What Is Immunotherapy for Cancer Treatment?

Traditional cancer treatments, like chemotherapy, radiation, and surgery, can effectively help treat cancer. But sometimes another treatment option is needed to better treat cancer.

Immunotherapy is a different type of cancer treatment. It works by helping your immune system to be better at finding and killing cancer cells. Thanks to advances in modern medicine and technology, new immunotherapies are emerging that can treat cancer. And they can potentially help people with certain cancers live longer compared to traditional treatments, too.

In this article, we’ll discuss what immunotherapy is and which medications are classified as immunotherapies.

What is immunotherapy?

Immunotherapy is a type of treatment that helps your immune system more effectively fight diseases like cancer. It can tell your immune system to be more active in certain ways, and it can teach it how to find and kill cancer cells better.

Cancer immunotherapy is different from allergy immunotherapy. This can understandably cause confusion, since both types of treatment are referred to as “immunotherapy.” 

With allergy immunotherapy, you’re gradually given higher doses of the substance you’re allergic to, called an allergen. Over time, this causes your immune system to become desensitized to the allergen. This means that when you encounter the allergen, your immune system won’t react as strongly — meaning you experience fewer or less severe allergy symptoms.

In other words, both allergy immunotherapy and cancer immunotherapy affect how your immune system works. But there are a few key differences:

• Allergy immunotherapy involves receiving a small amount of a substance (allergen) that causes an allergic reaction so that your body becomes less sensitive to it over time.

• With cancer immunotherapy, you aren’t injected with cancer cells. Instead, these medications teach your immune system to work better at finding and destroying cancer cells.

What types of cancer can be treated with immunotherapy?

Immunotherapy medications are FDA-approved to treat many different types of cancer. Examples of cancers that can be treated with immunotherapy include:

• Bladder cancer

• Blood cancers, including lymphoma and leukemia

• Breast cancer

• Colorectal cancer

• Kidney cancer

• Liver cancer

• Lung cancer, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)

• Multiple myeloma

• Skin cancer, including melanoma

Immunotherapy works well for some cancers but not for others. It may be used alone to treat some cancers. But for other types, immunotherapy may be used in combination with other cancer treatments.

Because immunotherapy works by affecting your immune system, some of these medications are also used to treat other conditions, including rheumatoid arthritis (RA) and psoriasis.

How is immunotherapy administered?

Immunotherapy medications can be administered in several different ways. These can include pills that you swallow, creams or ointments that you apply to your skin, or injections given into your bladder or a vein. 

How is immunotherapy different from chemotherapy and targeted therapy?

Chemotherapy medications usually come to mind when we think of traditional cancer treatments. Chemotherapy works by targeting cells that multiply quickly. This means it targets cancer cells, but it also affects normal and healthy parts of the body, such as hair cells. Because they can affect normal, non-cancerous parts of the body, chemotherapy medications tend to cause many side effects.

Targeted cancer therapies generally include medications that interfere with certain genes or proteins. Unlike chemotherapy, targeted therapies look for specific components of cancer cells — elements that only cancer cells have and healthy cells don’t, or that cancer cells have in higher numbers.

Targeted therapy and immunotherapy are similar: both are newer treatment types. In fact, sometimes immunotherapy is considered to be a type of targeted therapy. This is called targeted immunotherapy. But some targeted therapies aren’t considered to be immunotherapy. 

And while some immunotherapies work by targeting specific proteins on cancer cells, not all of them do. Instead, some help activate or help your own immune system better find and destroy cancer cells. 

If you or a loved one has a cancer diagnosis and think immunotherapy may be an option, please speak with a cancer specialist for more information. 

What current medications are considered to be immunotherapy?

There are several types of immunotherapy currently used to treat cancer. 

Monoclonal antibodies

An antigen is a portion of a pathogen, such as a bacteria, virus, or fungus, that provokes a response from the immune system. An antibody is a defense-oriented protein made by your immune system after it’s exposed to an antigen. Antibodies can bind to an antigen, serving as a warning flag. They send signals to your immune system to destroy the pathogen it’s warning the body about.

