"Once I felt the tiny lump, I knew it was cancer," says Debra,* remembering the day, four years ago, when she noticed the pea-size tumor in her neck. A trip to the oncologist confirmed it: At the age of 40, Debra had stage IV non-Hodgkin's lymphoma. As a busy physician living in Los Angeles with three children under the age of 9, she was horrified when her doctor told her she'd likely be so sick from chemotherapy she wouldn't be able to get out of bed—and in any case would probably be dead within four years.
Debra is one of more than 79,000 Americans diagnosed each year with some form of lymphoma. Chemotherapy remains one of the first lines of treatment, but Debra, now 44, wanted to try something—anything—else. "I feared the chemo would be a temporary solution until the cancer killed me," she says. "I had to live, for my family."
At a colleague's recommendation, Debra enrolled in a small clinical trial at Stanford University in 2010—and became one of the first 60 patients to test a new cancer vaccine for lymphoma. The vaccine would introduce into her body a small piece of synthetic DNA that looked and acted like a virus; if all went well, her immune system would be fooled into thinking the tumor was an infection and spring into action to target and destroy the cancer cells.
Decades ago cancer immunotherapy was considered by some to be voodoo medicine. "Initial studies were not very effective, and many doctors thought it was a lot of hype with very few results," says James Gulley, MD, PhD, director of the clinical immunotherapy group at the National Cancer Institute (NCI). All that began to change in 2010, when the FDA approved the cancer vaccine Provenge to treat metastatic prostate cancer. The results from the clinical trials on Provenge were remarkable, giving patients an extra four months, on average, to live. And they didn't just live longer; they felt better, too. The findings were early proof that the body's own immune system could be a powerful weapon against cancer. Today potentially more effective and longer-lasting vaccine immunotherapies are being tested in more than 600 clinical trials as treatments for many of the deadliest cancers, including those of the ovaries, lungs, and breast.
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*Name has been changed