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Expert Q&A on immunotherapy with Giao Q. Phan

Giao Q. Phan, M.D., F.A.C.S.

Former President Jimmy Carter announced this week that he is cancer free after undergoing a cutting-edge approach to cancer treatment known as immunotherapy. Massey surgical oncologist and member of the Developmental Therapeutics research program Giao Q. Phan, M.D., F.A.C.S., specializes in immunotherapy and sat down to answer some questions on the subject.

What is immunotherapy and why is it important?Immunotherapy is a treatment that uses the patient's own immune system to kill cancer cells, similar to how the immune system can kill foreign invaders like bacteria. The unique part of immunotherapy is that since the patient’s immune system is with them all the time, it can be working 24/7 to kill the tumor. Most importantly, it offers a chance for durable remission since the immune cells are potentially active every day even if the patient is not actively receiving therapy.

Are there different types of immunotherapy?
Yes, some work by stimulating the anti-cancer immune cells while some work by removing the brakes that suppress the immune cells. Immunotherapy can also involve infusing the body with active anti-cancer cells that are made in the laboratory, although this type of immunotherapy is still in clinical trials and not yet available for everyone.

What type of immunotherapy did President Carter have?
President Carter is receiving a drug that removes the brakes from the immune system (a “checkpoint inhibitor”), to allow his own immune cells to have more strength to fight against the cancer cells. The specific drug is he received is called pembrolizumab (trade name Keytruda); however, there are other drugs that work in similar ways and can be as successful.

Does Massey offer immunotherapy treatment options?
Massey offers all types of FDA-approved treatment options, including pembrolizumab, nivolumab, ipilimumab and talimogene laherparepvec (a virus that kills tumor cells and stimulates the immune system), among others.  Additionally, Massey is the only provider in Richmond offering Interleukin-2 (IL-2) therapy, an immune stimulant to treat advanced melanoma and kidney cancer. Click here to learn more about IL-2 therapy.

Who is a candidate for this type of treatment?
Most cancer patients can undergo these treatments. With the exception of IL-2, they are outpatient treatments and cause no immediate side effects.  They can cause unusual and serious side effects in the long-term, so good communication with the physician is crucial to ensure that the side effects are treated immediately.

For what cancer(s) is immunotherapy the best option?
Currently there are FDA-approved immunotherapies for patients who have advanced metastatic melanoma, kidney cancer and lung cancer. Ongoing clinical trials have suggested favorable results in some additional tumor types, so perhaps in the near future patients with other cancer types can also benefit.

Are there any clinical trials currently available at Massey for immunotherapy options?
Yes, there is an immunotherapy clinical trial available for melanoma patients, and Massey will soon have one opening up for breast cancer.

Giao Q. Phan, M.D., F.A.C.S., is a member of Massey’s Developmental Therapeutics research program and clinical investigator focusing on immunotherapy. Additionally, she is associate professor in the Department of Surgery’s Division of Surgical Oncology at the VCU School of Medicine. 

Aside from immunotherapy, Dr. Phan also specializes in melanoma, endocrine tumors and breast cancer. Prior to joining Massey, she was a surgeon and faculty member of the immunotherapy team at the National Cancer Institute (NCI) Surgery Branch, where she was an associate investigator in clinical trials involving state-of-the-art cancer treatments, including adoptive cell therapy for advanced cancers, particularly melanoma. 

Written by: Liza Janssen

Posted on: December 9, 2015