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University of Pittsburgh Swanson School of Engineering. This paper is a student, not a professional, paper. This paper is
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IMMUNOTHERAPY: IT MAY LEAD US TO A CURE
Kirah Strandquist ([email protected])
PANCREATIC CANCER: WHAT’S THE
BIG ISSUE?
One of the hardest things my parents have had to
do was telling me and my siblings that my Dad had
been diagnosed with pancreatic cancer. When they told
us, they told us not to look up any information about
pancreatic cancer so that we wouldn’t be as scared for
my Dad’s future. I’m a rule-follower, so I listened. A
year later I ended up doing some research by myself to
see how I could help the cause and then found out why
my mom didn’t want us to look anything up. Pancreatic
cancer is one of the worse kinds of cancer, considered
“the most lethal cancer.” It has a five-year survival rate
of less than 7%, and a low 20% survival rate after the
first six months [1]. As most other cancers have seen an
improvement in survival rates in the past 10 years, the
rate for pancreatic cancer has had very little change. As
Dr. Rachel Tompa put it, it is a “disease that desperately
needs something new” [2].
Although pancreatic cancer is an unforgiving
disease, there is hope in the treatments that have been
developed by research. There are many new and
incredible advances in the field of cancer research that
offer hope to those affected with the disease. One of
these advances has been in a treatment called
Immunotherapy. In short, immunotherapy is a treatment
that utilizes the body’s immune system to fight the
disease itself [3].
Many bioengineers and researchers report that
immunotherapy possesses the power to become the next
big treatment for cancer. This could bring relief and life
to many people and families, including my Dad. I think
this is a promising treatment because it works by
engineering an antibody to work with each patient’s
immune system to make it more individualized. It is
more specific than the current methods, of trying
chemotherapy and radiation in the hopes it will work for
that patient’s individual case. This is the treatment that
could change the world.
BREAKING DOWN WHAT CANCER IS
University of Pittsburgh, Swanson School of Engineering 1
11/01/2016
To understand how immunotherapy works, one
must first understand what cancer is. Cancer is a disease
in which cells of the body begin to grow and reproduce
abnormally and out of control. These abnormal cells
begin to overcrowd the healthy cells, making it hard for
that particular area of the body to function the way it is
supposed to. Often, these abnormal cells can spread to
other areas of the body, start to divide and cause another
tumor. This process is called metastasis [4].
What Pancreatic Cancer is and How it is Treated
Now
Pancreatic cancer is cancer in the pancreas, when
either cancer occurs from the exocrine or endocrine
cells. It is one of the deadlier cancers because it is able
to survive with a limited blood supply, making it
difficult to administer typical treatments such as
chemotherapy. Pancreatic cancer tumors are also very
prone to metastasis. For these reasons, it is important
that researchers and engineers keep working on a more
effective treatment [5].
Although there is not one set treatment for
pancreatic cancer and no cure, typical treatments
include combinations of chemotherapy, radiation, and
surgery. Specific to pancreatic cancer, the most
effective treatment is surgery, but only 20% of patients
are eligible for surgery [1]. Next patients would receive
chemotherapy, which is a drug administered into the
bloodstream. This is often effective for other types of
cancer, although it has a more difficult time reaching the
pancreas because of the smaller amounts of blood flow.
Radiation is then used to kill or slow cancer cells, by
use of particle wave similar to X-rays. It can usually
slow the growth and spread of the disease, but not
destroy it [4]. This is where new treatments such as
immunotherapy can step in.
A NEW APPROACH:
IMMUNOTHERAPY
Pancreatic cancer has not gotten the attention that
it needs to start to find a cure. In relation to other types
of cancer, pancreatic cancer has seen little to no
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progress over the past 20 years [6]. Pancreatic cancer is
projected to become the second leading cause of cancer
related deaths in 2020 [7]. It is crucial that bioengineers
and researchers are given the funds and tools they need
to find a treatment. If an effective treatment is not
engineered, no progress will be made.
