Setting Off a Smart Bomb

By empowering the body to fight breast and renal cancers, immunotherapies are poised to improve the treatment landscape.

By empowering the body to fight breast and renal cancers, immunotherapies are poised to improve the treatment landscape.

When Kevin Day was diagnosed with advanced renal cell carcinoma in the fall of 2011 at the age of 50, he was told he had just two years to live. His left kidney was removed, and he was put on Sutent (sunitinib) — the targeted drug that is a standard of care in stage 4 or recurrent renal cancer — but the disease had spread to his lungs and bones and there were no other good options to treat him.

Then Day’s doctor told him about a clinical trial of an immune-boosting drug called atezolizumab (MPDL3280A), which was opening up at the Carolina BioOncology Institute near his home in Charlotte, N.C. Day was accepted into the trial, and within two weeks of starting the drug, his tumors began to shrink. After eight weeks, they were half their original size. He was given the drug every three weeks for a year, by which time all of his tumors had disappeared.

In October of 2013, Day’s cancer relapsed in his spine, so he rejoined the study, which was testing atezolizumab as a single agent for various malignancies. Again, his cancer vanished. Day is still taking the drug as part of the ongoing study, and feeling lucky to be alive.

“The way I describe the drug is it boosts my immune system to fight the cancer,” Day says. “As long as it’s still working, I will stay on it. I can’t even put into words what this opportunity has meant to me.”

Checkpoint Inhibitors

Atezolizumab is among an emerging class of immunotherapy treatments called PD-L1 inhibitors. PD-L1 is a protein that is expressed on the surface of some cancer cells, enabling tumors to hide from T cells — important immune cells that have a natural ability to eradicate cancer. Inhibiting PD-L1 and a related protein known as PD-1 effectively unveils cancer cells, taking the brakes off the immune system and unleashing the body’s innate ability to fight cancer.

PD-L1 and PD-1 inhibitors, otherwise known as “checkpoint inhibitors,” are being studied in a variety of tumor types and may be particularly promising in fighting two that can be among the most difficult to treat — advanced renal cell carcinoma and breast cancer.


Kevin Day with his doctor, John Powderly II.

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