Immunotherapy is a category of treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.
Currently, immunotherapy (also referred to as biologic therapy) is showing great promise in the cancer field as a way to treat certain cancers. Several immunotherapy drugs have been approved by the FDA to treat many types of cancer. Still, researchers continue to study many new immunotherapy drugs in hope of improving and expanding treatment options for many types of cancer.
Immunotherapy treatments are currently FDA approved for the treatment of:
- Melanoma
- Colorectal cancer
- Non-small cell lung cancer
- Head and neck cancer
- Bladder cancer
- Kidney cancer
- Hodgkin’s lymphoma
- Renal cell cancer
How Immunotherapy Works
As part of its normal function, the immune system detects and destroys abnormal cells and most likely prevents or curbs the growth of many cancers. Cancer cells do their best to get past the immune system’s ability to detect them as abnormal. Immunotherapy helps the immune system better identify, andact, against cancer cells.
This can be done in different ways, including:
- Stimulating the immune system to work harder or smarter so that it attacks cancer cells
- Giving the immune system additional components, such as immune system proteins, to enhance the immune response
Immunotherapy covers several different categories of treatments that work in different ways. Some treatments boost the immune system in a very general way, while others help train the immune system to attack cancer cells specifically.
Types of Immunotherapy
Many different types of immunotherapy are used to treat cancer. They include:
- Monoclonal antibodies, which are immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be better seen and destroyed by the immune system. Such monoclonal antibodies are a type of immunotherapy. These types of monoclonal antibodies may also be referred to as targeted therapy. Many monoclonal antibodies have been approved to treat a wide variety of cancers.
- Immune checkpoint inhibitors, which are a type of monoclonal antibodies that boost your immune system by inhibiting or stopping immune checkpoints. An immune checkpoint is normally used by the body to naturally stop the immune system’s response and prevent it from attacking healthy cells. Many checkpoint inhibitors are approved by the U.S. Food and Drug Administration (FDA) for specific cancers.
- T-cell transfer therapy, which is a treatment that boosts the natural ability of your T cells to fight cancer. In this treatment, immune cells are taken from your tumor. Those that are most active against your cancer are selected or changed in the lab to better attack your cancer cells, grown in large batches, and put back into your body through a needle in a vein. T-cell transfer therapy may also be called adoptive cell therapy (ACT), adoptive immunotherapy, or immune cell therapy. In 2017, two CAR T-cell therapies (a type of ACT) were approved by the FDA.
- Immune-modulating agents, which include:
- Cytokines— proteins that are made by your body’s cells. They play important roles in the body’s normal immune responses and also in the immune system’s ability to respond to cancer. The two main types of cytokines used to treat cancer are called interferons and interleukins.
- BCG (Bacillus Calmette-Guérin) — an immunotherapy that is used to treat bladder cancer. It is a weakened form of the bacteria that causes tuberculosis. When inserted directly into the bladder with a catheter, BCG causes an immune response against cancer cells. It is also being studied in other types of cancer.
- Cancer vaccines, which work against cancer by boosting your immune system’s response to cancer cells. Cancer treatment vaccines are different from the ones that help prevent disease. You do not take this vaccine while healthy to prevent cancer from developing.
- Oncolytic virus therapy, which involves introducing viruses that tend to infect and kill cancer cells but not normal cells. Oncolytic viruses can occur naturally or can be made in the laboratory by changing other viruses. Certain oncolytic viruses are being studied in the treatment of cancer. They may make it easier to kill tumor cells with chemotherapy and radiation therapy. The first FDA-approved oncolytic virus therapy is talimogene laherparepvec (T-VEC, or Imlygic®).
Side Effects of Immunotherapy
Immunotherapy can cause side effects, many of which happen when the immune system that has been revved-up to act against the cancer also acts against healthy cells and tissues in your body. The most common side effects of immunotherapy include:
- Skin reactions at the needle site, including pain, swelling, redness, soreness, itchiness, and rash
- Bacterial, viral, or yeast infection
- Swelling and fluid retention-related weight gain
- Heart palpitations
- Pneumonitis
- Endocrinopathies
- Hepatitis
- Flu-like symptoms, such as fever, chills, aches, weakness, dizziness, nausea or vomiting, fatigue, and headache
You should speak with your oncologist or cancer care team if any of these side effects are experienced so they can help you better manage them.
How to Access Immunotherapy
Today, the best way to access these new immunotherapies is through clinical trials. This is how new therapies are developed and it is a safe way for patients to have access to the newest, most promising treatments.
Numerous clinical trials are available at Affiliated Oncologists. These clinical trials explore new immunotherapies and new uses for existing immunotherapies, including for the treatment of early-stage breast cancer.
Our physicians are dedicated to learning about and shaping the newest findings in cancer treatment, and as a result, are able to extend the latest in high-quality care to our patients as soon as new options become available. If you are in the suburban areas of Chicago and would like more information, you may speak to your oncologist about available cancer clinical research trials.