Immunotherapy is a treatment that shows great
promise on the road to finding a cure. Our anatomy is
programed so that when someone gets a virus or other
illness, the immune system fights back and attacks the
intruding bacteria or virus with antibodies. However,
since cancer is produced by the body’s own cells, the
body usually does not detect the abnormal cells to stop
the spread of the disease. Immunotherapy offers a
solution to this flaw by using T-cells, immune cells
“engineered in the lab to recognize and attack pancreatic
cancer” [2].
proving that immunotherapy using antibodies, like Tcells, can potentially shrink a tumor instead of just
slowing growth.
A few trials have been conducted with patients,
giving some patients a monoclonal antibody IMM-101
combined with chemotherapy, and other patients just
chemotherapy. They found that the patients with the
combined treatment survived the disease much longer.
The mean survival of the group increased by 59%, or
2.5 years. Professor Angus Dalgleish, head oncologist
of the trials reported that this treatment option also
“resulted in no added toxicity for the recipients, unlike
many other cancer treatments” [8]. These results
promise more effective and efficient treatment in the
near future for pancreatic cancer.
Case Study: Monoclonal Antibodies
There are a few different types of
immunotherapies that are in development. Specifically,
one that has shown particular promise for pancreatic
cancer are monoclonal antibodies. Monoclonal
antibodies are proteins engineered in a lab to seek out
cancerous cells with abnormal proteins [8]. Recently,
biomedical researchers and engineers have created a
monoclonal antibody called ipilimumab. It targets a
specific protein (CTLA-4), which shuts down the
immune system. This protein has already shown
promising results in melanoma skin cancer, lung cancer
and prostate cancer. Combining ipilimumab and
chemotherapy may help slow the spread of the disease
to other parts of the body in advanced pancreatic cancer.
Bioengineers in the United States are now in early trials
of combining this protein with chemotherapy to treat
advanced pancreatic cancer [9].
Another kind of monoclonal antibody that shows
promising results in trials is I131-KAb201. This
antibody contains radioactive iodine that can kill cancer
cells once the antibody attaches. In preliminary trials of
this new antibody, they found that the drug does not
necessarily shrink the tumor, but it could expand the life
span of the patient. The researchers and scientists
involved in this project are convinced that with further
engineering, this antibody could lead to a potential cure
for different types of cancer [10].
Not only has immunotherapy shown success in
advancing pancreatic cancer treatment, but it has many
benefits compared to current treatment. Immunotherapy
can be used as a long term treatment to the disease.
Since it uses the immune system to fight off disease, the
immune system will learn to fight the disease again if
another tumor begins to grow. Often, cancer cells will
become more resistant to chemotherapy and radiation as
it is used as treatment. Immunotherapy will offer hope
to those that have exhausted these treatments [11].
In my experience, chemotherapy and radiation
helped slow my Dad’s tumors, but can with many side
effects. He lost weight and hair very quickly, and also
became tired to the point where he couldn’t go to work
anymore. Immunotherapy is less toxic than current
treatments, so it limits powerful side effects. It could
limit some of these negative side effects that can often
damper the patient’s spirit and energy, since it utilizes
the patient’s own immune system to attack the disease
like it is supposed to [3].
Critics may point out that immunotherapy still can
cause side effects such as flu-like symptoms, fever and
fatigue. These side effects are not extreme, but could
possibly become more extreme in a patient whose
immune system has been compromised by the disease
and previous treatments [11]. These side effects may
cause problems for the patient, but immunotherapy still
offers a promising long term treatment for the disease
with fewer side effects than other treatments.
Immunotherapy in Action
IMPACT OF IMMUNOTHERAPY
Immunotherapy has given very promising results.
In a 2015 study performed by Dr. Sunil Hingorani and
Dr. Phil Greenberg, they used antibodies in the form of
T-cells in mice that had pancreatic cancer. They found
that administering T-cells boosts survival by more than
75% [2]. This was a huge breakthrough in research,
Advancement in such a promising field would
mean relief from such a ruthless cancer. Treatments
would help advance our society in the field of medicine.
Further development in immunotherapy through
engineering and research could lead to the potential cure
for cancer. Immunotherapy can be engineered to
Examining the Pros and Cons
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different cells all over the body, stopping the spread and
progression of cancer.
