Nobel Prize 2018 in Physiology or Medicine | Latest Burning Issues | Free PDF Download

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• Cancer comprises many different diseases, all characterized by uncontrolled proliferation of abnormal cells with capacity for spread to healthy organs and tissues.

Traditional approach

Try to beat Cancers – War of Attrition — A war of Numbers
Surgery – Often used to drastically reduce the population of
malignant cells to a manageable count
Chemotherapy

Radiation therapy
Until the point when the malignant tissue stops growing, or disappears altogether
Metastasis – Huge challenge

The immune system tells between the self and the other — an invading organism or cells of the self that have gone rogue — by a form of ‘friend or foe identification’, the technology that prevents military weapon systems from attacking their own side.

But like all other living systems, it is contained by feedback mechanisms which take cues from the body and the environment, to curb an action before it can go too far.

Previous Nobel Prizes

Methods for hormone treatment for prostate cancer (Huggins, 1966)
Chemotherapy (Elion and Hitchins, 1988)
Bone marrow transplantation for leukemia (Thomas 1990)

Cytotoxic T-lymphocyte antigen 4 (CTLA-4)
Programmed cell death protein-1 (PD-1)

• During the 1990s, in his laboratory at the University of California, Berkeley, James P. Allison studied the T-cell protein CTLA-4. He was one of several scientists who had made the observation that CTLA-4 functions as a brake on T cells. He developed an antibody that could bind to CTLA-4 and block its function

• The results were spectacular. Mice with cancer had been cured by treatment with the antibodies that inhibit the brake and unlock antitumor T-cell activity
• In 1992, a few years before Allison’s discovery, Tasuku Honjo discovered PD-1, another protein expressed on the surface of T-cells.
•  The results showed that PD-1, similar to CTLA-4, functions as a T-cell brake
• Results were dramatic, leading to long-term remission and possible cure in several patients with metastatic cancer, a condition that had previously been considered essentially untreatable
• James P. Allison studied a known protein that functions as a brake on the immune system. He realized the potential of releasing the brake and thereby unleashing our immune cells to attack tumors. He then developed this concept into a brand new approach for treating patients.
• In parallel, Tasuku Honjo discovered a protein on immune cells and, after careful exploration of its function, eventually revealed that it also operates as a brake, but with a different mechanism of action. Therapies based on his discovery proved to be strikingly effective in the fight against cancer.
• Of the two treatment strategies, checkpoint therapy against PD-1 has proven more effective and positive results are being observed in several types of cancer, including lung cancer, renal cancer, lymphoma and melanoma.
• New clinical studies indicate that combination therapy, targeting both CTLA-4 and PD-1, can be even more effective

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