A medication based on monoclonal immunotherapy recommended by the oncology staff at the Gregorio Marañón Hospital in Madrid meant the exit from the tunnel after months of chemotherapy, which in Cristina’s case was damaging the body without canceling the tumor. «I started to study and get advice and they told me that there were other options such as monoclonal antibodies and clinical trials already tested in people. Not only did I go to Gregorio Marañón, before I also went to other centers such as the Quirón Clinic, the Clara Campal Oncology Center, the Anderson Cancer Center in Madrid, the Vall d’Hebron Hospital in Barcelona and the Boadilla del Monte University Hospital because I was already looking for even phase 1 trials given my situation of imminent death,” says Cristina. «I had to decide it by myself. Your family supports you, your doctor tells you what is best, but you have to make the decision. “I trusted my oncologist, Aitana Calvo, who is the person who saved my life,” she recalls.

«Initially, the mixture of the two medications caused a harmful reaction to the liver – liver failure – after two sessions, but the tumor shrank by 30%, so my oncologist suggested that in case my liver failed, recovered he was going to try to get the compassionate use of medicine less harmful of the two,” he continues. Something that has allowed the laboratory that manufactures the medicine to pay for Cristina’s treatment.

Regarding the side effects of the treatment, Cristina explains that they depend largely on the specific patient, although in her case she cites «dry skin and fatigue» after each session before the overstimulation of the immune system which it supposes. «The first or second day after each session, your body has just taken off the brakes so that it attacks the cancer and it is like crazy, it is accelerated. It’s like when you get the flu and the first day you are devastated, your body is defending itself from the disease and you don’t have much energy,” she explains graphically. Something that, in his words, “is nothing” compared to the hard experience of having gone through chemotherapy. «It’s wonderful, I can’t say anything bad. The analytics What they do to me gives great results. It may raise your sugar a little, but nothing more. I don’t have diabetes, I don’t have cholesterol, these are wonderful results. It is true that I have to be careful with my liver, but I have the tumor in this organ, so it is evident that I must maintain exhaustive control of the liver. feeding, but I can have a normal life. That’s why I will always recommend immunotherapy before chemotherapy,” Cristina firmly states, whose positive mood is contagious.

Its treatment, whose value can amount to about 220,000 euros per year Currently, it is based on the sessions to which every fifteen days has to submit. These consist of one hour of treatment plus a quarter of an hour of serum before and after of the same. A method that presents excellent prospects in the treatment of melanoma, the type of tumor for which it is specifically indicated. «They gave it to me because I have microsatellite instability. “I think I am one of the two or three people in Spain who have been able to be treated with this medication because they have this specificity,” he points out in this sense, since currently there is no immunotherapy treatment focused on colorectal cancer. «I hope they can continue advancing in this line of research, there is a lot of ignorance and I encourage anyone to find out about possible alternatives to an unfavorable treatment. A trial can be used so that in the future specialists can calibrate the treatments 100%. You have to be altruistic too. If I hadn’t thought about that, I wouldn’t have saved myself,” Cristina concludes.

Determine which patients it works for

“We are already applying immunotherapy in many tumors as the first line of treatment,” he points out. Aitana Calvo, Cristina’s oncologist and scientific secretary of the Spanish Society of Medical Oncology (SEOM). «What is very important to highlight is that not in all situations it works this treatment. It is giving very good results in some tumors in which chemotherapy was not working, such as melanoma. It is one more treatment that is added to those we already had, but that does not mean that chemotherapy should be stopped,” he explains.

«Patients generally do not have problems being treated with immunotherapy. Many of them have heard about these treatments and when they are informed they do not show any problems, since in general the Adverse effects are much smaller. Most patients do not notice anything except slight fatigue. You talk to that same patient about the chemotherapy he has received before and it is incomparable. It is true that serious adverse effects occur with immunotherapy in a small percentage of patients who normally respond well. These are autoimmune adverse effects, since the immune system is activated too much and just as it acts against the tumor, it also acts against important organs such as the liver, thyroid or colon. “That must be identified and treated,” he says.

«There are many types of immunotherapy, what has now been awarded is the underlying mechanism of a very specific type of immunotherapy that has changed the natural history of some diseases. “Patients are living longer,” he says. «The treatment is much less aggressive than chemotherapy or radiotherapy. With the chemotherapy everyone has cumulative side effects. It is very difficult to continue beyond two or three cycles because there are many accumulating toxicities. This does not happen with immunotherapy, although it is true that we do not know how long the patient should remain on this treatment because we do not have data that tells us whether it is better to stop or continue. If we remove the brakes on the immune system we achieve a response towards the tumor and perhaps it is not necessary to stimulate this response for as long as in the case of chemotherapy. It is something that we still do not know exactly,” says Dr. Calvo.

“It should be noted that not all patients respond and progress. What is most important is to identify which patients are going to benefit from the effects of this type of treatment. They are very expensive treatments and above all, if we make a mistake we deprive patients of time and therefore opportunities to respond to the disease. Immunotherapy is commercially available only for some types of tumors. We are now focusing on the combined strategieson which many of the current clinical trials. For now they are very expensive treatments, but if they are useful they will become cheaper, so it is very important to select and specify in which case they will be effective,” concludes the doctor, who leaves the door wide open to new hope. against cancer.