Immunotherapy

Immunotherapy may be used at different stages of cancer care, depending on the type and stage of cancer. If your care team recommends immunotherapy, it can be delivered in several ways:

• Intravenous (IV) infusion
• Oral medications (pills or capsules)
• Direct application into the bladder (for certain cancers)
• Topical creams (for some skin cancers)

Your oncologist will guide you on the approach that’s right for your treatment plan.

Benefits of Immunotherapy

Immunotherapy offers several potential advantages, including:

• More precise targeting of cancer cells, which may reduce damage to healthy tissue
• Effectiveness for certain hard-to-treat cancers, including those that have not responded to other therapies
• Potential to lower recurrence risk, by helping the immune system “remember” cancer cells
• Improved quality of life, with less invasive treatment options and, in some cases, fewer side effects

Possible Side Effects

Immunotherapy can cause side effects that differ from traditional treatments like chemotherapy. These may range from mild to more serious and vary depending on your treatment. Common side effects may include:

• Fatigue
• Flu-like symptoms
• Headaches
• Diarrhea
• Skin changes (dryness, redness)
• Shortness of breath
• Hormonal changes
• Changes in blood pressure
• Heart palpitations
• Weight changes

How does Immunotherapy Work?

Cancer cells are able to hide from your immune system, making it easier for them to thrive and multiply. Certain immunotherapies can mark cancer cells so a person’s immune system can find and destroy them.

This can be done in a few different ways, which include:

• Stimulating the immune system to work harder or smarter so that it attacks cancer cells
• Giving the immune system man-made components, such as immune system proteins

Immunotherapy includes 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 drugs that are designed to bind to specific targets in the body. They can cause an immune response that destroys cancer cells. Other types of monoclonal antibodies can “mark” cancer cells so it is easier for the immune system to find and destroy them. These types of monoclonal antibodies may also be referred to as targeted therapy.
• Adoptive cell transfer, which is a cancer treatment that attempts to boost the natural ability of your T cells to fight cancer. T cells are a type of white blood cell and part of the immune system. Researchers take T cells from the tumor. They then isolate the T cells that are most active against your cancer or modify the genes in them to make them better able to find and destroy your cancer cells. Cancer researchers then grow large batches of these T cells in the lab.​
  You may have treatments to reduce your immune cells. After these treatments, the T cells that were grown in the lab will be given back to you via a needle in your vein. The process of growing your T cells in the lab can take 2 to 8 weeks, depending on how fast they grow.
• Immune checkpoint inhibitors, which are drugs that stimulate the immune system to recognize and attack cancer cells.
• Cytokines, which are 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.
• 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.
• BCG, which stands for Bacillus Calmette-Guérin, is 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.

Immunotherapy, the Future of Personalized Medicine

Although immunotherapy has been around for 30 years, it is not yet as widely used as surgery, chemotherapy, and radiation therapy. With that said, significant advancements have occurred in recent years. The FDA has approved new immunotherapies for melanoma and lung cancer which are now being used to treat patients. Additionally, a number of new approvals are expected in the near future, which means more FDA approvals are likely. There is enthusiasm in this area due to the significant number of patients that have had responses and long-lasting remissions that have not previously been seen within cancer care.

Questions to Ask about Immunotherapy:

• Why is immunotherapy the best option for me?
• What is the goal of this treatment?
• What side effects might I expect, and what can I do to manage them?
• What restrictions (dietary, working, exercising) will I have during my treatment?
• When will I be able to return to my normal activities?
• What experiences have other patients had with similar immunotherapy regimens?
• Am I ask risk for infections?

Take the Next Step

Immunotherapy is an evolving and promising treatment option, but it’s not right for everyone.
A personalized evaluation is key to determining the best approach for your care. Talk with our oncology team to find out if immunotherapy may be an option for you.