Using the Immune System to Target Cancer

When Ray Fitzgerald experienced shortness of breath while hiking, he thought he had a respiratory illness.  A former Navy pilot, Ray leads an active life and was anxious to return to his usual level of activity. He was totally blindsided when he received a diagnosis of lung cancer, and further devastated by the news that it had spread to his pancreas and possibly his brain.

Ray began chemotherapy, but his tumors didn’t respond to standard treatment and his health was deteriorating rapidly.  On a friend’s recommendation, he went to see Roy Herbst, MD, PhD, chief of medical oncology and associate director of translational research at Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven. He learned he was eligible for a clinical trial to test pembrolizumab, a drug helps the immune system fight cancer by blocking a pathway that prevents immune cells from destroying cancer cells.

In his case, the tumor responded to the treatment and he has been able to maintain his activities, including skiing. “I get so excited when someone comes for a return visit, because I really hope to see the tumor shrink or at least remain stable,” said Dr. Herbst. “In his case I knew he was feeling better just talking to him on the phone.”

Dr. Herbst is at the forefront of cancer research using immunotherapy, an approach that uses the body’s own immune system to kill cancer cells. Just a few years ago, patients like Ray had very few new options for treatment. Now Dr. Herbst and others are developing and testing new drugs that target specific pathways in order to harness the power of the immune system.

Every patient’s cancer is somewhat different in terms of what’s turned on or off in the genes of a particular tumor, explains Dr. Herbst.  “We need precision medicine: the right drug for the right patient at the right time,” he says. Yale offers a tumor profiling program at Smilow Cancer Hospital and the 12 cancer care centers around Connecticut in which each patient’s tumor is analyzed at our state-of-the art genomics facilities in order to match it to the right drug or combination of drugs. “Personalized medicine really is a game changer for the way we treat patients with cancer,” says Dr. Herbst.

Currently, only about 25% of lung cancers can be successfully targeted with immunotherapy. With the help of Ray and other cancer patients, however, Dr. Herbst and his colleagues are continuing to do laboratory research utilizing tumor specimens to uncover mechanisms of response and resistance, with the aim of helping more patients. “People become resistant to these drugs so we have to keep one step ahead of the cancer,” he notes. 

Bringing science to bear on the development of more effective cancer treatments and testing those treatments in clinical trials gives hope to cancer patients like Ray. “Yale Cancer Center is continually bringing new advances to our patients through clinical trial opportunities at Smilow Cancer Hospital,” Dr. Herbst says.  “These advances are giving patients new options and making a huge difference for patients in Connecticut and around the world.”


Ray Fitzgerald and Dr. Roy Herbst

Ray Fitzgerald and Dr. Roy Herbst

"Personalized medicine really is a game changer for the way we treat patients with cancer."