Why Can't T Cells Finish Off Cancer?
Peter Attia says T cells rarely mount a response strong enough to finish the job on their own, even when they already know a lethal tumor is not self. A couple of years earlier on his podcast, Steve Rosenberg shared data that 80% of solid organ tumors had novel neoantigens the immune system is able to recognize. Attia says the figure covers the cancers people think of as the really bad ones, breast, colon, lung, and pancreas. In his reading, T cells know the tumor is bad and it is not self.
Checkpoint inhibitors remove the brakes on the immune system and unleash the immune system on the cancer. Attia says the success of the class suggests immune cells at least have the potential to recognize cancer as non-self. The checkpoint drugs take only a subset of cases. Sometimes immune cells clear the cancer alone, and Attia says the event is very rare. He describes care as still wandering in the desert with cancers that are non-self and an immune system that cannot make the clearance happen.
