Two miracle workers win Nobel and save my life

Nobel prizes often come cloaked in ambiguity. We know that a Nobel laureate achieved something big, something forward-looking, yet we’re hard-pressed to explain exactly what it is and how it changed the world.

Not so for James P. Allison and Tasuku Honjo – at least from where I sat last week.

The two men, Dr. Allison from the United States and Dr. Honjo from Japan, share this year’s Nobel Prize in Physiology or Medicine for their years of research into using the immune system to detect and destroy cancer cells. Their separate efforts laid the groundwork for a new generation of immunotherapy drugs that now offer real hope to cancer patients who previously had none whatsoever.

I know this because I’m one of them.

Nestled in my comfy chair Friday morning at New England Cancer Specialists in Scarborough, reading about these two heroes while 240 milligrams of nivolumab drip-dripped its way into a vein in my right arm, it occurred to me that science is a wondrous thing. As are the men and women who devote their lives to it.

Science, let me be clear, is not my forte.

My most noteworthy scientific achievement to date came in the form of a huge, purple-tinted crystal I once grew in my high school chemistry lab. That is until the morning I came in to check on it, only to find that cooler-than-normal overnight temperatures in the lab had reduced it to a mere thread hanging in a jar of supersaturated saline solution.

“It happens,” my chemistry teacher said with a shrug. “It doesn’t take much to dissolve them.”

The next year, only a week or two into senior physics, good old Mr. Duddy asked me to stay after class one day. He’d help catapult my older brother into MIT, but the look on his face foreshadowed his message.

“This isn’t really working for you, is it?” he asked kindly.

“Not even close,” I replied.

“Let’s go down to the office and see what we can do with your schedule,” he suggested.

“Thank you, God,” I thought to myself.

In college, I dabbled briefly in geology (I love rocks) and plant propagation (free house plants), but by then the die was cast. Of the many potential paths stretching out before me, science wasn’t even on the map.

Not so for these two Nobel laureates.

Dr. Allison, 70, so loved biology that he took it via a correspondence course as a high school student in Texas.

Later, bolstered by a Ph.D. in biological science, he would go on to lay the groundwork for the development of “immune checkpoint inhibitors” – drugs, including my nivolumab, that essentially override certain “checkpoint” proteins that act as brakes on cancer-fighting T cells. Let up on the brake – or in Allison’s case, the CTLA-4 protein – and the T cells are free to go after certain tumors.

Dr. Honjo, 76, grew up in Kyoto, Japan. Criss-crossing between there and the United States over his 52-year career, he’s focused on another checkpoint, known as the PD-1 protein, and likewise enabled stalled T cells to wake up and go to work.

Don’t be fooled. Endless reading about this stuff, along with detailed tutorials from my cancer docs, may give you the impression that I know what I’m talking about here. But the truth is I’m as clueless about how this stuff really works as I was back when Mr. Duddy started explaining the difference between vectors and scalars.

I’ve never laid eyes on a T cell, let alone a CTLA-4 or PD-1 immune checkpoint. And how these geniuses manage to spot them, not to mention inhibit them, will forever be a mystery to me.

But this I do know: Back in 2015, when I was first diagnosed with metastatic melanoma in my armpit, brain, stomach and lung, to name the most prominent hot spots, my surgeries and radiation were immediately followed by the very immunotherapy drugs that grew out of Allison’s and Honjo’s exhaustive research.

“Oh, you mean you’re now on chemo,” people would tell me.

“No,” I’d reply. “Not chemo. Immunotherapy. It’s newer. It uses your own immune system, rather than toxic chemicals, to go after the cancer.”

I wasn’t kidding about the “newer” part. Nivolumab was approved by the federal Food and Drug Administration for treatment of melanoma in December 2014, a mere month before my diagnosis.

Eight months of treatment back then put me in partial remission. Now, after the discovery of a new tumor last spring, I’m back on nivolumab, known commercially as Opdivo. And by all indications, it’s working again.

Unlike physicians who actually treat patients, researchers like Allison and Honjo toil away in laboratories and rarely witness the fruits of their labors firsthand.

But according to The New York Times, that changed one day in 2006 for Allison when Dr. Jedd Wolchok, a cancer specialist at Memorial Sloan Kettering Cancer Center in New York, called Allison at his nearby lab and urged him to come over to the clinic.

Upon Allison’s arrival, Wolchok introduced him to a young woman. She’d almost died from melanoma, but after four doses of ipilimumab, the immunotherapy drug Allison developed, she was now cancer-free.

“Dr. Allison wept,” the Times reported.

To be sure, much more work remains before any and all cancers, with their confounding mutations and genetic complexities, someday join the litany of once-horrific diseases now largely consigned to history.

Still, last week was as good a time as any to look up at that little bag hanging from my IV pole and give thanks for the men and women out there who dedicate their entire professional lives to helping people they’ll never meet. People like me.

How Drs. Allison and Honjo found their way to these miracles, I’ll never fully comprehend. Heck, I can’t even grow a decent crystal.

But I’m certain of one thing. These science guys saved my life.

Bill Nemitz can be contacted at:

bnemitz@pressherald.com