Psychoneuroimmunoloy as a missed opportunity in immuno-oncology drug development

Immuno-oncology drugs stimulate the immune-system of the patient to fight cancer cells. These effects might be enhanced by using Pawlowing conditioning of external stimuli to the drug. For example, Pawlow demonstrated that by exposing dogs (cf patients) to the ringing of a bell  (eg white coat of clinician) during feeding time, the unconditioned reaction of saliva production (cf immune response) with food (cf drug ) was associated with the ringtone of the bell (eg white coat of the clinician).

The field of psychoneuroimmunology has pointed out multiple pathways how responses of the immune system may be conditioned to external stimuli. By training the patient’s immune system to associate selective external stimuli (eg shapes and colors, music, smells, tastes or textures) with the immune response one could strengthen the drug effect, for example, by using super-stimuli (eg replace red-white striped computer screen in white room by room covered with red-white stripes) to trigger a stronger immune response. Alternatively, one could reduce the drug dose by the conditioned stimuli, which may be able to reduce the drug side effects while maintaining the main effect. This would also may offer some application for use of virtual reality, which could at least allow to vary the audiovisual stimuli.

This hypothesis could be tested rather easily in animal experiments, since conditioning should work in animals similarly to humans.

This would be a paradigmatic shift in the drug development by putting the patient in an active role in treating his own disease while the integrated concept of drug treatment would be in an empowering supportive role.

While I am very positive regarding the feasibility  of this approach, I am less positive that this can be turned into a marketing concept interesting to the pharma industry….

McDonald, P. G., O’Connell, M., & Lutgendorf, S. K. (2013). Psychoneuroimmunology and cancer: A decade of discovery, paradigm shifts, and methodological innovations. Brain, Behavior, and Immunity30(0), S1–S9., LINK: