Two Revolutions in Cancer Treatment Are Giving Patients New Hope

M.D. and Author
We are living in the lucky days of cancer research. Two revolutions in cancer therapy — one successfully tested by President Jimmy Carter — are giving patients of all kinds a new hope. One of the world's leading medical researchers, Dr. David Agus, discusses the many ways our understanding of cancer is changing. From immunotherapy, which remove cancer cells' "don't eat me" signal, to personalized therapy (the kind tested on President Carter), we are conceptualizing cancer in fundamentally new ways.
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TRANSCRIPT

David Agus:  Cancer, it's a word that if I say it to somebody you have cancer this is like hitting you on the head with a club. It's a life-changing event no matter how you look at it. My goal is not to be aggressive as possible and kill everything, my job is to make cancer a livable manageable condition so that you live with cancer rather than dying with cancer. And this really is or are the lucky years with regard to cancer. I want to talk about two kinds of fundamental shifts that are happening now. The first is what we call immunotherapy. When cancer cells happen they have a don't eat me signal on the surface. Well, we now have the ability, and there are drugs that are approved that block that don't eat meat signal and allow the immune system to come in and basically eat the cancer.

We've seen this work with a remarkable 90+ year individual named Jimmy Carter, our former president. And we've seen it work with many other patients. So cancers like skin cancer melanoma, like kidney cancer, some types of lung cancer and others have had some pretty dramatic results with this immunotherapy and it's only getting better. We're learning how to harness the power of our own immune system to attack cancer literally more on a daily basis. Number two is what we call precision or personalized medicine. And they mean the same thing. And there's a lot of confusion out there some call it precision medicine or personalize, they're the same thing. And what it means is that I can now, for example if you have cancer, I can take a piece of your cancer and sequence the DNA and look at what genes are turned on and what genes are turned off and hopefully develop a way to turn off the driving genes. And it works. And it works in many of the patients, not all. In many of the patients we don't yet know the drivers. We don't have drugs to turn off every gene, but I can sequence the DNA of the cancer and develop a personalized therapy of that patient. So there may be a drug that was FDA approved for breast cancer, that gene is driving lung cancer and I can use it in that patient.

You know, in the 1800s in Europe they started to classify cancer by body part. You have breast cancer, you have prostate cancer or lung cancer. The next generation of students of doctors are going to classify cancer by what are the on switches and the off switches and it doesn't matter what body part it originated. At the same time, there's another way of thinking about cancer. Because historically we would say we have got to target that cancer cell and kill it. Well, to me cancer is a verb and not a noun. You're canering, something the body does and not that the body gets. And so that philosophy needs a very different way of approaching disease and it means changing the system in addition to trying to target the cancer. So, for example, there was a trial done about a decade ago where they took women with premenopausal breast cancer and normally we treat them and then wait for the cancer to reoccur and we treat again. In this group of women after treatment we divided them into two. Half got a drug that builds bone that was meant for osteoporosis and half got a placebo. And the cancer recurrence was reduced by about 40 percent. Why? Because breast cancer metastasizes to bone. So if I change the soil the seed doesn't grow.

So one of the most remarkable advances in cancer was from a drug that didn't even touch the cancer. Just this week we announced a trial where patients with advanced prostate cancer who are on aspirin do better because aspirin blocks inflammation. There is data out of there that across the board with every cancer people who are on a statin, as the Lipitor/Crestor's of the world, that those patients do better than patients who were not. Why? Again, because those drugs block inflammation and inflammation allows cancers to change more over time. So if we can block that change we can get a better outcome no matter what cancer no matter what treatment. So we're learning a lot, new ways to target the cancer and treat it, immunotherapy, molecular targeted therapy, and at the same time looking to change that system so the cancer doesn't want to grow. Because remember, if you drop a match after it rains, nothing happens. If you drop a match in Los Angeles it goes up in flames. I want you, as an individual, to be much more like after it rains than to be like that sunny Southern California.