Sunday, September 25, 2016

CAP16 Scientific Plenary Session - The Immune Checkpoint Revolution in Cancer Treatment: "Moonshot" or "Pie in the Sky"

I'm attending the scientific plenary session at the 2016 annual meeting of the College of American Pathologists in Las Vegas. The discussion is being led by Dr. Lynette Sholl (pathologist), Dr. Christopher Lathan (medical oncologist), and Barry Nelson (lung cancer patient).  Although not directly related to neuropathology, the discussion of the role of biomarkers as a means of directing treatment impacts every area of surgical pathology -- including neuropathology. Mr. Nelson recounted his journey through immunotherapy. Dr. Sholl talked about the paradigm shift that has occurred in cancer therapy by virtue of harnessing T-cell mediated immunity, particularly related to PD-L1. Dr. Lathan, who is Mr. Nelson's physician, talked about his relationship with both the cancer patient and the pathologist. It was pointed out that everything starts with the diagnostic tissue; and the pathologist, as custodian of that tissue, is at the foundation of every patient's battle against cancer.  Importantly, Dr. Lathan pointed out that Mr. Nelson is a outlier. Most patients, at this point in our understanding of treatment, do not respond to immunotherapy. Finally, Mr. Nelson pointed out that he does not consider himself cured, but rather "healed". Thanks to immunotherapy, he lives with cancer rather than being cured from it. That relationship with cancer in itself is a paradigm shift, much like the one we have already gotten used to with regard to AIDS.

Left to right: Sholl, Nelson, Lathan

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