What Is Immunotherapy? - Cancer.Net

Immunotherapy is a type of cancer treatment. It uses substances made by the body or in a laboratory to boost the immune system and help the body find and ... SkiptoContent Español Search Menu YouarehereHome>NavigatingCancerCare>HowCancerisTreated>ImmunotherapyandVaccines>WhatIsImmunotherapy? RequestPermissions WhatIsImmunotherapy? ApprovedbytheCancer.NetEditorialBoard,05/2022 Immunotherapyisatypeofcancertreatment.Itusessubstancesmadebythebodyorinalaboratorytoboosttheimmunesystemandhelpthebodyfindanddestroycancercells. Immunotherapycantreatmanydifferenttypesofcancer.Itcanbeusedaloneorincombinationwithchemotherapyand/orothercancertreatments. Thisarticlewillhelpyouunderstandthebasicsofhowimmunotherapyworkstotreatcancer.Learnmoreaboutthesideeffectsofimmunotherapy. Howdoestheimmunesystemfightcancer? Theimmunesystemconsistsofacomplexprocessthatyourbodyusestofightcancer.Thisprocessinvolvescells,organs,andproteins.Cancercancommonlygetaroundmanyoftheimmunesystem'snaturaldefenses,allowingcancercellstocontinuetogrow. Differenttypesofimmunotherapyworkindifferentways.Someimmunotherapytreatmentshelptheimmunesystemstoporslowthegrowthofcancercells.Othershelptheimmunesystemdestroycancercellsorstopthecancerfromspreadingtootherpartsofthebody. Thedifferenttypesofimmunotherapyinclude: Monoclonalantibodiesandimmunecheckpointinhibitors Non-specificimmunotherapies Oncolyticvirustherapy T-celltherapy Cancervaccines Thetypeofimmunotherapy,dose,andtreatmentscheduleyourdoctorrecommendswilldependonmanyfactors.Thesecanincludethetypeofcancer,size,location,andwhereithasspread.Yourage,generalhealth,bodyweight,andthepossiblesideeffectsarealsoimportant.Talkwithyourdoctoraboutwhyaspecificimmunotherapyplanisbeingrecommendedforyou. Whataremonoclonalantibodiesandimmunecheckpointinhibitors? Whentheimmunesystemdetectssomethingharmful,itmakesantibodies.Antibodiesareproteinsthatfightinfectionbyattachingtoantigens.Antigensaremoleculesthatstarttheimmuneresponseinyourbody. Monoclonalantibodiesaremadeinalaboratorytoboostthebody'snaturalantibodiesoractasantibodiesthemselves.Monoclonalantibodiescanhelpfightcancerindifferentways.Forexample,theycanbeusedtoblocktheactivityofabnormalproteinsincancercells.Thisisalsoconsideredatypeoftargetedtherapy,whichisacancertreatmentusingmedicationthattargetsacancer'sspecificgenes,proteins,orthetissueenvironmentthathelpsthetumorgrowandsurvive. Othertypesofmonoclonalantibodiesboostyourimmunesystembyinhibitingorstoppingimmunecheckpoints.Immunecheckpointsareusedbythebodytonaturallystopanimmunesystemresponseandpreventtheimmunesystemfromattackinghealthycells.Cancercellscanfindwaystohidefromtheimmunesystembyactivatingthesecheckpoints. Checkpointinhibitorspreventcancercellsfromblockingtheimmunesystem.CommoncheckpointsthattheseinhibitorsaffectarethePD-1/PD-L1andCTLA-4pathways. Examplesofimmunecheckpointinhibitorsinclude: Atezolizumab(Tecentriq) Avelumab(Bavencio) Dostarlizumab(Jemperli) Durvalumab(Imfinzi) Ipilimumab(Yervoy) Nivolumab(Opdivo) Pembrolizumab(Keytruda) ManycheckpointinhibitorsareapprovedbytheU.S.FoodandDrugAdministration(FDA)forspecificcancers.Therearealso2checkpointinhibitorsthatareusedtotreattumorsanywhereinthebodyiftheyhavespecificgeneticchanges.Thiskindofapproachiscalleda"tumor-agnostictreatment." Forinstance,pembrolizumab(Keytruda)isapprovedtotreatanytumorsthathavespreadtodistantpartsofthebodyiftheyhaveaspecificmolecularchangecalledmicrosatelliteinstability-high(MSI-H)orDNAmismatchrepairdeficiency(dMMR).Anotherexampleisthatdostarlimab(Jemperli)canbeusedforadvancedcancerorcancerthathascomebackifithasdMMR.Learnmoreabouttumor-agnostictreatments. Thesideeffectsofmonoclonalantibodytreatmentdependonthedrug'spurpose.Forexample,thesideeffectsofmonoclonalantibodiesusedfortargetedtherapyarenotlikethoseusedforimmunotherapy.Thesideeffectsofimmunecheckpointinhibitorsmayincludesideeffectssimilartoanallergicreaction.Learnmoreaboutsideeffectsofimmunecheckpointinhibitors. Returntotop Whatarenon-specificimmunotherapies? Non-specificimmunotherapies,alsocallednon-specificimmunomodulatingagents,helpyourimmunesystemdestroycancercells.Thereareseveralkindsofnon-specificimmunotherapiesthatworkindifferentways. Cytokines.Cytokinesareapartoftheimmunesystem.Theyareproteinsthatsendmessagesbetweencellstoactivatetheimmunesystem.Therearetwotypesofcytokinesthatareusedtotreatcancer: Interferons.Theseproteinsareproducedbyyourimmunesystemtoalertyourbodythatthereisapathogen,typicallyavirus,inyourbody.Interferonscanbemadeinalaboratorytohelpyourimmunesystemfightcancer.Theycanalsoslowthegrowthofcancercells. Themostcommontypeofinterferonusedincancertreatmentiscalledinterferonalpha(Roferon-A[2a],IntronA[2b],Alferon[2a]).Interferoncanbeusedtoseveralmanydifferenttypesofcancer.Sideeffectsofinterferontreatmentmayincludeflu-likesymptoms,anincreasedriskofinfection,skinrashes,andhairthinning. Interleukins.Interleukinsareproteinsthatpassmessagesbetweencells.Theyalsostartanimmuneresponse.Forexample,thelab-madeinterleukin-2(IL-2)oraldesleukin(Proleukin)cantreatkidneycancerandmelanoma.CommonsideeffectsofIL-2treatmentincludeweightgainandlowbloodpressure.Somepeoplealsoexperienceflu-likesymptoms. BacillusCalmette-Guerin(BCG).Thistypeofimmunotherapyissimilartothebacteriathatcausestuberculosis.Itisusedtotreatbladdercancer.BCGisplaceddirectlyintothebladderthroughacatheter.Itattachestotheinsideliningofthebladderandactivatestheimmunesystemtodestroytumorcells.BCGcancauseflu-likesymptoms. Returntotop Whatisoncolyticvirustherapy? Oncolyticvirustherapy,sometimesjustcalledvirustherapy,usesvirusesthathavebeenchangedinalaboratorytodestroycancercells.Ageneticallymodifiedversionofthevirusisinjectedintothetumor.Whenthevirusentersthecancercells,itmakesacopyofitself.Asaresult,thecancercellsburstanddie.Asthecellsdie,theyreleaseproteinsthattriggeryourimmunesystemtotargetanycancercellsinyourbodythathavethesameproteinsasthedeadcancercells.Thevirusdoesnotenterhealthycells. Currently,onetypeofoncolyticvirustherapyisapprovedintheUnitedStatestotreatcancer: Talimogenelaherparepvec(Imlygic)orT-VEC.Thisoncolyticvirustherapyisapprovedtotreatadvancedmelanomathatcannotbetreatedwithsurgery.Itisusedmostoftenforpeoplewhocannotorchoosenottoreceiveanyotherrecommendedtreatments.T-VECisamodifiedversionoftheherpessimplexvirus,whichcausescoldsores.Itisinjecteddirectlyinto1ormoremelanomatumors.Sideeffectsofoncolyticvirustherapyincludeflu-likesymptomsandpainattheinjectionsite. Clinicaltrialsaretestingotheroncolyticvirusesfordifferentcancers.Theyarealsotestinghowthevirusesworkwithothercancertreatments,suchaschemotherapy. Returntotop