, but could not get rid of the disease. And now they are living with the disease habitual life” – says Prof. Schachter.

⇒ Digital mapping of skin – early diagnosis of melanoma

Today in Israel a new technology of oncological tests for oncomarker genes are developed, that allows to test a wide range of immunological drugs against cancer, including Keytruda, and choose the appropriate treatment according to the individual protocol for each patient.

⇒ More details about personalized treatment.

⇒ CANscript test – the selection of an individual treatment protocol.