That’s when the oncologist told her about a clinical trial just getting underway, of a medication called ipilimumab. The drug’s mechanism of action was entirely new: Instead of attacking cancer cells (like chemo), or indiscriminately revving up the immune system (like IL-2), ipilimumab blocked a single receptor on one type of immune cell.
“Would you like to try it?” the doctor asked.
“The choice was to do nothing and die, or take a chance,” Belvin recalls. “It was the easiest decision I ever had to make.”
In September 2005, she received the first of four 90-minute infusions, spread over a 12-week period. The only adverse effect was a daylong spell of shaking and sweating. Soon, she felt well enough to walk her dog again. Her tumors were shrinking dramatically, and they kept doing so for months after her final session.
By September 2006, they’d vanished. After declaring Belvin in remission, the oncologist introduced her to the man behind ipilimumab, immunologist James P. Allison. Belvin burst into tears. Then she hugged him so hard, she nearly knocked off his glasses.
Moon Shot Man
That was Allison’s first encounter with a patient whose life he’d helped to save, and he still chokes up when he recalls the moment. Over the past decade, he’s been the recipient of many such embraces — as well as an array of honors, including the 2015 Lasker-DeBakey Clinical Medical Research Award, often a precursor to a Nobel Prize. The class of medications that he conceived, known as immune checkpoint inhibitors, works counterintuitively: By turning off one of the immune system’s built-in safeguards, the inhibitors allow T cells — the system’s foot soldiers — to attack tumors more effectively.
“Jim’s work has really allowed immunotherapy to become a game changer for patients with cancer,” says Elizabeth Jaffee, deputy director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Since approving ipilimumab five years ago, the Food and Drug Administration has OK’d two similar drugs — pembrolizumab and nivolumab — for melanoma and certain lung cancers. Dozens more are in development. At oncology conferences, speakers use the phrase “paradigm shift” when discussing these therapies.
Checkpoint inhibitors already produce unprecedented rates of long-term remission for a handful of hard-to-treat cancers, but their potential is even greater: Because such drugs modify the body’s response to cancer, rather than the cancer itself, they could theoretically be effective against almost any kind of malignancy.
As with any good bluesman, however, Allison’s sense of fun is informed by tragic experience.
Allison’s brainchild — and the pioneering research that led to its birth — has brought him a renown that’s rare among his peers. “He’s one of our rock stars,” says Jaffee. Yet at 67, he remains true to his bar-band roots — literally. Allison has played in blues-rock groups since his 20s, and he currently fronts an all-cancer-researcher combo called the Checkpoints. Round-faced and rotund, with long, gray hair and a scruffy beard, he blows harmonica and contributes occasional vocals, belting out classics like “Big Boss Man” in a gravelly baritone.
In his day job, at the University of Texas MD Anderson Cancer Center in Houston, Allison serves as chair of the immunology department, deputy director of the David H. Koch Center for Applied Research of Genitourinary Cancers and executive director of the immunotherapy division of the Moon Shots Program, a multidisciplinary effort tackling cancer mortality. In his cluttered office, a Willie Nelson poster hangs amid the diplomas and trophies — a memento of a long-ago jam with the master. In conversation, Allison can seem shy and distracted until he gets onto a topic that excites him. Then, his eyes sparkle, and the words come at warp speed.
“I just like to have fun with it,” he says when asked about his music, and he speaks of his scientific pursuits in almost identical terms. As with any good bluesman, however, Allison’s sense of fun is informed by tragic experience. To grasp the passion that drives his work, it helps to glimpse the pain that shaped his youth.
Confronting Cancer at an Early Age
Allison grew up in the small oil town of Alice, Texas, the youngest of three brothers. His father was a country doctor, his mother a homemaker. She was seriously ill for several years, but no one mentioned that she had lymphoma until shortly before she died — with Allison, who was 11, holding her hand. “I saw the burns on her neck from radiation treatment,” he recalls, “but I didn’t know what they were. Back then, people didn’t talk about cancer.”
Over the next few years, Allison watched an uncle die of melanoma, and another of lung cancer. Meanwhile, he began showing an obsessive interest in science — as well as a rebellious streak. He got in trouble for talking out of turn and playing hooky. When he learned that his high school biology teacher refused to teach evolution for religious reasons, he boycotted the class. A counselor suggested he take a correspondence course from the University of Texas instead. Studying solo in a room near the gym, Allison stoically bore the taunts of jocks and coaches.
He graduated early, at 16, and enrolled at UT Austin as a premed. Soon, though, he realized that he didn’t want to follow in his father’s footsteps. “I thought how scary it was to be a physician and have someone’s life in your hands,” he says. “In medicine, you have to be right all the time. In science, you learn by being wrong.” He wound up with a bachelor’s degree in microbiology, and he went on to earn a Ph.D. in biological science.