Immunotherapy is a type of disease treatment that boosts the patient’s own immune system to fight a disease, like cancer. Along with standard cancer treatments such as surgeries, radiation therapy, chemotherapy, and hormone therapy, immunotherapy is a promising new treatment that makes a valuable addition to a cancer care team’s arsenal.
Cancer & Our Immune System
Our immune systems have naturally evolved to protect us against foreign and abnormal bodies such as viruses, bacteria, and fungi. Cancer cells also cause an immune reaction in many, but not all people, which is why immune cells, called tumor-infiltrating lymphocytes (TILs), can be sometimes found around the location of a tumor. Unbeknownst to us, our immune systems likely prevent or reduce the growth of cancer in many cases.
Unfortunately, for a variety of reasons, our immune systems are not 100% successful in stopping cancer:
- Cancer cells were once normal cells and may not be as visible to our immune systems as “foreigners”
- Cancer cells have genetic differences that make them less likely to be recognized
- Some cancer cells have surface proteins that cause immune cells to turn off
- Cancer cells alter the normal cells in the surrounding area interfering with the immune system’s response
- Sometimes, the cancer cells are recognized, but the immune system is not strong enough to kill the cells
Immunotherapy works by overcoming these obstacles, helping our bodies to better recognize cancer cells or giving our bodies more strength and resources to attack cancer cells.
Types of Immunotherapy
There are several kinds of immunotherapy treatments, some of them which work better for some cancers or some types of patients.
- Immune checkpoint inhibitors are drugs that block the immune system’s natural brake mechanism, called “checkpoints.” Normally, these checkpoints are good, and keep our immune system from going into overdrive and killing healthy cells. These drugs disable the brakes and allow our bodies to attack with more strength. The drug pembrolizumab (Keytruda) is one type of checkpoint inhibitor drug. It specifically blocks the PD-1 protein and is used in breast cancer treatment.
- Immune system modulators, also called immunomodulators, are drugs that improve the immune system’s response to specific types of cancer.
- Monoclonal antibodies, also called mAbs or MoAbs for short or therapeutic antibodies, are lab-made versions of our natural antibodies. Some mAbs are specially designed to attack specific points on cancer cells. Other mAbs don’t attack, but instead are designed to mark cancer cells to make them more visible to our natural immune system.
- T-cell immunotherapy, also called T-cell transfer therapy, adoptive immunotherapy, adoptive cell therapy, or immune cell therapy, is a type of treatment that removes a patient’s own immune cells near their tumor. The cells that are best at fighting the cancer are chosen, those cells are duplicated in large quantities in a lab, and then re-infused back into the patient via an IV. CAR T-cell therapy is a type of T-cell therapy in which the T-cells are genetically altered before being returned to the patient.
- Cytokines are proteins that carry messages from cell to cell. This therapy uses cytokines to encourage our immune system to destroy cancer cells.
- Treatment vaccines, popularly called cancer vaccines, are injections that cause the body to begin an immune response against cancer. Treatment vaccines can be made of parts of cells, cancer cells, proteins from cancer cells (antigens), or the patient’s own immune cells. They are usually combined with additional substances called adjuvants to improve the immune response further.
How Immunotherapy Is Used
Immunotherapy has been used to treat allergies, multiple sclerosis, Crohn’s and asthma, but it is most known as a treatment for cancer. Cancers that are treated with immunotherapy include melanoma, bladder cancer, prostate cancer, pancreatic cancer, liver cancer, lung cancer, ovarian cancer and breast cancer among others.
In triple-negative breast cancer, immunotherapy is often used in conjunction with chemotherapy for patients whose cancer has recurred, are in stages 2-3 before or after surgery, or for patients whose cancer has spread.
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Although immunotherapy has not been historically used to treat hormone-receptor positive breast cancers (which are the majority of breast cancers), a 2018 study has shown that T-cell therapy was effective at shrinking tumors.
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- Immune Checkpoint Inhibitors, National Cancer Institute
- Immunotherapy to Treat Cancer, National Cancer Institute
- Immunotherapy, Wikipedia
- CAR T-Cell Therapy and Its Side Effects, American Cancer Society
- Cancer Vaccines and Their Side Effects, American Cancer Society
- How Immunotherapy Is Used To Treat Cancer, American Cancer Society
- Immunotherapy For Breast Cancer, American Cancer Society
- “NIH study advances personalized immunotherapy for metastatic breast cancer,” National Institutes of Health