Is immunotherapy better than chemotherapy or radiotherapy? Of course, it works differently, but when it is used alone or combined with traditional treatment, it can give spectacular results.
Immunotherapy is a method that boosts the patient immune system, helping it to beat cancer. It treats cancer by ameliorating deficits in the immune system functioning or eliminating immune cells’ dysfunctions.
It’s most significant advantage over other therapies is that it works with a pinpoint precision, and may help when other forms of treatment fail. The patients also have better outcomes and live longer after treatment.
Medical researchers developed several different types of immunotherapies for many cancers, such as breast cancer, leukaemia, or melanoma. All can cause adverse effects, but when you know the early symptoms, you can react promptly.
How does immunotherapy work in treating cancer?
What is immunotherapy? It is a kind of biological therapy for cancer. It means that this method uses substances made of the biological component produced in living organisms to treat the disease.
Typically, our immune system detects and kills suspicious cells or inhibits cancer cells’ growth. Health care specialists often find lymphocytes, immune cells, surrounding or infiltrating tumours.
What types of immunotherapies are available, and which cancers do they treat?
Medical researchers developed many types of cancer immunotherapies. Depending on the agent used, they are classified as follows:
- Immune checkpoint inhibitors
- T-cell transfer therapy (adoptive cell therapy, adoptive immunotherapy, immune cell therapy)
- Monoclonal antibodies (therapeutic antibodies)
- Treatment vaccines
- Immunomodulators (immune system modulators)
Immune cells use proteins called checkpoints to prevent immune responses from being too strong. Immune checkpoint inhibitors block these checkpoints and allow immune cells to respond robustly to cancer.
This therapy improves your natural T-cell-killing capacity. A health care specialist will retrieve your T-cells from the tumour samples, select the most active and modify them in the laboratory to boost their cancer-fighting ability. Then, they are grown in culture media in laboratory dishes, properly prepared, and reintroduced to your body as a venous injection.
In our body, B cells produce proteins, called antibodies or immunoglobulins, targeting cancer cells or infectious agents. Monoclonal antibodies are designed in the lab to bind to specific targets on cancer cells. For example, they may mark cancer cells to attract immune cells, which will destroy them.
They boost your immune system’s response to cancer.
They enhance your immune system’s natural response to cancer. Some support specific immune components, whereas others have a systemic effect. The most commonly used agents from this group are cytokines.
Immunotherapies have been approved for the treatment of many types of cancer. You can check if immunotherapy can be used for your cancer in the PDQ, a cancer information database maintained by the National Cancer Institute.
Cancer type | monoclonal antibody | checkpoint inhibitor | cancer vaccine | T-cell therapy | immuno- |
breast cancer | ✅ | ✅ |
|
|
|
cervical cancer | ✅ | ✅ | ✅ |
|
|
colorectal cancer | ✅ | ✅ |
|
|
|
brain cancer | ✅ |
|
|
|
|
bladder cancer | ✅ |
| ✅ |
| ✅ |
oesophageal cancer | ✅ | ✅ |
|
|
|
childhood cancer | ✅ | ✅ |
| ✅ |
|
head and neck cancer | ✅ | ✅ |
|
|
|
kidney cancer | ✅ | ✅ |
|
| ✅ |
leukaemia | ✅ |
|
| ✅ | ✅ |
liver cancer |
| ✅ |
|
|
|
lung cancer | ✅ | ✅ |
|
|
|
lymphoma | ✅ | ✅ | ✅ | ✅ | ✅ |
melanoma |
| ✅ |
|
| ✅ |
multiple myeloma | ✅ |
|
|
|
|
ovarian cancer | ✅ |
|
|
|
|
pancreatic cancer |
| ✅ |
|
|
|
prostate cancer |
| ✅ | ✅ |
|
|
sarcoma | ✅ |
|
|
|
|
stomach cancer | ✅ | ✅ |
|
|
|
Tab. Examples of immunotherapies available for different types of cancer.
Why is immunotherapy the most specific response to cancer?
With immunotherapy, doctors can precisely target cancer cells overexpressing or expressing mutated proteins. Radiotherapy and chemotherapy affect all rapidly dividing cells, including healthy ones in our gut, skin, or brain.
While chemo – and radiotherapy work quickly, immunotherapy needs time to be effective but works long after the end of the treatment.
The anticancer monoclonal antibodies act on three basic strategies:
- blocking essential growth factors and receptors (such as tyrosine kinase),
- inducing cancer cell death,
- binding to cancer cells and delivering substances that kill them.
Ideal targets for monoclonal antibodies are proteins with expression that is high or restricted to tumour cells and which are stably exposed on the cell surface. Frequently, these proteins are involved in the process of cancer development.
What are the risks and side effects of immunotherapy?
Immunotherapies require more thorough patient monitoring. Although in immunotherapy side effects are less frequent than in chemo- or radiotherapy, they may be severe and require immediate medical attention. So you need to be aware of signs and possible solutions when problems arise.
The side effects may occur anytime during the immunotherapy, even after it is terminated. Unfortunately, it is not possible to predict when they will happen and how strong they will be. The type and intensity of immunotherapy side effects depend on factors like your overall health, age, immunotherapy type and dosage, and cancer type and stage.
Certain reactions are common to all types of immunotherapies, like those involving your skin at the needle site, such as swelling, pain, rash, or itching.
Furthermore, flu-like symptoms may develop, including:
- dizziness,
- weakness,
- fever,
- chills,
- fatigue,
- muscle and joints pain,
- headache,
- breathing problems,
- nausea,
- vomiting,
- blood pressure fluctuations.
Other side effects:
- weight gain caused by fluid retention,
- sinus congestion,
- heart palpitations,
- infection,
- diarrhoea,
- organ inflammation.
Doctors qualify patients for immunotherapy on a basis of the tumour type, overall physical condition, and age.
Patients over 65, on steroid treatment, at an advanced stage of cancer development, and with tumours resistant to treatment, still may benefit from immunotherapies, but require stricter surveillance, as they are more susceptible to immunotherapy risks.
What are the signs that immunotherapy is working?
It takes some time to activate the immune system, so you probably will not see and feel the effects of treatment right after its start.
During routine physical exams, your oncology specialist will ask about your symptoms and verify your blood tests and tumour scans. Tumour shrinkage, dropping cancer markers in the blood, and improvement in your well-being are all clear signs that your immunotherapy is proceeding in the right direction.
The initial tumour enlargement is normal and called pseudoprogression. This is caused by immune cells which infiltrate the tumour and make it look bigger. The doctor in charge of your case will ask you to wait for confirmatory scans after two or three treatment cycles (of two months each).
The survival rate is a more clinical way to measure immunotherapy success rates. It tells how many people survive a specific period of time (usually five years) after diagnosis and treatment.
To wrap up
Immunotherapy boosts your immune system, helping to treat many cancer types. Different types of such therapies are currently available. Unfortunately, all may cause severe side effects related to the autoimmune response. However, immunotherapies are more targeted, work longer, and give patients higher chances for survival than radio- or chemotherapy. Still, not all patients may benefit from them. If you have more questions, contact your oncology specialist.