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The immune system is a powerful force that helps protect a person from diseases and illnesses. With advances in cancer research, scientists have discovered ways to harness the abilities of the immune system to fight cancer. This process is called immunotherapy.
Immunotherapy is one of many treatments offered at Regional Cancer Care Associates (RCCA). RCCA is a group of more than 90 medical oncologists and hematologists who treat patients who have solid tumors, blood-based cancers, and benign blood disorders at more than 20 locations throughout New Jersey, Connecticut, Massachusetts, and the Washington, D.C. area. At RCCA, patients are able to receive comprehensive cancer care close to home.
Here, we explore immunotherapy, how it works, the different types, and who is eligible, helping you to understand your options.
Immunotherapy is a treatment designed to harness the patient’s immune system to detect, target, and destroy harmful cells. The immune system works by detecting abnormal or harmful pathogens, toxins, and cells to keep a person healthy and protected from disease. However, cancer cells can prevent the immune system from working properly. They can disguise themselves to avoid detection, suppress immune cell function, and prevent T cells from attacking the cancer cells.
Immunotherapy is designed to address this. It can do this in a few ways: enhancing immune responses, blocking checkpoints that hide cancer cells, or re-engineering cells to target a specific type of cancer cell. Immunotherapy is best for certain types of cancer, which have specific tumor traits. These include:
It may also be used for certain colorectal cancers, gynecological cancers, and other solid tumors, including triple-negative breast cancer.
Immunotherapy works differently from other cancer treatments such as chemotherapy and radiation therapy. Chemotherapy uses strong systemic drugs to kill cancer cells, while radiation therapy delivers high-energy rays directly to a certain area to damage the cancer cells’ DNA. Unlike chemo and radiation, immunotherapy does not target cancer cells directly. Instead, it trains the immune system to recognize and fight cancer cells.
Therefore, immunotherapy side effects are different from chemo side effects. Chemotherapy results in systemic issues, such as hair loss, nausea, and low white blood cell counts, due to its systemic effects. Immunotherapy works to remove the safeguards on your immune system that are preventing the cancer cells from being detected. This results in overactive immune cells that can attack healthy organs, leading to side effects such as colitis, pneumonitis, hepatitis, and endocrine disorders.
There are various types of immunotherapies to treat cancer, and the best type for a person will depend on several factors, including specific biomarkers, the cancer type and stage, and their overall health. The types of immunotherapies include:
Checkpoint inhibitors are the most widely used type of immunotherapy. In the immune system, checkpoints are regulatory molecules that act as the “brakes,” preventing T cells from destroying healthy cells. However, they can also prevent the T cells from targeting cancerous cells, enabling their growth and spread. Checkpoint inhibitors are specialized drugs that prevent checkpoint proteins from connecting with cancer signals, effectively releasing the “brakes.” This causes the T cells to reactivate, helping them detect and destroy cancer cells.
Common checkpoint inhibitors used in cancer treatment include:
Cancers treated with checkpoint inhibitors include skin cancers, lung cancers, Hodgkin lymphoma, triple-negative breast cancer, and more.
Chimeric antigen receptor (CAR) T-cell therapy, or simply T-cell therapy, is another type of immunotherapy. It involves a person’s T cells, which are specialized white blood cells that destroy infected or cancerous cells. The process includes:
Once these cells are infused into the body, the patient’s immune cells are engineered to fight cancer. CAR-T cell therapy is suitable for treating blood cancers, including leukemia, lymphoma, and multiple myeloma.
Antibodies are a vital component of the immune system, recognizing and attacking foreign invaders such as viruses and bacteria. Monoclonal antibodies are man-made proteins that imitate the behaviors of natural antibodies, acting as targeted immune messengers.
In cancer treatment, monoclonal antibodies target the specific proteins that are only found on the surface of cancer cells. They may directly attack the cells, prevent cancer cell growth, or mark cancer cells for the immune system to fight. Examples of monoclonal antibody treatments include rituximab, trastuzumab, and bevacizumab. They can help treat various cancers, including melanoma, lung cancer, brain cancer, stomach cancer, and more.
Vaccines can also be used to prevent and treat cancer. A preventative (prophylactic) cancer vaccine triggers the immune system to prevent certain viruses and infections that may cause or contribute to the development of cancer. These are given to healthy people with no symptoms of cancer.