Finding the cure for cancer would mean finding
the cure for the second highest cause of death in the
United States [4]. It would lead to incredible leads in the
health of our nation and the field of bioengineering. It
would end the immense pain and suffering for those
who are diagnosed with pancreatic and other types of
cancer. I know that I personally grab on to any hope
possible, and immunotherapy could offer a solution to
so many people like my Dad.
cancer/type/pancreatic-cancer/treatment/whats-new-inpancreatic-cancer-research.
[10] “A Trial of a Monoclonal Antibody and Iodine
Treatment (I131-KAb201) for Advanced Cancer of the
Pancreas.” Cancer Research UK. 11.23.2015. Accessed
10.27.2016.
http://www.cancerresearchuk.org/aboutcancer/find-a-clinical-trial/monoclonal-antibody-andiodine-treatment-for-advanced-cancer-of-thepancreas#undefined.
[11] “Shining the Light on Immunotherapy: The Pros
and Cons of Targeted Treatment.” Chase After a Cure.
10.2015
Accessed
10.27.2016.
http://chaseafteracure.com/shining-the-light-onimmunotherapy-the-pros-and-cons-of-targetedtreatment/.
SOURCES
[1] E. Jaffee. "Cancer Immunotherapy: Pancreatic
Cancer." Cancer Research Institute. 3.2016. Accessed
10.27.2016.
http://www.cancerresearch.org/cancerimmunotherapy/impacting-all-cancers/pancreaticcancer.
[2] R. Tampa. “Immunotherapy for Pancreatic Cancer
Boosts Survival More than 75 Percent in Mice, Study
Finds.” Fred Hutchinson Cancer Research Center.
10.29.2015.
Accessed
10.27.2016.
https://www.fredhutch.org/en/news/centernews/2015/10/Immunotherapy-boosts-pancreaticcancer-survival-study-finds.html.
[3] “Immunotherapy.” Pancreatic Cancer Action
Network.
3.2016.
Accessed
10.27.2016.
https://www.pancan.org/facing-pancreaticcancer/treatment/immunotherapy/.
[4] “What is Cancer?” American Cancer Society.
12.08.2016.
Accessed
10.27.2016.
http://www.cancer.org/cancer/cancerbasics/what-iscancer.
[5] “Types of Pancreatic Cancer.” Pancreatic Cancer
Action Network. 3.2016. Accessed 10.27.2016.
https://www.pancan.org/facing-pancreaticcancer/learn/types-of-pancreatic-cancer/
[6] “New immunotherapy treatment could lead to better,
cheaper results for pancreatic cancer.” ScienceDaily.
09.8.2016.
www.sciencedaily.com/releases/2016/09/160908131055
.htm.
[7] “Pancreatic Cancer Facts 2016.” Pancreatic Cancer
Action Network. 2.2016. Accessed 10.27.2016.
https://www.pancan.org/wpcontent/uploads/2016/02/2016-GAA-PC-Facts.pdf.
[8] “What Is Cancer Immunotherapy?” American
Cancer Society. 8.08.2016. Accessed 10.27.2016.
http://www.cancer.org/treatment/treatmentsandsideeffec
ts/treatmenttypes/immunotherapy/immunotherapy-whatis-immunotherapy.
[9] “Pancreatic Cancer Research.” Cancer Research UK.
06.17.2014.
Accessed
10.27.2016.
http://www.cancerresearchuk.org/about-
ADDITIONAL SOURCES
“New Immunotherapy Treatment may Offer Hope for
Many Pancreatic Cancer Patients.” News-Medical.net.
09.08.2016. Accessed 10.27.2016. http://www.newsmedical.net/news/20160908/New-immunotherapytreatmentc2a0may-offer-hope-for-many-pancreaticcancer-patients.aspx.
“What Is Cancer?” National Cancer Institute. 2.09.2015.
Accessed 10.27.2016. https://www.cancer.gov/aboutcancer/understanding/what-is-cancer.
ACKNOWLEDGMENTS
I would like to thank Shaun Halla and John Bee
for helping me revise and edit my paper. I would also
like to thank my Mom for helping me chose a topic to
research. I would also like to give a shout out to my
Dad, who is staying strong to do what he can to fight
pancreatic cancer.
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