Nobel Prize in Medicine awarded to researchers for cancer breakthrough

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Japanese scientist Tasuku Honjo, who jointly won the Nobel Medicine Prize with James P Allison of the U.S., is credited for his discovery of a protein that contributed to the development of an immunotherapeutic drug, opening a pathway for an altogether new way of treating cancer.

The 9-million-kronor (US$1.01 million) prize will be shared by James Allison of the University of Texas and Tasuku Honjo of Kyoto University.

Lower left: Antibodies (green) against CTLA-4 block the function of the brake leading to activation of T cells and attack on cancer cells.Upper right: PD-1 is another T-cell brake that inhibits T-cell activation. By releasing this brake, the body's own immune system can be stimulated to attack tumors.

The pioneering work of Allison and Honjo led to the development of several drugs, including ipilimumab (Yervoy), the first immunotherapy drug, and the PD-1 inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda). In a series of experiments, Honjo showed that PD-1 also works as a T-cell brake, but operates in a different way.

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Although the concept of using the immune system against cancer arose in the 19th century, initial treatments based on the approach were only modestly effective.

"The booming field of immunotherapy that these discoveries have precipitated is still relatively in its infancy, so it's exciting to consider how this research will progress in the future", said Charles Swanton, Cancer Research UK's chief clinician. "It was one of those moments when we figured out that CTLA-4 was the brakes on the immune system". Rather than targeting the activation of the immune system or the tumour cell itself, both focused on removing inhibitors of the immune response - a potential reason why this treatment has succeeded where so many others have failed.

Other cancer treatments have previously been awarded Nobel prizes, including methods for hormone treatment for prostate cancer in 1966, chemotherapy in 1988 and bone marrow transplantation for leukaemia in 1990.

In 2012, a pivotal study demonstrated clear results for patients with different types of cancer.

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Tasuku Honjo was born in 1942 in Kyoto, Japan. "The immune system was neglected because there was no strong evidence it could be effective", said Nadia Guerra, head of a cancer laboratory at Imperial College London.

"It's a great, emotional privilege to meet cancer patients who've been successfully treated with immune checkpoint blockade", he added.

They are the first Nobel Prize winners of the year, as medicine or physiology is the first of five categories to be given out this week. American James Allison and Japanese Tasuku Honjo were awarded the honourable prize by the award-giving body.

Allison and Honjo "established an entirely new principle for cancer therapy", according to a press release from the Nobel Assembly.

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