Immune Therapy Expands Melanoma Treatment to More Patients

Immune therapy is generally better tolerated than chemotherapy in treating melanoma, allowing more patients to receive treatment, including those with heart, lung or kidney conditions, according to Dr. Douglas Johnson.

Johnson is a physician-scientist and professor of medicine in the Division of Hematology/Oncology at Vanderbilt University Medical Center, where he leads the melanoma clinical research program, located in Nashville, Tennessee.

While people with severely limited physical function or serious autoimmune diseases may face challenges, many can still be treated with care from a specialist. Organ transplant recipients are a unique group at risk of rejection, but research is exploring ways to treat them safely. Overall, few conditions completely rule out immune therapy, and doctors often collaborate across specialties to help patients benefit while managing risks.

CURE recently sat down with Johnson to discuss the safety of immune therapy and challenges that patients with autoimmune disease or organ transplants may face.

Transcript:

Immune therapies, in general, are much better tolerated than some of our traditional cancer treatments, like chemotherapy. So, we are able to treat a broader range of patients than we used to be able to with conventional chemotherapy combinations. There are actually very few absolute contraindications, as I would call them.

So, there are very few things that would completely prevent a patient from receiving immune therapy. However, a few factors that I consider might make treatment more challenging would be significantly impaired functional status. By that, I mean people who have considerable difficulty even getting up and moving around and performing their normal daily activities. We know that even something like immune therapy can be very hard on those patients, and they are also very unlikely to benefit. Patients with very severe autoimmune diseases can also be very challenging, but the vast majority of patients with autoimmune diseases can still receive treatment.

Often, we will co-manage these patients with their rheumatologist, neurologist, or whichever specialist is caring for their autoimmune disease. We may need to adjust some of their regimen slightly and treat them with other medications that partially block the immune system to tamp it down just a bit. But generally speaking, patients with heart problems, lung problems, or kidney problems can receive immune therapy. We just need to monitor them a bit more closely.

I will say that one other area that is certainly under research and that we are concerned about is giving immune therapy to our patients who have had organ transplants. So, if someone has had a liver transplant or a kidney transplant, those patients are at risk of rejecting their organ. There are some new studies that have recently suggested ways they might be able to be treated with pulses of steroids and similar approaches. It seems they can do okay, but that is certainly an area we are just beginning to understand.

Transcript has been edited for clarity and conciseness.

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