According to data from the World Health Organization, cancer is the second cause of death globally. Unfortunately, the numbers of new diagnoses are increasing – in 2022 there were almost 400,000 new diagnoses in Italy – due to the aging of the population and the increasingly accurate diagnosis capacity. But scientific research is working on the development of new tools, such as oncological immunotherapy which in recent years has revolutionized the therapy of some forms of cancer. The “I know too” information campaign, created by Bristol Myers Squibb, with the participation of APaIM (Italian Patient Association Melanoma), Living without a stomach (you can), FIAGOP (Italian Federation of Parents and Healed Pediatric Oncohematology Associations), TUTOR (Rare Chest Tumors Association), FAVO (Italian Federation of Voluntary Oncology Associations) and WALCE (Women Against Lung Cancer in Europe), and the patronage of AIOM (Italian Association of Medical Oncology).
First stop Naples
The first appointment is in Naples, followed by Milan and Rome. In the Campania capital, and precisely in Piazza Cavour, a gazebo will be set up which will remain open from 10 to 18 until 14 May. Inside you will find a “time machine” designed to show the main stages in the history of immuno-oncology. Meetings in the squares and the activation of a dedicated portal are also planned. “The last ten years have profoundly changed the challenge against cancer, but the level of awareness of immuno-oncology is still low – says Monica Forchetta, President of APaIM -. This is why we are committed to ‘I know too’, the information campaign to increase the level of knowledge on the progress of science in immuno-oncology”. According to what emerged from a survey carried out on over five thousand patients, in fact, many still do not know how this type of treatment works.
Tumors, the Italian way for “targeted” immunotherapy
by Tiziana Moriconi
Immunotherapy combines surgery and chemotherapy
“Thanks to the use of monoclonal antibodies, the immune system can be stimulated to react more strongly against tumors – explains Paolo Ascierto, Director of the Melanoma Oncology, Oncological Immunotherapy and Innovative Therapies Unit of the ‘Pascale’ Institute of Naples -. Immuno-oncology targets the cells that make up our immune system and joins treatments aimed directly against tumor cells: surgery, chemotherapy, radiotherapy, hormone therapy and targeted therapies”. The basic idea of immunotherapy is in fact to unleash our own immune defenses against the tumor, with the aim of “defeating it from within”, so to speak.
To pave the way for the application of this type of treatment, continues Ascierto, was melanoma, a much feared form of cancer because it is capable of causing metastases very quickly: “Before the arrival of this innovative approach, the life expectancy of patients with metastatic melanoma was approximately 6 months and less than 10% were alive at 5 years. But today the story of this skin cancer has changed: “In particular – continues Ascierto – thanks to the combination of two immuno-oncological molecules, nivolumab and ipilimumab, in the front line in metastatic melanoma almost half of the patients (48%) are alive at 7 and a half years. The dual immunotherapy also shows a significant ‘memory effect’: its effectiveness is maintained in the long term, even after the end of the treatments”. This type of approach constitutes the standard of care not only for the metastatic phase of melanomas, but also for stage III and IV, even following the complete surgical removal of the tumor mass: “Treating patients at this stage – continues Ascierto – increases the possibility to avoid a recurrence and, therefore, potentially recover”.
Melanoma, the first data on the combination of the mRNA vaccine and immunotherapy are positive
by Tiziana Moriconi
Effective against many cancers
But the use of this therapeutic approach is not limited to the treatment of melanomas. As underlined by Ferdinando De Vita, Director of the Precision Medicine Department and Professor of Medical Oncology at the University of Campania Luigi Vanvitelli in Naples, immunotherapy is the therapeutic standard also for many other types of neoplasia, from lung and kidney to gastrointestinal ones, up to pleural mesothelioma: “In particular, immunoncology has constituted a real evolution in gastroesophageal adenocarcinomas (stomach, gastro-esophageal junction and esophagus), in an advanced or metastatic phase, where, for over 10 years, no there has been progress and the benefits of chemotherapy have been limited. We can now offer patients an effective first-line option of immunotherapy with nivolumab in combination with chemotherapy that can significantly improve both overall and progression-free survival. To these advantages is added the maintenance of a good quality of life”. And again, the stimulation of the immune system is also proving to be highly effective in the treatment of colorectal cancer: “Dual immunotherapy, in patients already treated with chemotherapy – continues De Vita – has led to a 4-year survival in 70% of cases”.
Lung cancer, does immunotherapy work before and after surgery
by Dario Rubino
A look to the future
Immunotherapy, underlines Cosimo Paga, Executive Country Medical Director, Bristol Myers Squibb Italy, is not only used in advanced forms of cancer, but can also be useful in the treatment of the disease in its initial phase, when the immune system is potentially more reactive. “Our research – continues Paga – is focused on the development of new immuno-oncological molecules, such as relatlimab, which interact on different targets of the immune system, and on different combinations of immuno-oncology with chemotherapy and targeted therapies”. In fact, he continues, the future goal is to develop the so-called precision immuno-oncology, which would make it possible to predict the sensitivity of the individual patient to immunotherapy: “This model, defined as agnostic, makes it possible to expand the number of patients who can benefit from a specific therapeutic approach, regardless of the location of the tumour”.
Lung cancer, chemo with immunotherapy reduces the risk of recurrence by 32%.
by Irma D’Aria
Expand availability
The long “journey” of immunotherapy, which began in the early 1900s, reached its culmination in 2018, when the Nobel Prize for Medicine was awarded to James P. Allison and Tasuku Honjo for their studies on the mechanisms that prevent the system immune system to recognize cancer cells. And it is thanks to this long journey that today “more and more patients can claim to have overcome the disease or live with cancer with a good quality of life – says Claudia Santangelo, President of Living without stomach (si può) -. Research offers tangible new opportunities for treatment and survival. The Associations also have the task of making patients and citizens aware of the importance of research, to inform them about clinical trials, with the possibility of having early access to innovative medicines. Furthermore, the times for making new therapies available must be speeded up, because people affected by cancer cannot wait”. In fact, given the great advantages of this therapeutic approach, the experts underline the importance of making the treatments available to all patients who need them: “So far – concludes Paga – we have obtained reimbursement in Italy for 16 cancer indications in various stages of the disease for our immuno-oncological drugs. Our goal is to extend the efficacy of immuno-oncology to the greatest number of patients to improve their survival”.