In a newly published article on the STAT web site, two clinicians at Oregon Health and Science University argue that the benefits of immunotherapy in the treatment of cancer are being greatly over-“hyped”.
The article by Gay and Prasad is entitled “Few people actually benefit from ‘breakthrough’ cancer immunotherapy“, and there is some justification for their perspective. We suggest that you read the article for yourselves.
The authors, however, do not include prostate cancer in the list of forms of cancer for which immunotherapeutic “drugs” are approved by the US Food and Drug Administration (FDA). Strictly speaking, they are correct, sipuleucel-T (Provenge) is not a “drug”; rather, it is a form of biological therapy. However, since it is an FDA-approved form of “biological therapy” one might want to feel that the authors are splitting hairs.
On the other hand, of course, the authors would probably still, and with justification, argue that it is only the minority of patients treated with sipleucel-T who show striking responses to this type of therapy. For many patients there is little to no benefit although there are significant costs and distinct risks for adverse effects of treatment.
Having said all of this, however, the authors are also careful to point out that there is a relatively small subset of patients (of the order of 10 percent) who respond astonishingly well to various types of immunotherapy:
When immunotherapy works, the result is terrific, even life-changing.
The question is going to be if and when and how we are going to be able to identify with accuracy the patients who really have a high likelihood of responding well to specific types of immunotherapy for specific subsets of cancer (and specific subsets of prostate cancer in particular). It may take a while to work out the answer (or answers) to that question.