Posted by Bob Simmons
Last week, Dr. Steven Schuster, Medical Director of Oncology Research at UC Health, presented a primer on clinical cancer research focusing on targeted therapy including cancer genetics and immunotherapy.  One of the primary goals of cancer therapy research is to eliminate, or at least diminish, the role of traditional chemotherapy.
Medical  treatment of cancer may consist of observation alone, chemotherapy and/or immunotherapy or even stem cell transplant depending on the severity and  presence of symptoms.  Treatment usually consists of 2 phases - induction and maintenance.  Improved survival is the endpoint when “cure” is not possible.
Three cancer examples illustrate current advances in therapy.  Chronic leukemia (CML) is associated with a specific mutation, the Philadelphia chromosome.  Treatment with Gleevec blocks this mutation and allows patients to expect a normal lifespan (vs 4-5 years untreated).  This is an example of genetically targeted therapy.
Medical therapy of multiple myeloma,  associated with an untreated 2-year survival rate, has evolved into treatment with multiple drugs utilizing targeted immunotherapy as well as chemotherapy.  This lengthens the life expectancy to 10 years.  Since this is a disease of unknown cause, research defining the natural history and precancerous state was vital in pointing to more specific and timed  therapies.
The third example was illustrated by a case presentation  of lung cancer in a nonsmoker (15% of cases). Since lung cancer is the 6th most common cause of cancer deaths, this is a large number of persons.  In 2016 the first publication appeared reporting effective treatment of immunotherapy in this setting. This is a major step, illustrating that immunotherapy can be effective in non-blood cancers.
How does immunotherapy work? Cancer appearance is thought to  represent a failure of our immunosurveillance systems.  T cells are our main defense against the appearance of abnormal (cancer) cells.  It is possible that many of us produce cancer cells that are eliminated by T cells before they ever multiply or cause symptoms. Unfortunately, cancer cells often develop protective mechanisms to avoid the attack of T cells.  Immunotherapy acts to counteract these cancer protective mechanisms at a cellular level.
The last part of the presentation was a review of Oncological research in Northern Colorado. Appropriate acknowledgment was given to our current FCRC president, Dr. Rob Marshke, for his pioneering efforts in establishing Northern Colorado as an Oncologic research center.  There are currently 80 open studies. The goal is to attract  world-class projects to NOCO and to conduct world-class research locally.  Seems these goals are  being met - we are part of the LAST Project- one of 9 centers west of the Mississippi which will get to participate in the very best studies.  Also, the ORIEN Project is collecting blood samples in NOCO in order to construct a massive database which will someday provide  for uniform cancer treatment across all types.