In the past year, a growing number of cancer patients in central Indiana have gone through a new treatment that is showing great promise.
The treatment injects the patient with a form of the herpes virus, with the goal of activating the patient’s immune system to recognize and fight cancer.
The genetically modified virus doesn’t create the same infection in the patient’s body from the Herpes 1 virus, which typically causes cold sores, but does allow the body to target the cancer cells, said Dr. Pablo Bedano, medical director of Community Hospital South cancer center.
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“It can cause a herpes-like infection, but it can also cause an immune response when the body is trying to fight the virus,” he said.
A new direction of cancer treatment research is aimed at finding ways to make the patient’s own body fight the disease. This treatment, known as Imlygic, is the first oncolitic viral therapy approved by the FDA to fight cancer, Bedano said.
The treatment is also offered locally at Franciscan Health Indianapolis, where select patients who have melanomas that can’t be removed surgically can receive the injections, said Dr. Juliana Meyer, a cancer surgeon and medical director of the multidisciplinary melanoma program.
Indiana University Health was a part of the trial that allowed the treatment to get FDA approval, said Dr. Lawrence Mark, a dermatologist who treats cancer.
Right now, the treatment is only being used for patients with melanoma, or skin cancer, but it is being researched in other cancers, including head, neck or pancreatic cancer and brain tumors, Bedano said.
The approach doesn’t work for all patients and is only effective if the cancer is confined to the skin or lymph nodes and has not spread anywhere else. Because of that, the treatment has only been used on a few patients so far in the past year, Bedano, Mark and Meyer said.
For example, IU Health has had six patients in the study, two receiving treatment now and one about to begin, Mark said. The narrow population of patients that can receive the treatment has made it far less popular than other treatments, he said.
Mark called the treatment primitive, compared to what will be available in the future.
In order for it to be effective, the modified virus has to be injected into the tumor through the skin, Mark said.
The modified virus is only able to replicate itself if it is in an abnormal cell, such as one with cancer. The virus is then able to stimulate the immune system to recognize the cancer as foreign in the body and then fight it, Mark said.
Right now, the effectiveness in patients has been about 60 percent, with patients having a positive effect from the treatment, though not necessarily going into full remission, Mark said.
The therapy works over the course of two to four treatments, and one benefit is that it can be used time and time again with no lifetime limit, only a limit as to how much a patient can receive in one dose, Meyer said.
The treatment takes time before doctors can tell it is working, Bedano said.
The patient’s skin will likely look worse before it gets better, so the treatment does require doctors and patients to have patience, he said.
But the treatment is far less damaging than chemotherapy, surgery or other treatments that can be harmful to patients, Bedano said.
And the virus can be directly injected into the cancerous area, making the treatment more targeted, he said.
Another benefit is that patients tolerate the treatment well and it gives patients a more active role in their care where they previously may have felt like they had no options, Meyer said. If a new melanoma appears that can’t be surgically removed, doctors can tell patients they do have a treatment for them, Meyer said.
So far, the treatment looks promising, especially as a way to move toward using the patient’s own immune system to fight cancer, Bedano said.
“This is a way we can move away from chemotherapy and radiation and surgery, which have been our traditional approaches to cancer,” he said.