Monoclonal antibodies are human-made antibodies. They’re made by scientists to flag specific antigens found on cancer cells. These medications help your immune system find cancer cells so your body knows to destroy them. Examples of monoclonal antibodies for immunotherapy include:

• Cetuximab (Erbitux)

• Pertuzumab (Perjeta)

• Rituximab (Rituxan)

• Trastuzumab (Herceptin)

Some monoclonal antibodies work by interrupting certain systems your immune system has in place to make sure it’s not underactive or overactive. These medications are technically monoclonal antibodies, but they’re also classified as immune checkpoint inhibitors. 

Immune checkpoint inhibitors

These medications stop certain checks and balances that are in place to keep your immune system from becoming overactive. By interfering with these checks, your immune system can become more active and mount a stronger response against cancer. Examples of immune checkpoint inhibitors include:

• Atezolizumab (Tecentriq)

• Durvalumab (Imfinzi)

• Ipilimumab (Yervoy)

• Nivolumab (Opdivo)

• Pembrolizumab (Keytruda)

Immune system modulators

Immune system modulators help enhance your immune system’s response to cancer. For example, they may tell your immune system to make more of a specific protein useful in fighting your specific type of cancer. Examples of immune system modulators include:

• Imiquimod (Zyclara)

• Lenalidomide (Revlimid)

• Pomalidomide (Pomalyst)

• Thalidomide (Thalomid)

T-cell transfer therapy

T cells are an important part of the immune system. They directly target and get rid of unwanted substances, like bacteria, viruses, or cancer cells. 

With T-cell transfer therapy, your own T cells are collected and modified in a lab. While in the lab, they’re trained to better recognize and fight your cancer. Large numbers of these T-cells are produced, trained, and then injected back into your body. 

Examples of T-cell transfer therapies in use include axicabtagene ciloleucel (Yescarta), brexucabtagene autoleucel (Tecartus), and tisagenlecleucel (Kymriah).

Treatment vaccines 

We typically think of a vaccine as something given to prevent disease. This isn’t the case with cancer treatment vaccines: They’re given to people who already have cancer in order to strengthen the body’s natural defenses. 

Treatment vaccines help your immune system better recognize, find, and destroy cancer cells. Examples of cancer treatment vaccines include sipuleucel-T (Provenge) and talimogene laherparepvec (Imlygic).

How long does immunotherapy treatment last for?

Unfortunately, a specific timeline isn’t available. How long immunotherapy treatment lasts depends on several different factors, including:

• The type and severity of your cancer

• The type of immunotherapy you’re prescribed

• How your cancer and body respond to immunotherapy

If you’re curious about how long a particular immunotherapy may be effective for you or a loved one, speak to a cancer specialist. 

What side effects are associated with immunotherapy cancer treatment?

Like with all medications, people can experience different side effects from immunotherapy. Side effects you get from immunotherapy can vary depending on the medication you get, the type of cancer you have, how advanced your cancer is, and the dose you’re prescribed.

However, some side effects common across most immunotherapy medications include:

• Flu-like symptoms, such as chills, fever, fatigue, or weakness

• Injection-site reactions (e.g., pain, rash, itchiness, soreness, swelling)

• Diarrhea

• Fast or irregular heartbeat

• Retaining water (e.g., swelling, weight gain)

• Higher risk of infection

Keep in mind that some immunotherapy medications may carry risks for more serious side effects than others. Other side effects may also be experienced that aren’t listed here. Your cancer specialist can give you more details on the side effects of immunotherapy medications.

How much does immunotherapy cost?

Unfortunately, immunotherapy can be expensive. But its costs vary depending on several factors, including:

• The type of immunotherapy you receive

• How often you receive or take immunotherapy

• Your insurance coverage and status

For example, Keytruda’s listed price per dose, according to the manufacturer, is over $10,000. This medication is usually given once every 3 weeks. But to determine the actual out-of-pocket costs you’d pay, contact your cancer specialist’s office. They can work with your insurance company to help determine the costs you’ll pay for immunotherapy, based on your treatment plan and coverage. 

If you don’t have insurance coverage, your cancer specialist’s office may also be able to find other options to help lower the cost of treatment. These may include patient assistance programs from a medication’s manufacturer or from organizations like the PAN Foundation, HealthWell Foundation or Good Days.  

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Written by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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