The immune system is always geared up and ready to go. Certain immune cells have molecules—called checkpoints—that must be turned on or off to move the immune system from “ready” to “action.”
When this failsafe system doesn’t work, the immune system starts to attack normal organs. This can cause people to develop autoimmune diseases like inflammatory bowel disease, rheumatoid arthritis, some kinds of thyroid disease, and certain skin diseases.
These checkpoints typically work pretty well. But just like any security system they can be blocked, tricked, or overridden—and some cancer cells have figured out how to do just that.
A new class of cancer drugs called checkpoint inhibitors work by keeping the cancer cell from blocking the checkpoint. These drugs, which have been approved for certain types of cancers, are now being studied in breast cancer clinical trials.
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[00:00:06] Dr. Susan Love: I'm Dr. Susan Love, and I'm the Chief Visionary Officer of the Dr. Susan Love Research Foundation. Our mission is a future without breast cancer. We do that through innovative research into the cause and prevention of the disease. Impatient science is a series of videos that help explain to you breast cancer, how it works and what your choices and options are.
[00:00:28] Narrator: Clinical trials are studies that explore the safety and effectiveness of new treatments in fighting disease. For cancer patients, there are a multitude of trials studying a variety of treatments.
[00:00:39] Dr. Susan: For instance, if you have metastatic triple-negative breast cancer, you may want to consider trial studying new drugs called checkpoint inhibitors. These drugs unmask cancer cells, so they can be identified and destroyed by your immune system.
[00:00:54] Narrator: T cells, the foot soldiers of our immune system, use proteins called checkpoints to identify healthy cells. They check each cell to prevent our immune system from attacking normal, healthy tissues. Normal cells carry checkpoint proteins called PD-L1. When our T cells meet a healthy cell, the PD-L1 protein indicates that the cell is safe.
[00:01:16] Dr. Susan: Atezolizumab and avelumab are checkpoint inhibitors that block the PD-L1 protein, so cancer cells can be seen by the immune system.
[00:01:27] Narrator: There is another protein called PD-1 that serves a similar purpose. Pembrolizumab and nivolumab block the PD-1 protein, so the T cells can do their job. Ipilimumab is another type of checkpoint inhibitor. It blocks a protein on T cells called CTLA4, revving up the immune system to attack cancer cells. All of these drugs are given intravenously, and must be administered in a hospital, doctor's office or treatment facility.
[00:01:54] Dr. Susan: Checkpoint inhibitors to treat breast cancer are being tested in clinical trials.
[00:01:59] Narrator: Immunotherapy works much differently than chemotherapy, and its side effects are different too. Be sure to tell your doctor immediately if you experience flu-like symptoms, fatigue, fever, skin rashes, itching, gastrointestinal, thyroid or lung problems. In phase one and phase two studies, patients may be given a checkpoint inhibitor in addition to chemotherapy. In phase three studies, some patients will be randomized to receive chemotherapy alone, while others receive both chemotherapy and the checkpoint inhibitor. This allows researchers to compare their effectiveness.
[00:02:34] Dr. Susan: The women and men who take part in these studies are critical to helping us learn more about which tumors respond to these drugs and why.
[00:02:43] Narrator: Talk to your doctor, or look on breastcancertrials.org or clinicaltrials.gov for more information. Your participation will help breast cancer patients for many years to come.
[00:02:57] Dr. Susan: The Dr. Susan Love Research Foundation is dedicated to a future without breast cancer, and we do this through innovative research into the cause and prevention of the disease. We ask you to join us at drsusanloveresearch.org. You can participate in our research, you can support our research, because if we all work together, we can be the generation that ends breast cancer.
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