What Is Immunotherapy?
How immunotherapy works
Your immune system is a powerful and important defense system. It’s designed to protect your body from dangerous threats. It can attack germs like bacteria and viruses, and it can also help prevent and fight cancer.
But when fighting tough-to-treat illnesses like cancer, your immune system sometimes needs a little help. That’s because cancer cells can be smart and tricky. They may find ways to avoid the immune system, and they can also make it less active or effective.
This is where immunotherapy can step in.
Immunotherapy is a type of medical treatment that can help make your immune system better at finding and attacking cancer cells. Many medications are considered immunotherapy medications.
Immunotherapy medications are usually used to treat cancer. But some can also treat certain autoimmune disorders. A different type of immunotherapy can also help prevent allergy symptoms.
Table of contents
Uses
Immunotherapy medications are flexible — they can treat many types of cancer. Depending on the medication and situation, they can treat cancers such as:
Blood cancers, like leukemia, lymphoma, or multiple myeloma
Cancers that involve internal organs, such as the brain, breasts, or lungs
Childhood cancers
Skin cancers, like melanoma
Current immunotherapy medications are effective for many cancers. But they’re ineffective for others. If you have questions about whether immunotherapy can treat a specific type of cancer, talk to your cancer specialist.
This is also an area that researchers are still working on. As time goes on, researchers aim to make immunotherapy available for all forms of cancer.
Types of immunotherapy
Immunotherapy medications are diverse. There are a lot of them, and they work in different ways. Because of this, they’re divided into different groups. These include:
Immune checkpoint inhibitors: Some cancers learn to “turn off” parts of the immune system. Immune checkpoint inhibitors help prevent this to make your immune system more effective.
Monoclonal antibodies (MAbs): MAbs are lab-made antibodies (proteins) that find and attack cancer cells.
Cancer vaccines: Similar in style to MAbs, cancer vaccines help your immune system recognize what cancer cells look like. They can help your immune system find and destroy cancer cells.
T-cell transfer therapy: These treatments train T-cells in your immune system to better attack cancer cells.
Immunomodulators: This is a diverse group of medications that “turn on” immune activity that is helpful and lower immune activity that can be harmful.
As time goes on, it’s likely that other types of immunotherapy medications will become available.
Immunotherapy medications
All immunotherapy medications are used for specific purposes. Two of the most common types are immune checkpoint inhibitors and monoclonal antibodies.
Examples of immune checkpoint inhibitors include:
Atezolizumab (Tecentriq)
Ipilimumab (Yervoy)
Pembrolizumab (Keytruda)
Examples of monoclonal antibodies include:
Daratumumab (Darzalex)
Rituximab (Rituxan)
Trastuzumab (Herceptin)
Cancer vaccines and T-cell transfer therapies continue to be a topic of interest among health experts. These will likely be more common in the future.
Examples of cancer vaccines are sipuleucel-T (Provenge) and talimogene laherparepvec (Imlygic). Examples of T-cell transfer therapies are tisagenlecleucel (Kymriah), brexucabtagene autoleucel (Tecartus), and axicabtagene ciloleucel (Yescarta).
How it’s administered
Immunotherapy medications can be given to you in a few different ways. They’re usually given to you at a doctor’s office, hospital, or infusion center. But sometimes, you can use or receive them at home. And you’re usually scheduled to get these medications at specific times, such as once every few weeks.
Immunotherapy medications are often given as an:
Infusion into a vein
Oral medication
Topical medication applied to the skin
Injection into the bladder
Your cancer specialist will tell you how, when, and where you should receive your treatments.
Side effects
Like with all medications, immunotherapy medications have many possible side effects. Some may be mild, and others can be serious. Specific side effects vary by person and medication. Other medications you’re taking can also impact the side effects you might have.
Nonetheless, a few side effects are often seen. You may end up feeling symptoms like:
Pain, redness, or swelling near the injection site
Flu-like symptoms, like fever, chills, and tiredness
Inflammation around the body, which may cause symptoms like abdominal discomfort or muscle and joint pain
Diarrhea
Fluid retention
Fast heartbeat
Higher chance for infection
For a more complete list of side effects, look at your medication’s label. You can also talk to a healthcare provider or pharmacist for more information.