A cancer treatment (therapeutic) vaccine helps boost the immune system’s natural abilities to fight off cancer by training it to detect, attack, and destroy cancer cells. These are given to patients who already have cancer. There are two types available: the Bacillus Calmette-Guérin (BCG) vaccine used to treat bladder cancer, and Sipuleucel-T, used to fight advanced prostate cancer.
Cytokine immunotherapy involves using engineered or naturally occurring soluble proteins (cytokines) to stimulate and enhance the body’s immune system. Cytokines help certain immune cells, such as T cells and natural killer (NK) cells, identify and destroy cancer cells. The two most common types include:
Although cytokines are effective for certain cancers, they also tend to have a narrow treatment window and can lead to severe systemic toxicity. Therefore, research is ongoing to mitigate these hurdles.
Immunotherapy is a great advance in cancer research, but it’s not suitable for every patient. To determine if immunotherapy is a viable treatment option, patients must undergo biomarker testing. This involves examining blood, tissue, or bodily fluids to identify specific genes, proteins, or molecules that can be targeted with immunotherapy. Common biomarkers that are looked for include:
These biomarker tests help determine whether immunotherapy will be an option for the patient. However, patients may need to meet other requirements, such as having good organ function and performance status, so they can tolerate the demanding treatment and recovery period.
Since immunotherapy turns off the “brakes” that prevent cancer cells from being identified and attacked, it can lead to overactive immune cells. These may attack healthy organs, resulting in immune-related adverse events (irAEs) and side effects including:
If you’re experiencing these side effects after treatment, reach out to your oncologist to discuss them.
Certain types of immunotherapies can also have specific side effects, such as CAR-T cell therapy. This type of immunotherapy can lead to severe side effects, including cytokine release syndrome (CRS) and neurotoxicity.
CRS causes high levels of inflammatory cytokines to be released into the bloodstream, resulting in symptoms such as high fever, fatigue, low blood pressure, rapid heartbeat, and trouble breathing. Neurotoxicity occurs when the immune response affects the central nervous system, leading to symptoms like confusion, hallucinations, tremors, and seizures. Both can be life-threatening, so seek immediate medical attention if you experience these side effects after CAR-T cell therapy.
If you’re curious whether immunotherapy can be an effective treatment for your cancer, reach out to Regional Cancer Care Associates (RCCA), which offers checkpoint inhibitor infusions at infusion therapy centers near you, as well as CAR-T cell therapy through its clinical trials program.
RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.
To learn more about RCCA, call 844-346-7222 or contact RCCA online.
What is immunotherapy for cancer?
Immunotherapy is a cancer treatment that uses the patient’s immune system to detect, target, and destroy harmful cells, which often go undetected otherwise.
How does immunotherapy work differently from chemotherapy?
Immunotherapy works differently from chemotherapy because it does not directly target cancer cells. Immunotherapy trains the immune system to detect and attack cancer cells, whereas chemotherapy uses strong drugs to kill cancer cells.
What cancers can be treated with immunotherapy?
Immunotherapy only works for certain types of cancer that have specific tumor traits. They include kidney cancer, leukemia, lung cancer, lymphoma, prostate cancer, and skin cancer. It can also be used for colorectal cancers, gynecological cancers, and solid tumors, such as triple-negative breast cancer.
What is CAR-T cell therapy?
Chimeric antigen receptor (CAR) T-cell therapy is a form of immunotherapy that involves T cells. The T cells are collected from the patient’s body, modified in a lab to help them detect and attack cancer cells, and infused back into the patient’s body.
Who qualifies for immunotherapy?
To qualify for immunotherapy, a patient must have a specific biomarker that the therapy can target. Some common biomarkers include PD-L1, microsatellite instability (MSI), tumor mutational burden (TMB), and human epidermal growth factor receptor 2 (HER2) status. Doctors will also consider a patient’s overall health to see if they can handle the therapy and recovery.
What are the side effects of immunotherapy?
Immunotherapy can cause immune-related adverse events (irAEs), which occur when the therapy causes the body’s immune system to attack its own healthy tissues. It can cause side effects like:
Can immunotherapy put cancer into remission?
Although it’s not effective for every patient, immunotherapy can lead to long-term remission in some patients, helping them achieve the best possible outcomes.
Is immunotherapy available at RCCA?
Yes. At RCCA, we provide both checkpoint inhibitor infusions at our infusion therapy centers and CAR-T cell therapy via our clinical trials.
For more information or to schedule an appointment,
call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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