WhatisT-celltherapy? Tcellsareimmunecellsthatfightinfection.InT-celltherapy,thedoctorremovesTcellsfromtheblood.Then,alaboratoryaddsspecificproteinscalledreceptorstothecells.ThereceptorallowsthoseTcellstorecognizecancercells.ThechangedTcellsareputbackintothebody.Oncethere,theyfindanddestroycancercells.Thistypeoftherapyisknownaschimericantigenreceptor(CAR)T-celltherapy.Sideeffectsincludefevers,confusion,lowbloodpressure,and,inrareoccasions,seizures. CART-celltherapyisusedtotreatcertainbloodcancers.ResearchersarestillstudyingthistypeoftherapyandotherwaysofchangingTcellstotreatcancer.LearnmoreaboutthebasicsofCART-celltherapy. Returntotop Whatarecancervaccines? Acancervaccinecanalsohelpyourbodyfightdisease.Avaccineexposesyourimmunesystemtoaforeignprotein,calledanantigen.Thistriggerstheimmunesystemtorecognizeanddestroythatantigenorrelatedsubstances.Thereare2typesofcancervaccine:preventionvaccinesandtreatmentvaccines. OneexampleofacancerpreventionvaccineisGardasil,thevaccinetoprotectagainstthehumanpapillomavirus(HPV),avirusthatcancausespecifictypesofcancer.Anexampleofatreatmentvaccineincludesspuleucel-T(Provenge),whichtreatsadvancedprostatecancerthatdoesnotrespondtohormonetherapy.T-VEC(seeabove)isalsoconsideredacancertreatmentvaccine.Sideeffectsforbothofthesecancervaccinesareflu-likesymptoms. Returntotop Ingeneral,immunotherapyisanimportantapproachascancerresearcherscontinuetolookfornewcancertreatments.Theexamplesabovedonotincludeeverytypeofimmunotherapytreatment.Researchersarestudyingmanynewdrugs.Youcanlearnmoreaboutimmunotherapyineachcancer-specificsectiononCancer.Net.Lookatthe"TypesofTreatment"and"LatestResearch"pagesforspecificinformationaboutimmunotherapyforthattypeofcancer.YoucanalsolearnaboutthelatestimmunotherapyresearchontheCancer.NetBlog. Questionstoaskyourhealthcareteam Ifimmunotherapyisacancertreatmentoptionforyou,consideraskingyourhealthcareteamthesequestions: Whattypeofimmunotherapydoyourecommend?Why? Whatarethegoalsofthistreatment? Whatimmunotherapyclinicaltrialsareopentome? Willimmunotherapybemyonlytypeofcancertreatment?Ifnot,whatothertreatmentswillIneed?When? HowwillIreceiveimmunotherapytreatment? WherewillIreceivethistreatment? Howlongwilleachtreatmenttake?HowoftenwillIneedtogetthistreatment? Whatarethepossibleshort-termsideeffectsofimmunotherapy?Howcanthesebemanaged? WhoshouldItalkwithaboutanysideeffectsIexperience?Howsoon? WhatsideeffectsshouldIletyouknowaboutrightaway? WhomshouldIcallwithquestionsorproblems? HowcanIreachthemduringregularbusinesshours?Afterhours? Howwillthistreatmentaffectmydailylife?WillIbeabletowork,exercise,anddomyusualactivities? IfI'mveryworriedoranxiousabouthavingthistreatment,whocanItalkwith? IfI'mworriedaboutmanagingthecostofthistreatment,whocanhelpme? Whatarepossiblelong-termsideeffectsofthisimmunotherapy?Howcanthesebemanaged? Howwillweknowifthisimmunotherapyisworking? WillIneedanytestsorscansbefore,during,orafterimmunotherapy? Couldthedoseordurationofmyimmunotherapychangeovertime? RelatedResources ASCOAnswersFactSheet:UnderstandingImmunotherapy(PDF) SideEffectsofImmunotherapy MoreInformation AmericanCancerSociety:CancerImmunotherapy NationalCancerInstitute:BiologicTherapies Español DownloadafreefactsheetonUnderstandingImmunotherapy(PDF). This1-page(frontandback)factsheetprovidesanoverviewofthedifferenttypesofimmunotherapy,possiblesideeffects,termstoknow,andquestionstoaskthehealthcareteam.OrderprintedcopiesfromtheASCOStore.  f t k e P Moreinthissection Timely.Trusted.Compassionate. Comprehensiveinformationforpeoplewithcancer,families,andcaregivers,fromtheAmericanSocietyofClinicalOncology(ASCO),thevoiceoftheworld'soncologyprofessionals. FindaCancerDoctor