Other uses
Immunotherapy can also treat certain autoimmune disorders. Autoimmune disorders — also called autoimmune conditions — are caused by problems with the body’s immune system.
At first glance, this relationship may seem confusing. Autoimmune disorders are often caused by an overactive immune system. But cancer immunotherapy medications often boost the immune system. Wouldn't immunotherapy make most autoimmune diseases worse?
Not necessarily. They can also help tamp down certain immune system functions that help cause autoimmune disease. Certain conditions, like rheumatoid arthritis (RA), can benefit from immunotherapy medications.
For example, look at rituximab. It’s an immunotherapy medication used for cancer, but it’s also approved to treat RA, Wegener’s granulomatosis, and pemphigus vulgaris. These are autoimmune disorders. It helps by interfering with B cells, an important immune system cell.
Common concerns
Some cancer treatments — like chemotherapy and radiation — usually start working quickly. This isn’t usually the case for immunotherapy medications. Immunotherapy can take some time to start working, often a couple months or more. But the specific time frame varies for everyone. It depends on your cancer type and other treatments you may be receiving.
Research shows that immunotherapy medications can be used in many scenarios. They can be a first-choice option or an option if nothing else has worked. They are also used in combination with many other cancer treatments. This will differ based on your cancer, other health condition(s), and test results.
Compared to other cancer treatments — such as chemotherapy — immunotherapy is less likely to cause hair loss. Many people who receive immunotherapy don’t have any hair loss or hair thinning. But it’s still possible. For example, in clinical trials, atezolizumab contributed to hair loss in some people who also received chemotherapy.
If you’re taking immunotherapy medications, it’s best to limit or avoid alcohol when possible. But this can be hard in social situations like dinner events or family gatherings. If you would like to drink alcohol while receiving treatment, talk to your cancer specialist. They can help you figure out a plan that keeps you safe.
Yes. This is called allergy immunotherapy. Even though it shares a similar name, allergy immunotherapy works differently than immunotherapy for cancer and autoimmune disorders.
Allergy immunotherapy aims to make your immune system less sensitive to something that you’re allergic to. This treatment currently comes in two forms — as an injection under the skin and as a pill that can dissolve under your tongue.
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References
American College of Allergy, Asthma, & Immunology. (2021). Allergy immunotherapy.
American College of Allergy, Asthma, & Immunology. (2017). Allergy shots.
American College of Allergy, Asthma, & Immunology. (2017). SLIT.
Cancer Research Institute. (2020). Cancer vaccines: preventive, therapeutic, personalized.
Cancer Research Institute. (2021). How cellular immunotherapies are changing the outlook for cancer patients.
Cancer Research Institute. (2021). Immunotherapy: impacting all cancers.
DailyMed. (2019). Imlygic - talimogene laherparepvec injection, suspension.
Dendreon Pharmaceuticals. (2020). Provenge [package insert].
Genentech. (2021). Rituxan [package insert].
Genentech. (2021). Tecentriq [package insert].
Genetic and Rare Diseases Information Center (GARD). (2021). Pemphigus vulgaris.
Kite Pharma. (2021). Tecartus [package insert].
Kite Pharma. (2021). Yescarta [package insert].
Lopez, M.J., et al. (2021). Drug labeling. StatPearls.
MedlinePlus. (2016). Immune system and disorders.
National Cancer Institute. (2019). Cancer treatment vaccines.
National Cancer Institute. (2019). Immune checkpoint inhibitors.
National Cancer Institute. (2019). Immune system modulators.
National Cancer Institute. (2019). Immunotherapy side effects.
National Cancer Institute. (2019). Immunotherapy to treat cancer.
National Cancer Institute. (2019). Monoclonal antibodies.
National Cancer Institute. (2020). T-cell transfer therapy.
Nature Biomedical Engineering. (2019). Immunotherapies for autoimmune diseases.
Novartis. (2021). Kymriah [package insert].
Randall, K.L. (2016). Rituximab in autoimmune diseases. Australian Prescriber.
Sandhu, V. (2019). Granulomatosis with polyangiitis (Wegener's). Rheumatology.
