Bobak Parang in the Los Angeles Review of Books:
“No cancer patient should die without trying immunotherapy” is a refrain in oncology clinics across the country right now. A treatment consisting of antibodies that awaken the immune system to attack cancer, immunotherapy carries far more promise than chemotherapy, and it has considerably fewer side effects. Since the FDA’s first approval a decade ago, it has revolutionized cancer care. Consider Stage IV non-small cell lung cancer. Twenty years ago, when the only option was chemotherapy, oncologists could tell their patient, with almost 100 percent certainty, that they would not be alive in two years. Today, miraculously, many patients with Stage IV lung cancer are alive five years after diagnosis — and some are even cured.
But the rub is that this immunotherapy revolution applies only to a narrow set of patients. Some benefit, but the majority do not. And patients who are cured constitute an even smaller minority. Why is this?