The Medicine of the Future Is You

Dear Reviewer,

The most promising and exciting advance in all the history of medicine is upon us, and yet it is actually not new at all — it’s as old as humans. The advance? Our immune systems. There are very few diseases that can’t be conquered by our own bodies. But sometimes, they need a little push.

For a real-world example, you have only to look at someone who doesn’t get Ebola when exposed to it. Such people are said to be “immune” to the disease, and they carry antibodies in their blood that can identify Ebola and kill it before it overwhelms them. A study of about 4,000 people in Gabon a few years ago found that an average of 15% of people there had antibodies for Ebola. If your immune system is primed, it can keep you free from even the most deadly diseases in the world.

Or perhaps you have met someone who was cured of an incurable cancer. I knew a woman whose lungs were full of tumors. Her doctors stopped her chemo treatments and told her to make hospice arrangements. Five years later, no one could find any evidence she had ever had lung cancer. Chemotherapy can’t do that. Her immune system had somehow finally figured out who the bad guys were and attacked them.

The concept that our own bodies are better than anything modern medicine can offer is an extraordinary idea. We carry with us all the medicine we need in our own immune systems to ward off cancer, germs, viruses and a host of other diseases that can kill us.

But the system isn’t perfect. Some diseases, like cancer, have evolved strategies to hide from our killer immune system cells. For example, cancer tumor cells can coat themselves with fats that look normal to the immune system.

And that isn’t the only problem — sometimes our immune systems can go haywire and attack healthy and natural cells in our bodies instead of invaders. Rheumatoid arthritis, a debilitating disease, is caused by the immune system attacking healthy cells — in this case, the linings of joints.

We are at the very early stages of understanding cancer itself, much less how cancer cells can hide from the immune system and why the immune system revolts and attacks healthy cells.

But it may not matter how much we understand about cancer or why cancer cells can’t be identified by the immune system. Perhaps all we need to know is how to attach a marker to cancer cells so that our immune systems see them as foreign. The approach some scientists are taking is to leapfrog ignorance and just go ahead and tweak the immune system.

Oncologists are beginning to treat a patient’s immune system instead of treating the disease. For example, we clearly understand that when an antibody — which is simply a protein — is attached to a cell, that cell suddenly carries a big red flag saying kill me. Immune system macrophages, T-cells and killer cells will see the flag and go to work.

About 40 years ago, two researchers who went on to win Nobel Prizes figured out that those antibody markers could be produced in a laboratory. Ever since then, with growing but always with limited success, scientists have been making antibodies and trying to use them as medicine.

Still, even three years ago, immunotherapy seemed to be more theory than therapy. Then in 2011, a researcher at the University of California, Berkeley who had been trying to defeat melanomas with engineered antibodies came up with an antibody system that was rushed through by the FDA. It was a breakthrough. And by 2013, the prestigious journal Science had designated immunotherapy as the breakthrough of the year.

These days, immunotherapy is so hot that every major drug company is trying to develop therapies based on it. There is a mad scramble to be in this game, and it seems like almost any new startup, like Juno Therapeutics, that declares it is working on immune system antibodies for cancers is going up in price. Each one has a unique approach to creating antibodies, and it’s doubtful that most will succeed. Those that are on the right path will sort themselves out quickly. In this game, longevity and experience count.

This is all part of a field that I have followed for years, because it just makes sense that no medicine is likely to do as well as the human immune system, which has evolved over 2 million years to combat anything nature can throw at us.

To your health and wealth,

Stephen Petranek
for The Daily Reckoning

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