More Cancer Mutations May Be Good for Immunotherapy Patients


“Mark Perkins considers himself a poster child for the new generation of cancer drugs that harness the patient’s immune system to attack sick cells. Two years after trying Merck & Co.’s Keytruda — and almost four years after receiving a prognosis of as little as six months left to live — he is cancer free.

“The 56-year-old grandfather’s case is more than a success story for a new class of treatments that have fewer side effects than standard chemotherapy. It’s also at the frontier of what could possibly lead to a new approach to treating cancer, if it turns out that patients who, like Perkins, have many more mutations in their tumors than the average have a better chance of responding to immunotherapy.

“Drugs like Keytruda, known as checkpoint inhibitors, have produced dramatic responses in some advanced cancer patients, but doctors still don’t understand why only about 20 percent gain long-term survival. Researchers say looking at the mutation load for answers makes scientific sense, because these drugs work by taking the brakes off the immune system’s killer T-cells, unleashing them to go after cancerous cells. In theory, the more mutations a cancer has, the more foreign it will appear to the newly enhanced immune cells.”

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