“First and foremost, if you combine immunotherapy with the standard of care, you can sometimes extend the benefits of immunotherapy because you’re providing an extra level of efficacy to help get over the hump,” says Goldstein. “For instance, when you combine immunotherapy with chemotherapy, in some tumour types, you get the benefit of rapid tumour control from the chemo, but then you have the immunotherapy that can encourage the immune system to respond to the cancer. You’ll get that long-term benefit from an immune system that continues to survey the patient’s system and eliminate any residual cancer.”

Because immunotherapy targets the patient’s immune system, you can also combine two different immunotherapies to target multiple parts of the immune system. For any individual patient, this combination strategy improves the chances that the treatment is targeting the correct part of the immune system that their cancer is using to hide.

According to Goldstein, “That’s exciting because the immune system is very, very complex. That means there are lots of different ways that any individual cancer may be using to hide, also lots of different ways that you can intervene with a drug. Sometimes, if your cancer is not responding to one immunotherapy, it’s because that particular therapy is targeting part of the immune system that the cancer isn’t necessarily leveraging. You might need a different immunotherapy, or you might need to put two of them in combination.”

Clearly, we need to get better at matching individual therapies to individual patients based on what their own anti-cancer immune responses look like. There are some, but not many, tests that can be done to see how a patient’s own cancer may be hiding from their immune system. Patients should never shy away from asking their health care team about the latest advancements and technology in cancer testing.