2018 Nobel Prize in Medicine: “Immune Checkpoint Blockade Therapy”

In 2018, the Nobel Prize in Medicine was awarded to Dr. James P. Allison and Dr. Tasuku Honjo for their work on checkpoint inhibitors as a new cancer therapy. Targeting cancer using the immune system has been a goal for at least half a century, but has had many challenges. The function of the immune system can be viewed as two-fold: to eliminate ‘non-self’ and to eliminate ‘altered-self’ from the body. Because cancer cells can be considered ‘altered-self’, the question becomes, why does the immune system not recognize and eliminate these cells from the body? To answer this question, one must understand how the immune system is activated and regulated and how cancer cells ‘avoid’ immune recognition and elimination. Research into these areas has led to a plethora of immunotherapy protocols for the treatment of cancer, with varying degrees of success. Checkpoint blockade therapy represents another strategy to use the immune system to treat many types of cancer. Recent advances have moved checkpoint blockage therapy to “front line” status for some types of cancer (Keytruda a.k.a pembrolizumab) and represent an entirely new form of therapy for cancer, and were a major impetus for awarding the Nobel Prize at this time. This talk will explain the basis of this therapy, the successes and failures, and some of the challenges remaining.