We’ve had surgery for at least 3,000 years. Then in 1946, chemical warfare research led to the use of a mustard gas derivative to poison cancer cells and the advent of chemotherapy. More recently, we also started poisoning cancer through drugs that attempt to starve tumours of nutrients or blood supply. Those traditional “cut, burn and poison” techniques are effective in about half of cases. It’s a laudable medical accomplishment that also leaves behind the other half of cancer patients. According to the World Health Organisation’s international agency for research on cancer, that translates to 9,055,027 deaths worldwide in 2018 alone. Our usual defence against disease is our immune system. It does an excellent job of sorting out what doesn’t belong in the body and attacking it – except when it comes to cancer.
For 100 years, the reasons behind that apparent failure were a mystery.
Jim Allison’s breakthrough was the realisation that the immune system wasn’t ignoring cancer. But what if you could block those tricks and unleash the immune system’s killer T-cells against the disease? Instead, cancer was taking advantage of tricks that shut down the immune system. The trick Allison’s immunology lab at the University of California, Berkeley, found involved a protein on the T-cell called CTLA-4. When stimulated, CTLA-4 acted like a circuit breaker on immune response. These brakes, which he called checkpoints, kept the cell killers from going out of control and trashing healthy body cells. Cancer took advantage of those brakes to survive and thrive. In 1994, the lab developed an antibody that blocked CTLA-4.
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