Cancer by Florent Pagny: what is immunotherapy, the treatment that the singer will follow?

Cancer by Florent Pagny: what is immunotherapy, the treatment that the singer will follow?

“It is important to remember that it is essential to follow the prescribed treatment until its end and without interruption. This is true for any pathology, and particularly for cancer! Like many people, immunologist Sandrine Sarrazin has heard confidences of Florent Pagny on TF 1this Sunday, March 5 in the evening.

While he thought he was in remission from his lung cancer after undergoing long chemotherapy, the singer learned that a lymph node had appeared, “which means that there is a risk of metastasis”.

“If I had followed the planned program, maybe…”

The fault of his refusal immunotherapy treatment when he left France for his residence in Patagonia, five months earlier? It is possible, although no one will ever be able to prove it. “If I had followed the planned program, maybe… It’s a bit my fault”, confided the former juror of the telecrochet “The Voice”. Interviewed in January, he then planned to “return quickly” to seek treatment in Paris.

When we talk about treating cancer, whether of the lung or another organ, we immediately think of chemotherapy. Chemical molecules attack very harshly the cells which multiply, whether they are cancerous or not, “a bit like an assault tank which destroys everything in its path”, illustrates Pr Nicolas Girard, oncologist and pulmonologist at the Institute. of the Curie Montsouris thorax.

Hence the many side effects, the most spectacular presumably being hair loss.

“Breaking down the mask” to cancer cells

At the same time, immunotherapy is developing more and more. It even becomes “almost as important” as chemotherapy, says Cyrille Cohen, director of the immunotherapy laboratory at Bar Ilan University (Israel). “It’s a revolution” in the fight against lung cancer, enthuses Jean-Emmanuel Bibault, doctor-researcher in oncology.

Its principle? Antibodies are injected which will stimulate our T lymphocytes (also called white blood cells) and allow them to detect cancer cells, before attacking them either by destroying them or by preventing them from developing and spreading.

“It’s been in development for about 20 years and it’s a complete paradigm shift. Instead of going directly to kill the cells without distinction, we will educate the immune system so that it recognizes the cancerous ones itself,” develops Sandrine Sarrazin. “Sick cells have a kind of mask around them, which makes them invisible. In a way, the immunotherapy antibodies make them drop the mask”, describes Nicolas Girard.

Support is quite cumbersome in practice. Generally, this involves an injection as an infusion for a few hours in the hospital every two or three weeks. Another technique under development consists of recovering a patient’s T lymphocytes, educating them so that they effectively target cancer cells, and then reinjecting them into the body.

“You still have to be sure of having universal and specific markers for such cancer, against which to train the T lymphocytes”, points out Nicolas Girard. This area is the subject of much research, notably at the Institut Curie.

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Immunotherapy is more or less effective depending on the organ affected, the patient’s profile, when it starts, etc. It therefore works rather well against lung cancer – implemented after a combined radiotherapy and chemotherapy phase, it “halves the risk of relapse”, indicates Nicolas Girard – but also against that of the skin.

Conversely, this support “works very little against prostate cancer, for example, completes Jean-Emmanuel Bibault. It all depends on the number of mutations, which make it easier to distinguish cancer cells from those that are still healthy. “Like when the police are looking for a thief in a crowd. The more the thief presents distinctive signs in his behavior or his outfit, the easier it is to detect him”, illustrates Cyrille Cohen.

However, immunotherapy will not work for everyone, for reasons that have yet to be clarified. Like any treatment, it also has possible side effects. This treatment can in particular cause autoimmune diseases, due to an overactivation of the immune system. It can also cause “problems with the thyroid or the digestive tract, such as diarrhea, but this is relatively rare”, describes Jean-Emmanuel Bidault.

“Our patients recognize themselves in celebrities”

If Florent Pagny resumes his treatment with immunotherapy as he indicated, it will not necessarily have effects for several months. But it could be useful, if ever metastases were to appear. And his speaking out should have a more global positive impact, says Nicolas Girard: “It is very interesting and important that light is shed on these issues through celebrities, because our patients recognize themselves in them. »

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