2018 Nobel Peace Prize Awarded to Allison and Honjo for Cancer Research

This year’s Nobel Prize for Medicine was awarded to James P. Allison and Tasuku Honjo for major advances in the fight against cancer. The two researchers have developed therapies that use the human immune system to fight against cancerous cells, a feat never before accomplished due to cancer’s ability to outsmart the immune system.

First, let’s get into a bit of background information. Cancer cells are sneaky. That’s a very elementary way to go about discussing cancer, but it’s true. They are complex living organisms that have evaded human understanding for years, but in basic terms, cancer cells are sneaky. When they are developing and spreading, they activate certain “checkpoints” in the immune system. Most of these checkpoints are found in cytotoxic T cells (known also as killer T cells), which are the cells that are responsible for killing any virus or pathogen that enters the body, including cancer. The activation of these checkpoints takes the immune system off high alert, and the cancer cells trick the T cells into thinking nothing is wrong.

This process can be compared to the Greek myth wherein Orpheus sneaks into the Underworld by playing music that lulls Cerberus, the three-headed guard dog, to sleep, allowing him to walk through the gates unnoticed and with nothing in his way. Much like in this myth, cancer cells are able to “lull the T cells to sleep” by activating these certain checkpoint proteins. The T cells think there is no threat and do not attack the cancer cells, allowing them to slip through the immune system undetected.

As you may know, other ways of fighting against cancer that are commonly used include surgery, radiology treatment, and chemotherapy. These methods target active cancer cells and tumors to stop the division of the cells. Specific drugs do specific things, but the basics of what chemotherapy drugs can do are as follows: impair the ability of cells to reproduce, target cancer cells’ food source, cut off oxygen to the tumor by stopping the growth of new blood vessels around the tumor [although the effectiveness of cutting off blood supply has been questioned in recent years], and triggering apoptosis in cancer cells. Apoptosis is the pre-programmed cell suicide that afflicts all healthy cells at some point, the instructions to which are embedded in the cell’s DNA. It should be noted that cancer cells do not perform apoptosis, which is what makes them cancerous; they never stop growing and they never stop reproducing. If the cancer metastasizes and spreads to different parts of the body before doctors have a chance to treat it, not much can be done to help the patient.

However, Allison and Honjo have done great research on a new type of cancer treatment known as “checkpoint inhibitor” therapies. This breakthrough has led to a completely new class of drugs and has opened doors to patients who previously lacked success with radiology and chemo. Their new type of drugs are aimed, instead of at the cancer cells, at the immune system. More specifically, they are aimed at the cytotoxic T cells. These drugs inhibit the cancer’s ability to activate those checkpoints and bring the T cells’ guard down. With the use of these drugs, cancer cells are no longer able to sneak by unnoticed. Once the T cells notice the cancer cells, they get right to work at destroying them.

The problem with cancer in the past has been it’s inherent ability to elude the immune system by taking down the immune system’s safeguards, leaving doctors and scientists without a way from preventing its inevitable spread. How does one stop Orpheus from getting into the Underworld? He’s bound to play the lyre and Cerberus is bound to hear the music and fall asleep. That’s how the story goes, right? With this new wave of drugs, Allison and Honjo have given Cerberus earplugs. He is no longer at the will of Orpheus, and T cells are no longer at the will of cancer cells. Now, the immune system can spot cancer and fight back on its own, cutting out the need for invasive practices like chemotherapy and surgery. Use of checkpoint inhibitor therapies concurrently with radiology or chemotherapy typically results in a faster and more complete remission for cancer patients.

Of course, this method doesn’t work for everyone, and there are some risks with using it, as there are risks or side effects with any type of medication. But hopefully, with the research by Allison and Honjo, the world will have a real and indisputable cure for cancer that lets patients live a long, full life without worry of a relapse.