Convergence in Healthcare is a movement to bring the sciences together in a deeply collaborative way to solve the world’s most pressing health issues. In a 2016 whitepaper, Massachusetts Institute of Technology (MIT) academics defined Convergence in Healthcare as “an approach to problem solving that integrates expertise from life sciences with physical, mathematical, and computational sciences, as well as engineering.” Even though the medical community has yet to declare broad public support for the movement, a convergent approach to medical research is naturally occurring in the work of some of the most brilliant minds in medicine.
A shining example of this is shown in the work of James P. Allison, PhD, and Tasuku Honjo, MD, PhD. The convergent work Allison and Honjo performed earned them the 2018 Nobel Prize in Physiology or Medicine for their discovery of cancer therapy that works by harnessing the body’s own immune system.
Decades of Work Converge
While working separately, the men made groundbreaking parallel discoveries. Their efforts led to the successful application of a new realm of cancer treatment — immunotherapy, or “immune checkpoint therapy.”
Both scientists’ work centers on the discovery of methods allowing the release of biological check points. These check points restrict what the immune system’s “fighter” T-cells can attack and are therefore also referred to as “brakes” on the T-cells.
The immune system applies the brakes to prevent T-cells from attacking healthy tissues while they are fighting off harmful and foreign objects present in the body. Unfortunately, cancer cells are unique in that they are formed from the uncontrolled growth of the body’s own cells. This allows them to develop and spread without alerting T-cells to strike.
Allison and Honjo hypothesized that releasing specific immune system brakes would allow T-cells to recognize, attack and destroy cancer cells in a patient’s body. Essentially, the patient’s own immune system becomes a weapon against the disease.
Allison, chair of the department of immunology at MD Anderson Cancer Center in Houston, found a way to disengage the brake using a T-cell protein known as CTLA-4. He and his colleagues saw success in mice test subjects as early as 1994.
However, a clinical study from 2010 truly showed the effectiveness of Allison’s method. A study of a small group of patients battling advanced melanoma diagnoses saw the remaining signs of the cancer in their bodies completely eradicated through the targeting of CTLA-4.
Concurrently, Honjo focused on a T-cell protein he discovered in 1992 known as PD-1. Over a period of years, Honjo experimented with PD-1, eventually noting its power as a T-cell brake. He is distinguished professor, Kyoto University Institute for Advanced Study, and professor of immunology and genomic medicine at Kyoto University in Japan.
After years of development, PD-1 was a target in a clinical trial resulting in cases of long-term remission in cancer patients. There is also evidence suggesting PD-1 could form the basis of a possible cure for patients living with previously untreatable metastatic cancer.
Cancer Immunology’s Future
Immunotherapy will serve as a supplemental treatment method to current standard treatments such as chemotherapy, radiation and surgery, increasing the likelihood of success when combined with other therapies. It is also considered to be one of the last best hopes for successful treatment in cases where a patient’s illness does not respond to any other method.
Many distinguished research institutions in the United States have produced think pieces which explore the possible directions in which cancer immunology can go from here. However, there is only one thing which is known for certain: convergence is the key.
Pursuing cancer immunotherapy to its fullest extent will require collaboration between scientists from all sectors designated as crucial to the Convergence in Healthcare movement. This will enable researchers to explore the ways in which cancer immunotherapy and other promising treatments can be improved upon and made more effective for patients.