There is a small white tablet that millions of people in India and around the world take every day without much thought. Sold under the brand name 'Singulair' and generically as montelukast, it has been a first-line prescription for asthma and allergic rhinitis since the late 1990s.

It stops airways from narrowing and controls hay fever. It is cheap, widely available, and so well understood that doctors consider it one of the safest long-term medications on the market.

Now, a study published in the journal Nature Cancer suggests this familiar little tablet may have a remarkable second life — one far beyond the lungs.

The problem with immunotherapy

To understand why this discovery matters, it helps to understand both the promise and frustration of cancer immunotherapy. The idea is elegant: rather than bombarding the body with chemotherapy, train the immune system to recognise and destroy cancer cells on its own.

Over the past decade, treatments called immune checkpoint inhibitors have transformed outcomes for several cancers, including some melanomas and lung cancers, giving patients years of remission where there were once very few options.

But immunotherapy does not work for everyone. In some of the most aggressive cancers, including triple-negative breast cancer, tumours seem to shrug it off entirely. Triple-negative breast cancer accounts for between 20 and 31 per cent of all breast cancer cases in India — a significantly higher proportion than in Western countries — and predominantly affects younger, pre-menopausal women.

Its five-year survival rate in metastatic cases remains below 30 per cent. Understanding why immunotherapy fails in these tumours, and........

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