By: Dr. Maria Simbra
No chemotherapy, No radiation.
There’s a new way to treat cancer that doesn’t involve either. It’s working for patients and even doctors are excited about it.
Joe Milcarek had no symptoms of lung cancer. Doctors discovered it on scans he had as part of participation in a lung study.
“They found a tumor about the size of a small plum,” he said.
He was treated with radiation, chemotherapy and then surgery to remove the tumor and part of a lung. Then a few months later, a new tumor appeared next to his windpipe.
“It was choking me,” he said.
More radiation, more chemo. Joe lost some weight, some hair, some blood cells, and a lot of energy.
“The chemotherapy, it tires you out. You come home, you don’t feel like doing anything,” he said.
Then, his doctor suggested a new drug called Opdivo. At the time, it was in study. Joe got enrolled, the drug got approved in the meantime at the end of 2014, and Joe continues on it now. It requires a half-hour intravenous infusion through a port in his vein every other week.
Opdivo is the brand name for nivolumab, a genetically engineered antibody that helps T cell function. T cells are cancer-fighting immune system cells that the cancer can shut down. The Opdivo switches the T cells back up. It’s in a novel group of cancer drugs, and their use is called immunotherapy.
Opdivo has been used for melanoma, kidney cancer, and a few other cancers, but most commonly now, lung cancer. And the ideal candidate is a smoker and someone with a tumor that has lots of genetic mutations in its cells.
“We have never seen anything like this in most human solid tumors,” Allegheny Health Network Oncologist Dr. Gene Finley said.
Dr. Finley says immunotherapy was typically used after chemotherapy has stopped working. He says, in a big shift in thinking, it may now go the other way around with immunotherapy given first.
“Since December, there have been data presented showing that the immunotherapy actually works in about a third of lung cancer patients, and it works better than chemo,” Dr. Finley said. “For us, it’s just something we’ve never seen before, and we’re all very excited about the initial results.”
All this success is expensive – $14,000 a month. Joe’s insurance covers it.
In studies, when compared to chemo, patients getting Opdivo survive an additional three months.
“If you have on average a three-month improvement, or a four-month improvement in overall survival, that’s a very significant result in a disease, where the average survival is about one year,” Dr. Finley said.
Joe is most excited by what his scans show.
“No tumor activity on recent scans,” he said.
Skin, intestinal, lung, and thyroid problems are potential side effects. But, Joe has had none of it.
“I have no side effects at all. I can go over, get my treatment, and wash the car. Which, I couldn’t do with regular chemotherapy,” he said.
Joe feels the Opdivo has been whacking his cancer for the past few years now.
“I’m going to continue on taking it, and probably for another, I don’t know, six months, where I could get a few more scans and see if there’s any more activity with the cancer cells, and if there isn’t, I might take a break with it, you know,” he said.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.