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Immune Therapy Steps Up the Attack

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Science  22 Oct 2010:
Vol. 330, Issue 6003, pp. 440-443
DOI: 10.1126/science.330.6003.440

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Slowly, new immune-based therapies are registering successes in the fight against cancer. In some people riddled with the aggressive skin cancer melanoma, immunotherapy has not only eliminated disease but also kept it at bay for years. Such outcomes are virtually unheard of in patients with metastatic disease that has spread through the body. From a patient's perspective, the achievements are still tenuous. Some individuals respond dramatically, but only a fraction are treated successfully. What excites immunotherapists is that this modest group of responders keeps showing up in recent studies. With more tinkering, cancer specialists hope to shift additional patients into the responder category and devise more powerful combination treatments. At the same time, their successes are raising deep questions about where cancer therapy is headed. Integrating immunotherapy into clinical care will pose challenges of its own. Patients may take months to respond, making it difficult to assess whether treatment is helping. Furthermore, some treatments are highly personalized and impossible to administer outside of specialized settings. This makes them extraordinarily expensive. Many specialists wonder whether they can really become part of standard cancer care.