Immunotherapy

Immunotherapy for cancer is a treatment that changes the patient’s immune system to better target cancer cells. When the immune system is modified to identify cancer cells as harmful, it will attack those cells and try to destroy them

Immunotherapy may be used alone or with other cancer treatments such as radiation or chemotherapy. Unlike these other treatments, which typically will destroy both cancerous and healthy cells, immunotherapy is a more precise approach designed to kill only cancer cells. 

The effectiveness and benefit of immunotherapy depend upon the type of cancer being treated. Some cancers, such as melanoma, are especially susceptible to immunotherapy, but it can be useful in treating a wide range of cancers.

Side effects of immunotherapy vary.  

• Stem cell transplant: The oldest type of immunotherapy is a stem cell or bone marrow transplant, which replaces unhealthy blood stem cells with healthy ones. The cancer patient receives a transfusion of stem cells or bone marrow from a healthy person. The blood stem cells develop into new red blood cells, white blood cells and platelets. Essentially, a bone marrow transplant involves replacing a sick person’s blood and immune system with one from a healthy person.  
• Chimeric antigen receptor (CAR) T-cell therapy: T-cells are white blood cells that are part of the immune system. CAR T-cell therapy uses the patient’s own T-cells to fight cancer by engineering them so that they can recognize and attack cancer cells.
• Immune checkpoint inhibitors: Normally, immune system checkpoints keep the body’s immune responses from being too strong. Some cancers hijack our immune system’s checkpoints to prevent it from clearing them. Immune checkpoint inhibitors reverse the cancer’s blockage on the immune system and release ("take the brakes off of") T cells, the white blood cells naturally found in the immune system. The checkpoint inhibitors have no direct effect on the cancer cells; instead, they activate the T-cells which then kill the cancer cells.  
• Monoclonal antibodies: These 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. Monoclonal antibodies may also be called therapeutic antibodies.
• Immune system modulators: Modulators enhance the body’s immune response to cancer. Some of these agents affect specific parts of the immune system, whereas others are more widespread.
• Treatment vaccines: These vaccines work against cancer by boosting the immune system’s response to cancer cells. Treatment vaccines are different than vaccines that help prevent disease.

The form of immunotherapy used, and the length of time patients are in treatment, depend on the type of cancer being treated. A bone marrow transplant may be a one-time infusion, while others may be given every few weeks. 

If you have been diagnosed with cancer and your oncologist recommends immunotherapy or targeted therapy, you may want to ask questions such as:

• What type of therapy will I need?
• Will I take it by mouth or through an IV or injection?
• How often will I need it?
• How many treatments will I need?
• What are the side effects?
• How can I manage the side effects?
• Where do I go for treatment?
• Will I have to miss work or school?
• Is this covered by my health insurance?