A New Way to Beat Cancer
Editor's note: While some scientists and researchers are searching for a cure for Alzheimer's, others are focused on beating cancer.
And one company in particular is leading the way with a revolutionary new treatment called "immunotherapy."
In today's Masters Series – adapted from the July issue of Stansberry's Investment Advisory – Porter and senior research analyst Dave Lashmet explain how immunotherapy works... how it saved one woman's life... and why this could change the way we fight cancer forever...
A New Way to Beat Cancer
Seven years ago, Ariella Chivil was a 20-year-old college student with a "gnarly cough" that wouldn't go away.
She went to see the doctor, not expecting anything serious...
Instead, a chest X-ray revealed a giant tumor growing outside her right lung. This wasn't a "normal" case of lung cancer. Ariella didn't smoke. No one in her family smoked.
Ariella had a rare form of cancer known as Hodgkin's lymphoma.
For most people, that would be (relatively) good news. Hodgkin's lymphoma is usually treatable.
Ariella was not so lucky. She had a "refractory" cancer. It didn't respond to chemotherapy or radiation. She tried 14 different combinations of treatment over three years... with no luck. Meanwhile, her cancer spread to her liver and abdomen. She even joined experimental clinical trials – trying two drugs that had never been tested – to no effect.
Worse, she couldn't keep food down. She lost weight, then lost her hair. She was growing gray and weak. By the time she was 23, her latest doctors had never seen her stand, and she was on a last-ditch "salvage therapy."
That's when she tried a new drug. After a week of treatment, she felt a bit better. After a few more weeks, she was walking on her own. Her side effects were mild: fatigue, but no nausea. She could eat, exercise, and heal...
Most important, this drug was shrinking her tumors. After six months, they were disappearing. Ariella got her life back on track. She finished college, got a job, and became a patient advocate.
Today, at age 27, Ariella Chivil has a normal life. She's off the drug – and yet, as we'll explain... it's still working for her.
Stories like Ariella's are amazing. Even better, they are becoming more common. A new trend is under way in cancer treatment. The heavy investments in developing these new drugs are starting to pay off. They are saving lives... and becoming multibillion-dollar blockbuster drugs for the companies that own them.
That's why we need to understand a little more about how Ariella's life was saved – and what it means for global cancer treatments...
How Cancer Grows – and How You Stop It
Cancer cells start out as normal cells. Then, for some reason, they mutate to grow uncontrollably. Outside of every cell – whether healthy or cancerous – are control mechanisms that your immune system can use to fight cancer.
First, your immune system matters for its surveillance role. After that, it's a battle of white blood cells versus tumor cells.
But what happens when your white blood cells are the cancer cells? That's a lymphoma.
Hodgkin's lymphoma is identified by swollen lymph nodes or a swollen spleen, plus some blood tests. It's rare that a solid tumor forms with Hodgkin's. But if it does, like in Ariella's case, doctors treat it with targeted radiation or chemotherapy...
Radiation used to be the first line of treatment, but it causes lasting side effects in children and adults. So most doctors opt first for chemotherapy – usually with a four-drug combination therapy. If these treatments all fail, doctors can try stem-cell transplant therapy, where a whole new immune system is imported. Stem-cell transplants are very expensive, and the procedure itself can be fatal. But sometimes it works.
Regardless, around 1,000 people die from Hodgkin's lymphoma every year in the U.S. – one in eight new patients.
Fortunately, we now know the cause – and it's a key "off switch" used by the human immune system.
After an infection, your body needs to de-mobilize its army of defenders: White blood cells get shut down. That's why your immune system has "off switches." They help regulate the level of response.
For example, there's a special case where a foreign body is acceptable to your immune system: It's called a baby.
Pregnancy uses an off switch called PD-1. Without it, a mother's body would attack and destroy the fetus. And there are two chemical keys that fit this switch. Thanks to research in Japan and at Harvard, we know these two keys drive Hodgkin's lymphoma. Meanwhile, scientists at Kyoto University in Japan used a specialized antibody to shut down PD-1.
A therapy based on PD-1 is what saved Ariella's life. But it isn't just for treating Hodgkin's lymphoma. Here is what one of Ariella Chivil's doctors had to say...
"It's wild," says Anas Younes, M.D., chief of the lymphoma service at Memorial Sloan Kettering Cancer Center. "These agents work in everything, to a variable degree. It's advancing the response rate in almost all cancers."
So far, this drug is approved to treat eight different cancers – and seven of them have high mutation rates. That means there are a lot more genetic errors in these cancers, making them stand out during immune surveillance, which detects normal "self" versus monstrous "other." If your immune system can see these cancers, the differences are obvious, and you can heal yourself.
This drug defines a new class of cancer drugs known as "immunotherapy."
