Immunotherapy and Jesus Christ Superstar

Life has many of those incidents that change your life.  In University I stumbled upon auditions for Jesus Christ Superstar and Chicago.  I got parts (chorus type), due to the fact that not many guys auditioned.  Afterwards, I tried writing and directing.  I wrote a play (musical) thereafter, which was really, really, bad.  (At least, so I was told by one person I showed it to, the other person I showed it to liked it, but I think she was just being nice.)

The play was a musical, where the main character had HIV.  It was part comedy, part drama, and  part informative science.  There were two separate stories intertwined- one was the main story ‘real life’, and the other was a story of cops, army, intelligence, foreign armies, and home-grown terrorists (which were supposed to represent CD8+ T cells, B cells, CD4+ T cells, bacteria and malignant cells respectively.)  HIV (which kills or inactivates CD4+ cells, essentially inactivating the bodies ability to respond appropriately) was like massive budget cuts…..  Anyway, it’s clear I made a good choice NOT trying to make it in theatre :).

Immunotherapy or vaccines or other modalities to turn the immune system on has been one of the most promising avenues for cancer treatment over the past couple of years, and with drugs being approved in lung cancer treatment – such as Opdivo (nivolumab), and Keytruda (pembrolizumab), there is hope that we are just beginning to unlock the potential of these drugs and this avenue of treatment.

Basically, some cancers appear to be able to grow – i.e. the ‘home grown terrorists’ that are cancer cells are allowed to expand – because they have found a way to turn off the immune response in the tumour -i.e. they’ve paid off the local cops.  If we give a drug that turns off this ability (i.e., we confiscate the cash/freeze the assets), then we might be able to make those lazy cops active again, and fight the cancer.  (if you a police office reading this, please don’t be offended).

The problem with these drugs – different drugs having different problems, is that sometimes we WANT the immune system to be turned off, and if we give a drug that makes the immune system more active (i.e. really stimulates the cops), and there is the possibility that they will not only fight the cancer, but also harass some of the local ‘good guys’ – such as the gut, skin, lungs etc.  So the drugs have potential side effects.

We are working on our patient information/education, as well as education for all of the people who might contact a lung cancer patient in terms of immunotherapy toxicities.  I promise I won’t try to make the education materials be in ‘musical theatre’ format.