Must-Know Facts About Immunotherapy

Learn more about this exciting cancer treatment.

Must-Know Facts About Immunotherapy

The word 'breakthrough' gets thrown around in the media when it comes to medical advances. In the actual science and medical world, it’s significantly less used. But in 2016 the American Society of Clinical Oncology reported that immunotherapy—an exciting technique for treating cancer—might make the strongest case in some time for the title.

“I believe it’s the next level of oncology care,” says Bibas Reddy, DO, a medical oncologist with Medical City Fort Worth in Texas. “It’s a big deal because in oncology we used to apply the term breakthrough for some drugs getting approved based on increased survival of days or weeks. Now with some newer forms of therapies  patients can have survival increases measured in months and years.”

What is immunotherapy?
Cancer is a complex disease process. It “manipulates your immune system into leaving it alone,” says Dr. Reddy. Enter immunotherapy. “What immunotherapy is attempting to accomplish is taking the brakes off that process,” he says.

There are various types of immunotherapy used for cancer treatment. Some identify cancer cells, making it easier for your immune system to locate and destroy them. Others strengthen your immune system, making it easier for your body to work against the cancer. Researchers are learning more about how “targets" on tumor cells evolve as a tumor grows, and they’re beginning to use this to create immunotherapy treatments to attack each person’s cancer in novel ways that are more individualized instead of a one-size-fits-all approach.

How it works
According to Reddy, the first type of cancer that researchers found to respond well to immunotherapy was melanoma. President Jimmy Carter was treated for stage 4 melanoma in 2015; as his treatment showed, immunotherapy can be used for late-stage cancer that otherwise might be a death sentence. “Even in metastatic melanoma you have the potential to elicit a response where older treatments had little or no response,” says Reddy. “I think it’s something now that every patient facing metastatic melanoma needs to be considered for.”

One method that garnered headlines in 2016 involving T-cells—white blood cells that attack the bad stuff in the body, like bacteria and viruses—was staggeringly successful. In a small study, published in April 2016 in the Journal of Clinical Investigation, that began in 2013, some 94 percent of the acute lymphoblastic leukemia patients and more than just over half of the patients with other blood cancers went into remission. This type of immunotherapy, however, is not without its drawbacks. Complications may include fever, low blood pressure and damage to the nervous system—and for some it may prove fatal.  

Advantages and drawbacks
Despite the potential for serious side effects, most immunotherapy treatments are tolerated much better than traditional chemotherapy or radiation. Chemotherapy and radiation kill not only cancer cells but also can harm healthy cells, leading to side effects such as loss of appetite, increased bleeding and bruising, severe nausea, vomiting, diarrhea and hair loss. “The side effect profile tends to be a little more favorable with immunotherapy, but there are some unique ones,” says Reddy. Rashes are common, and some treatments can cause pneumonitis, an inflammation of the lungs. One 2010 study put the rate of severe side effects at nearly 20 percent for immunotherapy. In some cases the immune system can attack the bowels, liver, lungs, kidneys, adrenal and pituitary glands, heart and pancreas.

Reddy says immunotherapy is making headway in the treatment of kidney cancers, lymphomas, and head and neck cancers. “Kidney cancer is the next big cancer type to see what works and what doesn’t versus more traditional targeted therapies,” Reddy says. Immunotherapy has been shown to be effective in certain lung cancers as well.

Immunotherapy and other innovative cancer treatments like targeted therapies represent a new and promising avenue for research, and they have even experienced oncologists like Reddy excited. “We used to talk about the future and what was possible, but the future is here now, and it’s an exciting time to be on the front lines of cancer care. This is a definite change in the paradigm of how we have approached cancer treatment in the past,” says Reddy.

Medically reviewed in February 2019.

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