Respond to prefers-color-scheme dark in app web views

Follow section front redirects in Spectrum

Enable NLP source in PCS for load testing

Switch off the News Alerts Survey Widget when we have enough responses

Poll to determine if new LUF updates are available

Allows the winning A/B test variant to be turned on without Spectrum deployment

Show infinite scrolling sections in Assembler MultiView

Show option for NLP article summaries in Action Bar

A general feature flag for Recipe Features that aren't yet released

Feature flag for media team features that aren't yet released

Use new Orca video player for preroll plugin in Spectrum

Show the snow tracker (instead of the heat tracker) on Spectrum

Ask Amy: My boyfriend just confessed he’s almost $20,000 in debt

Miss Manners: Is it inappropriate to reach out to old girlfriends?

Carolyn Hax: Longtime friend won’t forgive being last-minute canceled for a guy

In photos: At least 39 dead as historic flooding hits southern Brazil

Sea level rise brings new era of dangerous flooding

Michael Cohen keeps broadcasting despite being a witness

Trump Media auditor charged by SEC with ‘massive fraud’

Google’s empire is massive. A judge will soon rule if it’s a monopoly.

Five tech products we actually like

The new cure-all for vacation excess: the IV drip 

What’s the best bus to New York? We tested 5 for comfort and value.

Adaptive equipment is making national parks more inclusive

The New York Times, alone in its outrage over access to Biden

The ‘Access Hollywood’ video cemented Trump’s air of invincibility

Stephen A. Smith would like even more of your attention

In a pinch, the Nationals finally find some offense

Is Pastis as good as our food critic thought? He sent spies to find out.

The Capitals, a team in transition, know what they want this offseason

Strangers help Sesame Street puppeteer after heirloom necklace was stolen

Teen grabs wheel when driver passes out and school bus veers into traffic

Cat climbed into Amazon return box, found alive 630 miles away

The Post endorses April McClain Delaney and Tom Royals for Maryland’s 6th District

On Press Freedom Day, little to celebrate for Hong Kong’s journalists

Young Georgians want to be part of Europe. Their government is in the way.

Confident of victory over Ukraine, Russia exhibits Western war trophies

Two women are seeking Mexico’s presidency. But the race is about a man.

Hamas in Cairo for hostage talks as Israel briefs aid agencies on Rafah

Biden confronts campus protests; Trump hedges on accepting election results

Kristi Noem just won’t stop talking about killing her dog

Noem’s dog-killing isn’t popular, though Trump supporters are divided

A new type of cancer drug designed to unleash the immune system is revolutionizing treatment for advanced melanoma, lung cancer and other malignancies. But some patients who initially respond to the therapy relapse, and researchers are anxious to figure out how and why the delayed resistance occurs.

"Does the immune system stop working, or does the cancer change so that it's no longer responding to the immune system?" said Antoni Ribas, director of the Jonsson Comprehensive Cancer Center Tumor Immunology Program at the University of California at Los Angeles.

New research by Ribas and others, published online Wednesday in the New England Journal of Medicine, provides some answers. The study, which outlines key mechanisms in how melanoma becomes resistant to immunotherapy, found that genetic changes in tumors allowed them to avoid recognition by the immune system or become less sensitive to its attacks.

"We are convinced that when late relapse occurs, it is the the tumor that has evolved and changed," Ribas said. "Now we have to figure out: What do we do about it?"

The UCLA study involved 78 patients treated with pembrolizumab, the drug given to former president Jimmy Carter. Forty-two of the patients responded but 15 relapsed. Of those, four met the criteria for inclusion in the study.

The researchers, led by Ribas and Jesse Zaretsky, a doctoral student in Ribas's lab, analyzed pairs of tissue samples taken from the individuals before they started treatment and after they relapsed. While the genomes of the post-relapse tumors were very similar to those of their initial tumors, researchers found some significant changes that allowed the cancer to fight back.

[Immunotherapy drugs prove their mettle against an array of cancers]

In one case, a tumor had lost a gene called B2M, making it harder for T cells, the workhorses of the immune system, to recognize the cancer. In two other cases, genetic mutations in the tumors interfered with genes called JAK1 and JAK2, which limited the immune system's effectiveness in killing cancer cells.

The fourth patient's tissue didn't have those genetic alterations, which indicates other mechanisms of resistance may be discovered in the future, Zaretsky said.

Cancer's ability to mutate and become resistant to treatments isn't new; the disease has long frustrated patients and physicians by rendering chemotherapy and targeted drug therapies impotent. But researchers are now intensely interested in how such resistance develops against the new class of immunotherapy agents called checkpoint inhibitors. These treatments don't attack the tumors themselves but instead spur the body's own immune systems to go after the cancer.

The UCLA researchers acknowledged that the study was small and that tumor resistance requires much more study. By learning more about the mechanisms involved, they hope to figure out how to combine treatments to delay resistance or block it entirely.

"This is part of an evolving story to examine why some patients do not respond to [immunotherapy] drugs, or why some patients respond at the beginning and later relapse," said Suzanne Topalian, director of the melanoma program at Johns Hopkins Kimmel Cancer Center. "Treatment resistance is a key issue now. We really need to understand it to improve the impact of these drugs."

About 30 to 50 percent of patients with advanced melanoma respond to checkpoint inhibitors, depending on whether they previously have been treated for their disease.

[Bloomberg, others give Hopkins big donation to research immunotherapy]

"We are at the start of a new field of study," said Ribas, who was involved in the original trial for pembrolizumab, also known as Keytruda. The drug drew worldwide attention last December when Carter announced that all signs of his advanced melanoma had disappeared. He had been treated with surgery and radiation as well as the drug.

Keytruda, made by Merck, is similar to another immunotherapy drug, Opdivo, which is manufactured by Bristol-Myers Squibb. Both block a protein called PD-1, which in turn allows the immune system to attack the tumors cancer.

The UCLA research was partly funded by the National Cancer Institute, Stand Up To Cancer and private philanthropy.

<a href="https://www.washingtonpost.com/news/to-your-health/wp/2016/07/06/leading-researchers-recommend-major-change-in-prostate-cancer-treatment/">Researchers recommend change in prostate-cancer treatment</a>

<a href="https://www.washingtonpost.com/news/to-your-health/wp/2016/04/18/six-key-things-you-need-to-know-about-immunotherapy-from-the-scientists-leading-sean-parkers-manhattan-project-for-curing-cancer/">Sean Parker wants to turn cancer into a chronic illness</a>

<a href="https://www.washingtonpost.com/newssearch/?query=ariana%20sean%20parker#page-3">Silicon Valley bad boy tries to tame cancer </a>

Part of Wall Street Journal team that won the 1997 Pulitzer Prize for national reporting on AIDS 

Syracuse University, BS in journalism

Laurie McGinley covers health and medicine for The Washington Post. She focuses on the Food and Drug Administration as well as cancer research and treatment. She was previously The Post's health, science and environment editor. 

Laurie McGinley

The Washington Post

Health Care

Medical Mysteries

Science

Well+Being

Health

prism://prism.query/site,/health&limit=20

The Washington Post health section provides coverage and analysis of health, healthcare, nutrition and fitness news.