Immunotherapy

Overview

Immunotherapy is a type of cancer treatment that locates and eliminates cancer cells by boosting your body’s immune system. Immunotherapy comes in a number of kinds, but all of them function through improving the ability of your immune system to fight cancer. Immunotherapy increases the ability of your immune system to identify and eliminate cancerous cells.

Healthcare providers often rely on immunotherapy as a primary treatment for various forms of metastatic cancer, where the disease has spread. Immunotherapy can be administered alone or in conjunction with targeted therapy, chemotherapy, or other cancer treatments. Different types of immunotherapy are employed to address different cancer types, leveraging the body’s immune system in distinct ways.

Immunotherapy has emerged as a highly effective treatment, potentially extending the survival of cancer patients. To broaden its applicability across different cancer types, medical researchers are actively developing novel immunotherapy treatments.

Types

The type of Immunotherapy includes the following:

• Checkpoint inhibitors: It is possible for your immune system to be overly effective in protecting yourself. Checkpoints are established by your body to prevent the overreaction of your immune system to invaders and subsequent damage to healthy cells.
  T lymphocytes, or T-cells, are white blood cells that are produced in your bone marrow. T-cells combat cancer cells and keep your body free from infection. T-cell surface proteins are contacted by immune checkpoints.
• T-cell transfer therapy (adoptive cell therapy): The capacity of your immune system to eliminate malignant cells is enhanced by this treatment. In a lab, healthcare providers take your immune cells and cultivate them. Providers reintroduce your cells into your body once they have grown so they can eradicate malignant cells. The two primary forms of T-cell transfer therapy are:
  • CAR T-cell therapy
  • Tumor-infiltrating lymphocyte therapy.
• Monoclonal antibodies: Your immune system’s initial line of defense against invaders includes antibodies. Proteins called antibodies combat disease by identifying invaders so your immune system can eliminate them. Lab-made antibodies that can complement your body’s natural defenses or function as their own offensive force are used in monoclonal antibody treatment for cancer.
• Cancer vaccines: Your body is protected against several infections by vaccinations. Certain vaccinations offer protection against viral diseases that have been connected to penile, throat, and anal cancers. One such vaccine is the human papillomavirus (HPV) vaccine. You can avoid contracting a disease that may cause cancer in the future by having these vaccinations. Cancer is not prevented by cancer vaccinations. However, cancer vaccinations prepare your body to combat cancer should it arise.
• Immune system modulators: Substances known as immunomodulators strengthen your body’s defenses against cancer. BCG, cytokines, and immunomodulatory medications are examples of immune system modulators.
  • Cytokines: Proteins called cytokines control how your immune system reacts to invaders, such as malignant cells. They aid in controlling the development and function of blood and immune cells.
    Cytokines alert your immune system to invaders like malignant cells so that they can be dealt with. In order for immune system cells to coordinate attacks on certain cancerous targets, they facilitate communication between the cells. In addition to helping in elimination of diseased cells, cytokines also serve to prolong the life of good cells and inhibit the growth of cancerous ones.
    Healthcare providers use two different cytokines to treat cancer:
    • Interferons: Your immune system fights cancer and inhibits the development of cancer cells with the help of interferons. Healthcare providers can treat a wide range of cancer types with interferons produced in a lab.
    • Interleukins: Both the immunological response and immune system cell communication are triggered by these proteins. White blood cell counts are raised in your body by IL-2, a particular kind of interleukin. T and B cells, which aid in the fight against cancer, are examples of this. Physicians may treat cancer, particularly melanoma and kidney cancer, with lab-made interleukins, similar to how they do with interferons.
  • Immunomodulatory drugs: Medications that strengthen your immune system are known as immunomodulatory medicines, or biologic response modifiers. Certain medications inhibit the growth of new blood vessels in malignant tumors. These medications may be prescribed by healthcare providers to patients with advanced stages of certain lymphoma types. Immunomodulatory medications comprise of Thalidomide (Thalomid®), lenalidomide (Revlimid®), pomalidomide (Pomalyst®), and imiquimod (Aldara®, Zyclara®).
    Lenalidomide, pomalidomide, and thalidomide induce the release of IL-2 from cells. IL-2 helps in the production of more white blood cells by your body to combat cancer. The three medications also slow the development of cancerous tumors. They achieve this by stopping the tumors from forming the new blood vessels that they require to continue spreading. Imidaclovir, another immunomodulatory medication, causes cells to secrete cytokines.