The eighth cancer is Hodgkin's lymphoma. Here, the drug is a targeted therapy... It directly targets the specific hallmark of this cancer – not just the way a cancer hides from your immune system. As a result, the effects are most dramatic here. And Ariella Chivil was one of the first 23 people to try the new therapy. All these people had end-stage Hodgkin's lymphoma and were heavily pre-treated patients. This means that radiation and repeated courses of chemotherapy had already weakened their immune systems.
To be honest, nobody expected much. Even Ariella was not optimistic... Her doctor thought "this was a real long shot."
But Ariella and the other 22 trial patients benefited. Four of the 23 had a complete response, as well as 75% or greater shrinkage of their primary tumors. Sixteen had a more than 50% shrinkage in their tumor – including four at 90%. And the last three patients had between a 20%-49% shrinkage in their tumors. That's stellar success.
After that, the U.S. Food and Drug Administration (FDA) wanted to see if these results could be repeated...
The graph that follows shows how much a tumor decreases in size or increases while on a drug. This is from 80 end-stage Hodgkin's lymphoma patients, to see if the first trial was a fluke. Note that each blue bar represents a person.
In a perfect outcome, all these bars would drop lower – hence the term "waterfall graph"...
As you can see, three bars go up – one just barely. The other 77 fall – some a little bit but most a lot, or even all the way to 100% shrinkage. This was from the earliest look at the data. Many of these patients had tumors that kept shrinking. Just as important, the longer data show the tumor response was sustained. Patients did not relapse.
That is clear from overall survival, which is an incredible 95% at one year for these end-stage patients. In other words, they aren't "end stage" any longer. They now have stable disease... Or they got better.
Let us point out two cautionary notes: First, Hodgkin's lymphoma patients are a lot younger than most cancer patients. Second, targeted therapies often have dramatic initial responses – making nice waterfall graphs.
So even though this drug helps Hodgkin's lymphoma patients, it's not a generalized cure for cancer. Still, it's FDA-approved to treat seven other cancers: lung, skin, kidney, head and neck, liver, kidney, and bladder cancers. For these seven cancers, this drug engages your immune system to fight cancer like it's healing a wound. The biggest risk is an overactive immune system, which can lead to immune-related side effects.
Thus far, side effects have been mild. If there are more serious side effects, they are controllable or reversible. And the responses can still be dramatic... Between 10%-30% of patients have significant responses. This includes many partial and complete remissions, and these responders have long-lasting benefits.
Both because of its limited side effects and long-lasting benefits, immunotherapy is a different business than chemotherapy. And we are only at the start of cancer immunotherapy. Two- and three-drug combinations are coming.
The FDA has approved one combination to treat skin cancer. This raises the objective response rate to 45%. It's "objective" because it's a before-and-after measurement from a CT scanner.
Based on this success, many more clinical trials are running with new drug candidates combined with PD-1 drugs...
The best result so far is with an IDO inhibitor drug... Indoleamine 2,3-dioxygenase – or "IDO" – is an enzyme that breaks down tryptophan. The buildup of tryptophan and the products after it's broken down by IDO suppress immune cells that typically attack a tumor. The net result is that the attacking immune cells die off, and new immune cells that support the tumor take over.
Doctors have added this IDO inhibitor drug to a PD-1 drug... and released their data at this year's American Society of Clinical Oncology (ASCO) conference, a meeting of 25,000 cancer doctors.
We were there at the ASCO meeting, and saw that for the two-drug combination, there's a 55% disease-control rate. That means more than half the patients benefit. Just as important, 7% had their cancers disappear and another 30% had their tumors objectively shrink. And we saw data showing that the fewer chemotherapies that these patients tried, the better they did on immunotherapy...
If these patients only used one or two drugs first, their objective response rate was closer to 45%. That's because, by design, chemotherapies kill all your fast-dividing cells, including your white blood cells. But you need your white blood cells to hold off cancer. So the less collateral damage, the better. Once we can limit that damage, immunotherapy drug combinations should be more and more effective.
The advantage of a combination therapy is to close off cancer's escape route from your immune system. The disadvantage is stronger immune side effects. So a good clinical team needs to deliver these drugs.
Already, the FDA has approved three immunotherapy approaches with different targets, so we may soon see triple-drug combinations. Over the next five years, we expect more drugs to supplement the first three cancer immunotherapies. Overall, it's an exciting time in cancer research – for doctors, for patients, and for health care providers.
Dave Lashmet and Porter Stansberry
Editor's note: This story is so important that our resident medical-technology experts Dave Lashmet and Dr. David Eifrig are hosting Stansberry Research's first-ever cancer briefing on Wednesday, November 15, at 8 p.m. Eastern time.
They'll discuss a scientific breakthrough that could destroy any cancer you or a family member may one day face. And they believe the little-known company behind it could also make you up to 500% gains in the market. Reserve your spot by clicking here.