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Practical Aspects of Immunotherapy… is Kenya Ready?
Moderator: Dr. Amina K Habib, Medical oncologist, Aga Khan University Hospital, Mombasa
- Dr. Andrew Odhiambo, Consultant Physician, and Medical Oncologist, Head, Thematic Unit of Medical oncology & Lecturer, University of Nairobi.
Immunotherapy is a form of cancer treatment that uses the power of the body’s own immune system to prevent, control, and eliminate cancer. William Coley is known as the “father of immunotherapy”, where he successfully used Coley’s toxin to treat cancer patients. Immune checkpoint inhibitors are the most common immunotherapies, including PD1/PDL1 and CTLA4. The demand for immunotherapy treatment is increasing and the expertise in Kenya is growing. This treatment has a minimum toxicity profile, where the colitis associated with immunotherapy is immune-mediated and not an infection. The high cost of treatment is a major challenge to the use of immunotherapy since the patients bear the cost of the drugs, hence the need for the Kenyan government to work with the manufacturers to bring the prices down. Additionally, the treatment is not available in public hospitals in Kenya, and there is a need to lobby for their availability in public referral hospitals. There are few clinical trials in oncology in Kenya. Oncologists need to do more research to generate data and to publish the outcomes, in addition to building capacity for clinical trials in Kenya. Aga Khan is undertaking a clinical trial that is studying biomarkers that can predict response to immunotherapies. This will guide the choice of patients who would benefit from immunotherapy treatment. Before using immunotherapy as the first line of treatment for non-small cell lung cancer, one has to check the presence of mutations that may give inferior benefits to the patients. Immunotherapy and chemotherapy combinations have no effects on neutropenia. Generic immunotherapy and biosimilars are also effective in the treatment of various forms of cancers. Chimeric Antigen Receptor engineered T cells (CAR T cells) are a form of immunotherapy used to treat aggressive relapsed and relapsed non-Hodgkin’s Lymphoma. Unfortunately, they are very expensive.