Reasons for undergoing the procedure

• Checkpoint inhibitors: Checkpoint inhibitors are commonly used by healthcare providers to treat many different types of cancers. Checkpoint inhibitors are typically used by healthcare providers to treat advanced cancer, cancer that has spread, cancer that is not surgically treatable, or cancer that has not responded to previous treatments. Drugs known as checkpoint inhibitors may be used in conjunction with other therapies like targeted therapy or chemotherapy.
  As more and more types of cancer are discovered that can be treated with immunotherapy, the following list is likely to expand:
  • Bladder cancer.
  • Cervical cancer.
  • Esophageal cancer.
  • Head and neck cancer.
  • Hepatocellular carcinoma.
  • Kidney cancer.
  • Melanoma.
  • Mesothelioma.
  • Non-small cell lung cancer.
  • Triple-negative breast cancer.
• T-cell transfer therapy (Adoptive cell therapy)
  • CAR T-Cell therapy: Specific blood cancers, such as specific forms of leukemia, lymphoma, and multiple myeloma, are treated using CAR T-cell therapy. CAR T-cell therapy is being studied by healthcare providers as a potential treatment for brain and breast cancer.
  • Tumor-infiltrating lymphocytes (TIL): Cancers treated by TIL: TIL therapy has not been authorized by the FDA to be used as a routine cancer treatment in the United States. TIL therapy is being investigated by healthcare providers as a potential treatment for cholangiocarcinoma (bile duct cancer), melanoma, and cervical squamous carcinoma.
• Monoclonal antibody therapy: More than 60 distinct monoclonal antibody medications that treat a variety of cancers have received FDA approval. Common cancer forms that are treated with various monoclonal antibodies consist of:
  • Bladder cancer.
  • Breast cancer, including triple-negative breast cancer.
  • Colorectal cancer.
  • Leukemia that includes acute lymphoblastic leukemia, hairy cell leukemia, acute myeloid leukemia and chronic lymphocytic leukemia.
  • Lymphomas that include non-Hodgkin lymphoma, cutaneous T-cell lymphoma and B-cell lymphoma.
  • Multiple myeloma.
  • Non-small cell lung cancer.
• Cancer vaccines: Different approaches to producing cancer vaccines are being assessed by medical researchers. An immune cell that reacts to certain antigens on prostate cancer cells is used in a cancer vaccination that the FDA has authorized.
• Immunomodulatory drugs: Immunomodulatory medications, such as pomalidomide (Pomalyst), lenalidomide (Revlimid), and thalidomide, activate your immune system. These medications also prevent myeloma cells from being fed by newly formed blood vessels.

It is approved to treat newly diagnosed patients with lenalidomide and thalidomide. Pomalidomide and lenidomide work well in the treatment of recurrent myeloma as well. These medications strengthen your immune system. Certain medications prevent malignant neoplasms from producing the new blood vessels required for their growth. Medical professionals frequently treat metastatic cancer using these medications.

Risk

Immunotherapy is not universally applicable to all cancer types, and not all patients who respond to treatment will experience its benefits. Moreover, most immunotherapy treatments entail adverse side effects. Your healthcare provider will discuss these individualized side effects with you and provide strategies for their management if immunotherapy is deemed appropriate for your treatment plan.

Procedure

Immunotherapy is administered to patients by intravenous (IV) infusion. Immunotherapy might be given to you once a week, once a month, or in cycles. Following treatment, you take a break when receiving cyclic immunotherapy. The break in activity allows your body to create new, healthy cells.

• Checkpoint inhibitors: T-cell signal flow is regulated by checkpoint proteins and other proteins, which instruct the cells when to switch on and off. To eliminate cancer cells, T-cells activate. They switch off to prevent harm to healthy cells.
  Immunotherapy medication known as checkpoint inhibitors function by breaking the link between checkpoint proteins and other proteins. By breaking the link, protein cells are prevented from instructing T-cells to stop functioning. In this manner, T-cells continue eliminating cancerous cells.\
• T-Cell therapy (Adoptive cell therapy):
  • CAR T-cell therapy: The mechanism of action of chimeric antigen receptor (CAR) T-cell therapy is to enhance the anti-cancer capabilities of your T lymphocytes, or T-cells. White blood cells in your immune system are called T-cells. Your immune system tracks proteins known as antigens that are present on the surface of intruder cells to keep an eye out for invaders, such cancer cells. T-cells are necessary for your immune system to locate and eliminate invaders.
    The proteins known as receptors are unique to your T-cells. Your T-cell security group utilizes their receptors to capture and stop invaders when they detect antigens that indicate a threat. Plus, your T-cells have the ability to eliminate the invaders. However, antigens possess a unique defense mechanism. To elude your T-cells, they might assume a false identity. Your T-cells won’t be tricked by antigens in disguise because of CAR T-cell treatment.
  • Tumor-infiltrating lymphocytes (TIL): TIL cells can infiltrate or approach cancerous tumors, but they are outnumbered and unable to effectively combat the tumor cells. They are unable to prevent malignant cells from transmitting signals that compromise your immune system, therefore they are unable to summon help.
    TIL treatment allows the healthcare provider to develop larger and more powerful TIL cells. In order to stimulate the growth of TIL cells, tumor cells are removed and given different treatments. Upon returning to the cancerous tumors, the enhanced TIL cells have the ability to eliminate malignant cells and interfere with signals that inhibit your immune system.
• Monoclonal antibodies: A portion of a cancerous cell may be attacked by the lab-made antibodies. They could, for instance, prevent proteins that are abnormal in cancer cells. Additionally, cancer cells can be specifically targeted by monoclonal antibodies to deliver medications, chemicals, or radioactive material that can destroy cells with cancer. (Healthcare providers view monoclonal antibody therapy as a type of focused treatment. Targeted treatment involves the targeting of certain genes, proteins, or tissues where cancerous growths are occurring.)
• Cancer vaccines: Vaccines against cancer function by assisting your immune system in recognizing antigens present in cancer cells. Cancer vaccines work by using all or a portion of cancer cells to assist your body recognize a dangerous tumor in your body, just like other vaccine types.

Outcome

Immunotherapy offers potential benefits for cancers that have failed to respond to standard therapy or have recurred after initial treatment. It can extend lifespan by managing cancer, impeding its spread, and occasionally shrinking malignant tumors. However, not all patients undergoing immunotherapy exhibit positive responses.

While most immunotherapy side effects are mild, some require immediate attention from a healthcare provider. If you experience side effects that are more severe than usual, it’s important to promptly contact your healthcare provider for guidance and possible intervention.