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Science

The Contrarian Who Cures Cancers (quantamagazine.org) 51

Claudia Dreifus, writing for Quanta magazine: When I first met the immunology researcher James P. Allison in 2014, he was just becoming an icon. Columbia University had brought him to its campus to present him with the Louisa Gross Horwitz Prize for the new type of cancer therapy he had developed. Instead of trying to burn, poison or surgically remove malignant cells from the body, his treatment mobilized a patient's immune system to destroy them. During his talk at the award ceremony, Allison explained that three years earlier, the Food and Drug Administration had approved the antibody drug he had developed, ipilimumab, for use against late-stage metastatic melanoma, which is among the deadliest of cancers. Some of the terminal patients who had participated in earlier trials, he reported, had gained a decade of life. As he described how his drug had changed the prognosis for some of these patients -- it was effective for about 20% of them -- tears came to his eyes.

In all my years on a science beat, I'd never seen a researcher cry. Allison, with his long gray hair and his loose-fitting clothes, struck me as among the most interesting figures in the scientific world. Speaking with him later, I sensed that he was someone deeply original, extremely confident of his intellectual powers and unafraid to go where they took him -- the exact qualities it takes to invent a paradigm-shifting cancer treatment. Allison's drug wasn't the first or only form of immunotherapy; scientists have worked on anticancer vaccines, for example, for decades. What made Allison's "immune checkpoint therapy" unique was that it used antibodies to unlock the immune system's potential to kill cancer cells. This approach is the culmination of Allison's highly accomplished immunology career.

In the early 1980s, he identified the receptor that allows the immune system's T cells to recognize the antigens of infected or abnormal cells. A decade later, he showed that T cells also need a signal from a "costimulatory" molecule to launch their attacks. Then Allison and his colleagues discovered that a molecule called cytotoxic T lymphocyte antigen-4 (CTLA-4) acts as a checkpoint, or built-in brake, on T cells. They could remove the brake and set T cells loose against cancer cells with an antibody -- ipilimumab -- that inhibited the CTLA-4 checkpoint.

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The Contrarian Who Cures Cancers

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  • The real travesty... (Score:5, Informative)

    by SirAstral ( 1349985 ) on Wednesday February 05, 2020 @12:37PM (#59693386)

    Is that far more people know more about someone that recently died and threw air containers through fixed rings as a crowd looks on.

    Far fewer people are going to know the name of someone that saved lives tucked away in a lab somewhere.

    Kudos to the work this individual has brought to the field of medicine!

    • by garyisabusyguy ( 732330 ) on Wednesday February 05, 2020 @12:45PM (#59693432)

      In other interviews, Allison describe the reaction to his research conducted in the 80's as being completely disconnected from the idea of delivering a cure, and it all would have been largely overlooked, if Allison himself had not decided to spend the next couple decades working on it.

      This really demonstrates how many of our research efforts are broken and way to dependent on following the direction of leaders who fail to listen to what their 'workers' are seeing

      • I agree, but that is just how humans like to do things... get politics involved. It usually does take individuals like this to move us forward because once a certain idea becomes entrenched, it becomes monolithic and counter productive to science itself.

        I really hate that humans institutionalize everything we lay our hands on... because someone feels like they need to control it.

      • by Immerman ( 2627577 ) on Wednesday February 05, 2020 @01:31PM (#59693590)

        > way to dependent on following the direction of leaders who fail to listen to what their 'workers' are seeing

        Who is the "leader" in this case, for whom he was a "worker"? Who was paying for the research?
        Seems to me there's three likelihoods:
        1) A federal research grant - in which case it's pretty much "blue sky" research and there's no real "goal" per-se. Find stuff out with faith that someone will do something with it if it's useful - there's usually not any real leader to be found
        2) Side project using slush funds from the university or other grants - in which case, again, no leader.
        3) Some medical/pharmaceutical company - in which case we're lucky the results weren't actively buried - a cancer cure is far less profitable than years of treatment, so there's not really any incentive to invest limited research funds into something that's going to undermine existing profit centers rather than create new ones.

        Meanwhile, what would you suggest some supposed "leaders" should have done? Force other researchers to abandon their own work to chase his pipe dream they could care less about? Sounds like he's had funding to continue his research, and once he showed he could actually use it to develop a cure, he started getting greater accolades and funding.

        I hate to say it, but revolutionary new possibliities are a dime a dozen, and most of them end up being dead ends. That's a big part of why the system works the way it does - individual researchers driven by their own passion chase probable dead ends, along with whatever assistants they can entice (and afford). It's generally not until they show that they have something with genuinely useful applications (for medical research: conclusively useful human, or at least animal, trials) that anyone gets really interested. Until then it's pretty much impossible to tell if you're dealing with an actual breakthrough, or just a promising-looking pipe dream that will suck down decades of funding to no good effect. Especially not if you're one of the bureaucrats with your hands on the purse strings rather than an expert in the field. And even field experts will tend to be blinded by orthodoxy when confronted by revolutionary approached - so putting them in charge of the purse strings wouldn't necessarily be an improvement.

    • Fortunately for us, we have people like you who are writing articles like this that keep us informed of these individuals. Keep up the good work! I agree, these people are largely unrecognized, you should write more articles like this.

    • someone that recently died and threw air containers through fixed rings

      Wow, surreal! Who is this magical dead guy you speak of?

      • Wow, surreal! Who is this magical dead guy you speak of?

        I'm not sure, but I heard that he was named after beef. Which makes sense, since beef was named a long time ago.

  • But cancer researchers didn't like immunotherapy because it wasn't intellectually interesting.

    See Ken Burns Netflix documentary about Cancer for more.

    In most cases, the experts in any given field are not helping people at all.
    • But cancer researchers didn't like immunotherapy because it wasn't intellectually interesting. See Ken Burns Netflix documentary about Cancer for more. In most cases, the experts in any given field are not helping people at all.

      Which is odd to me because how cells use chemicals to communicate is stupidly interesting IMO. I mean, a virus is something that hacks our cells to replicate itself along those same communication channels. That is amazing! Our immune system has so many checks of these systems, including looking at the communication channels to detect known bad proteins so it knows who to eat.

      I'll have to watch that documentary to learn more. Thanks for the suggestion!

    • by gtall ( 79522 )

      Really? Ever be a professor at a university and find you are the target of nutjobs the world over explaining how their new "discovery" will revolutionize your field? The experts in any given field are helping by sifting out the nutjobs and just plain incorrect research. Go get a science education before you show you know nothing about it.

  • So can we say that the skin cancer is not a disease of the skin, but an immune system disorder?

  • by shoor ( 33382 ) on Wednesday February 05, 2020 @04:57PM (#59694442)

    Very much a layman on this subject, but reading details in the summary about the discoveries of how the immune system gets activated, made me think, could this same knowledge be used to tell the immune system to stop when it was attacking the wrong thing? Like in rheumatoid arthritis?

  • Without a patent, his ideas are useless.
    Just like that Dutch student team which found a way to cure cancer with soda/backing power but could find a way to patent it.

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