KANSAS CITY, Mo. — A Kansas City woman living with metastatic lung cancer is grateful after an immunotherapy drug gave her a second chance at life.
Marilyn Aylward was diagnosed with lung cancer in 2009 and became a patient at the University of Kansas Cancer Center in Westwood, Kansas. She initially had chemotherapy, which was successful in killing the cancer cells but hard on her body.
Her doctors at the KU Cancer Center gave her a choice.
"He came in and said do you want hospice or more chemotherapy, and I said I'll take hospice," Aylward said.
She decided to stop the chemotherapy and started feeling better. Several months later, doctors went to Aylward with a new class of drugs in their cancer-fighting arsenal called checkpoint inhibitors, or immunotherapy drugs. The doctors again gave Aylward an option, this time to try one of the drugs, called Opdivo.
Dr. Chao Huang, an oncologist at the KU Cancer Center in Westwood, Kansas, is Aylward’s new doctor.
"So the beauty of it is, we are using the patient’s own immune system to attack the cancer, and therefore we don't have all those side effects of systemic chemotherapy," Huang said.
Cancer cells contain a protein known as PD-L1, which prevents the immune system's T cells from recognizing and killing cancer cells. Immunotherapy drugs act as a light switch on the wall, “turning on” or reactivating the T cells to recognize and destroy the cancer.
Initially, the drugs were used to treat lung cancer but can now be used for neck, kidney and breast cancer, as well as Hodgkin’s Lymphoma, a blood disease, Huang said.
"Perhaps we cannot cure the cancer, but we can keep the cancer under control and the patient can still live a meaningful life and be functional for as long as we can," Huang said.
Immunotherapy doesn't work for everyone, but it has worked for Aylward. She now gets monthly infusions of Opdivo and is leading an active, productive life, spending time with family, golfing and going to mass.
In the cancer magazine Cure, Opdivo (also known as nivolumab) showed better long-term survival rates in patients with metastatic non-small cell lung cancer. Sixteen percent of patients survived after five years, about four times what is typically expected for patients on chemotherapy.
Immunotherapy does have potential side effects. Huang said that the drugs can destroy healthy tissues and damage the kidneys and the bowel. He recommended that cancer patients ask their doctors about alternatives to chemotherapy before deciding on a treatment plan.
"I think it's going to be one of the miracle drugs. I've been taking it for three years and I'm still here," Aylward said with a laugh.