Immunotherapy Overview

Immunotherapy is the newest type of treatment available for people with cancer. For decades, doctors and researchers have conducted clinical trials to further the progress in immunotherapy as cancer treatment. Former President Jimmy Carter’s success with immunotherapy for advanced melanoma and Vice President Joe Biden’s Cancer Moonshot Initiative have brought this new treatment type, as well as cancer treatments in general, into the spotlight for the general public.

Cancer cells have a sneaky way of fooling the body into not recognizing they are dangerous. If the body can’t tell the difference between cancer cells and healthy cells, the cancer cells may be able to hide. Immunotherapy uses the body’s own immune system to slow the growth of and kill cancer cells by using substances made either by the body or in a laboratory. These substances allow the immune system to identify cancer cells as a threat and target them for destruction.

Different types of immunotherapy exist. Each works in a unique way to slow and stop the growth of cancer cells, stop cancer cells from spreading to other parts of the body and help the immune system work better overall at destroying cancer cells. Some types of immunotherapy boost the body’s immune system, and others train the immune system to attack cancer cells:

  • Checkpoint inhibitors are an important part of the immune system due to their ability to keep immune cells from attacking normal cells in the body. Checkpoints are proteins on immune cells that need to be turned on or off to start or stop an immune response. The immune system uses checkpoints to turn on an immune response, when appropriate, and turn it off, when necessary, to prevent itself from attacking normal cells in the body. But melanoma cells sometimes use these checkpoints to avoid being attacked by the immune system. Checkpoint inhibitors target the checkpoint proteins, helping to restore the immune response against melanoma cells.

Words to Know

Cancer cells – Cells with damaged DNA that causes mutations in normal cell growth and division. New cancer cells grow uncontrollably and old cancer cells don’t die when they should, resulting in a malignant tumor or cancer.

Immunotherapy – A type of cancer treatment that focuses on using the body’s own immune system to fight cancer.

Standard of care – A treatment regimen that is accepted by medical experts as a proper treatment for a specific type of cancer and is used widely by healthcare professionals to treat patients. This can also be called best practice, standard medical care and standard therapy.

  • Cytokines are proteins that enable cells to send messages to each other. Cytokines work together to make sure that the immune response is of the right strength and length of time. Laboratory-made versions of cytokines are sometimes used to boost the immune system in people with melanoma.
  • Oncolytic viruses are viruses altered in a laboratory so that they infect and kill mainly cancer cells. Along with killing the cells directly, the viruses can also alert the immune system to attack the cancer cells.
  • Cancer vaccines are substances that stimulate the immune system to fight infection or disease. Cancer vaccines strengthen the immune system against cancer cells.
  • Nonspecific immune stimulators boost the immune system in a general way to help the immune system attack cancer cells.

Although certain immunotherapies work well when given alone, others work better in combination with additional treatments.

The opportunity to have an improved quality of life is making immunotherapy an attractive choice for people who have this treatment option. Although traditional treatments, such as chemotherapy, for example, target cancer cells, healthy cells also are damaged, resulting in side effects such as alopecia (hair loss) and nausea. With immunotherapy, side effects may still occur, but they are primarily the result of an overactive immune system, not the destruction of healthy cells. Because not as many healthy cells are damaged, some patients have reported fewer and less severe side effects. Additionally, immunotherapy has the potential to remain effective long after the treatment is over, a feature called “memory.” This feature is the same one that allows a tetanus vaccine, for example, to remain effective for many years. For people with cancer, this effect can lead to long-term, cancer-free remission and better overall survival.

It is important to note that immunotherapy is effective for some patients but not for others, even when they seem to have the same cancer. Doctors and scientists continue to study this puzzling characteristic, along with how to improve existing therapies and develop new ones, through clinical trials. If immunotherapy is not an option for you, your doctor will recommend one or more of the treatments considered “standard of care” (approved and recommended).

Additionally, you may be able to take advantage of treatments that are not yet FDA-approved by participating in a clinical trial. Before you make any treatment decisions, talk to your doctor about whether you are eligible for a clinical trial.

A Long History

Overview_William_Coley.jpgCancer treatments are not discovered overnight. More than a century ago, Dr. William B. Coley worked with doctors and people with cancer to study how cancer tumors reacted to bacterial infections. His treatments for people with inoperable tumors consisted of injecting a combination of bacteria directly into the tumors. The treatment shrank the tumors and sometimes even led to a cure. Dr. Coley believed the body’s increased response to the bacteria also helped fight off the cancer.

More recently, in the 1960s, Dr. Donald Morton began experimenting with a vaccine that was intended not to prevent cancer but to stimulate the body’s immune system to attack cancer cells once they had developed. An early proponent of immunotherapy, particularly cancer vaccines, Dr. Morton was at the forefront of global cancer research and treatment, with a focus on melanoma. His work with bacillus Calmette-Guerin (BCG) for melanoma led to the approval of BCG for bladder cancer, the first successful immunotherapy against a human tumor.

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