In 2011, MD Anderson received a $150 million gift — the largest in its history — from the Khalifa Bin Zayed Al Nahyan Foundation.
Related story: The immuno man
Eight other immune checkpoint or costimulatory molecules have been identified, and drugs to block the PD-1 checkpoint currently are advancing through clinical trials.
When the FDA approved ipilimumab for metastatic melanoma, it cited the traditional measure of success: an increase of four months in the median overall survival (the point where half of treated patients remain alive) of treated patients.
But that’s not what has oncologists excited about the drug and the checkpoint blockade approach. When ipilimumab works, it works for a long time — complete remission or disease so tamped down that life returns to normal for patients who once faced certain death from the disease. This is an uncommon result not just for metastatic melanoma, but for any type of solid tumor that has spread to other organs.
“Long-term follow-up, so far, indicates that once a patient survives for three years, if they die after that, it’s from something other than melanoma,” Allison says.
One of the important mysteries that has yet to be solved is why the drug doesn’t work for more patients. Testing new combinations is an exciting area, as are discovering new checkpoints and co-stimulatory molecules, as well as developing drugs to address them.
Research at MD Anderson addresses all of these.
Five pharmaceutical companies have signed collaborative agreements with MD Anderson’s immunotherapy platform to develop new drugs.
Allison points out that one of MD Anderson’s strengths is the ability to conduct innovative clinical trials that include the measurement of scientific endpoints.
These protocols, developed by Padmanee Sharma, M.D., Ph.D., associate professor in Genitourinary Medical Oncology, allow patients to consent to presurgical treatment with an immunotherapy. This permits in-depth analysis of the molecular effect of the drug after the tumor is removed.
This approach allowed Sharma to discover that activation of a protein called ICOS increases ipilimumab’s effectiveness.
The details of this co-stimulatory molecule and its effect were then worked out in a mouse model. ICOS activation to improve treatment now is being explored by Jounce Therapeutics, a company co-founded by Allison and Sharma.
“Immunotherapy for cancer is really just beginning,” Allison says. “As we learn more and develop immunotherapy drug combinations,we can start thinking about curing cancer in many patients. MD Anderson is a center of immunotherapy excellence that will grow, improve and contribute significantly to that cause.”
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