James P Allison and Tasuku Honjo win Nobel prize for medicine

 

Two scientists who discovered how to harness the body’s immune system to fight cancer have won the 2018 Nobel prize in physiology or medicine.

James Allison, of the US, and Tasuku Honjo, of Japan, will share the 9m Swedish kronor (£775,000) prize, announced by the Nobel Assembly at the Karolinska Institute in Stockholm.

The scientists’ groundbreaking work on the immune system has paved the way for a new class of cancer drugs that are already dramatically changing outcomes for patients. It is the first time the development of a cancer therapy has been recognized with a Nobel prize.

The immune system normally seeks out and destroys mutated cells, but cancer finds sophisticated ways to hide from immune attacks. One way is by ramping up braking mechanisms designed to prevent immune cells from attacking normal tissue. In the 1990s, Allison discovered the first of these built-in brakes, known as checkpoints. Other teams were investigating the potential of enhancing the action of checkpoints to treat autoimmune diseases, but Allison showed that doing the reverse – switching off the brakes – could produce remarkable results in treating mice with cancer.

Independently, in 1992, Honjo discovered a second checkpoint that worked through a different mechanism and treatments based on this work have produced dramatic improvements to patient outcomes in the clinic.

The idea of mobilizing the immune system to tackle cancer was first proposed more than a century ago, but it was only after the discoveries of Allison and Honjo that this tantalizing possibility could be turned into a clinical treatment.

The resultant drugs, known as checkpoint inhibitors, have significant side effects but have been shown to produce remarkable results in treating lung cancer, renal cancer, lymphoma, and melanoma.

The Nobel assembly’s summary said Allison, who is professor and chair of immunology at the University of Texas’s MD Anderson Cancer Center, “studied a known protein that functions as a brake on the immune system. He realized the potential of releasing the brake and thereby unleashing our immune cells to attack tumors. He then developed this concept into a new approach for treating patients.

A large number of checkpoint therapy trials are currently underway against most types of cancer.

Allison’s former colleague, Prof Sergio Quezada of University College London, watched the Nobel prize announcement along with other former labmates at a cancer conference in New York. “The work that Jim and Honjo did was so seminal that people had been waiting for a few years for it [to win a Nobel],” he said.

Prof Dan Davis, of the University of Manchester and author of The Beautiful Cure, a book that describes the work that led to today’s prize, said: “I’m so thrilled that a Nobel has been awarded for this game-changing cancer therapy. It doesn’t work for everyone but lives have been saved, and it has sparked a revolution in thinking about the many other ways in which the immune system can be harnessed or unleashed to fight cancer and other illnesses. I think this is just the tip of the iceberg – many more medicines like this are on the horizon.”

The Nobel prize in physics will be announced on Tuesday, followed by chemistry on Wednesday, peace on Friday and economics on Monday. The literature prize has been canceled this year following allegations of sexual misconduct.

 

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