These resources can help you better report on cancer immunotherapy

By Tara Haelle

If you write anything about cancer treatment, it can be nearly impossible to avoid writing about immunotherapy. But reporting on immunotherapy can quickly become complicated, confusing and overwhelming. We hope this new tip sheet can help.

Immunotherapy is exactly what it sounds like. Cancer immunotherapy works to recruit the patient’s immune system to fight cancer instead of using chemotherapy to kill cancer cells directly. While the FDA did not approve the first immunotherapy drug for cancer — interferon-alpha 2 — until 1986, the groundwork for the therapy and its first use dates back nearly a century. For details, check out Sciline’s fantastic primer on cancer immunotherapy.

Not until the 21^st century did immunotherapy begin to be more adopted as a therapy, helping to revolutionize cancer treatment. That’s when researchers began developing checkpoint inhibitors, which are drugs that can release cancer’s chokehold on the immune system’s defenses so the immune system can attack cancer. The FDA in 2011 approved the first checkpoint inhibitor — ipilimumab — for treating melanoma.

Checkpoints are specific regulators of the immune system that hit the brakes on the immune response to keep the immune system in check. The goal is to avoid an autoimmune response in which the immune system would otherwise attack the healthy tissue. Cancer can hijack these regulators and put the brakes on so the immune system won’t attack cancer either. Checkpoint inhibitors lift the brakes, so the immune system is no longer inhibited.

Other forms of immunotherapy besides checkpoint inhibitors exist as well, such as CAR T-cell therapy. This therapy involves extracting T-cells from the patient, modifying them in the lab to make them capable of finding and killing cancer and then re-injecting them into the patient.

While the world of immunotherapy is exciting and rapidly advancing, it involves plenty of hype and pitfalls as well — and it certainly isn’t cheap. It’s important for journalists to know what questions to ask of researchers, what to look for in studies and where to investigate more broadly about these treatments to ensure their coverage is accurate, thorough and responsible.

The best introduction to tips on immunotherapy coverage comes from Joy Victory, former deputy managing editor of HealthNewsReview.org, in her “Six tips for writing accurately about cancer immunotherapy drugs.” In short, these are the tips:

Discuss the steep costs of immunotherapy, and they’re often very steep — and not always covered by insurance.
Pay close attention to the endpoints in immunotherapy studies and make sure you understand how they’re assessing a treatment’s effectiveness. If they use surrogate endpoints, be extra cautious about possible hype.
Find out what specifically the drug does for the patient: Extend life? Improve the quality of life?
Pay attention to side effects and toxicity. Though these drugs can be highly effective, they aren’t necessarily a walk in the park for your body for many people.
Consider these drugs’ roles within the context of precision oncology.
When interviewing a patient, find out how typical they are in terms of response. Do they respond as most other patients with their disease respond, or are they a “super responder” who does not necessarily represent the drug’s effectiveness?

Check out the following resources to familiarize yourself with different immunotherapy types, the meaning of various “mab” suffixes on monoclonal antibody drugs and other background information.