Immunotherapy
Definition:
Immunotherapy, also called biologic therapy, is a type of cancer treatment that uses your own body fight off cancer. Immunotherapy specifically targets your immune system. The immune system is what helps your body fight off infection and other diseases.1 The immune system is composed of white blood cells as well as organs and tissues of the lymph system. Substances that are normally found in the body are kept track by the immune system. Anything that the immune system does not recognize, it attacks. However, cancer cells are difficult for the immune system to detect. The reason for this is because cancer begins when cells become altered and grow uncontrollably. The immune system does not always recognize cancer cells as foreign and therefore does not attack them.2
Immunotherapy can be done by either stimulating your immune system to work harder or smarter and attack the cancer cells or by giving the individual immune system components, such as man-made immune system proteins. Immunotherapy can work by boosting the body’s immune system in a general way or by training the immune system to attack the cancer cells specifically. Some cancers respond better to immunotherapy than others. Immunotherapy can be used by itself for some cancers or combined with other treatments.2
Types:
There are several different types of immunotherapy that are used in the treatment of cancer. The different types are: monoclonal antibodies, adoptive cell transfer, cytokines, treatment vaccines and BCG.2
Monoclonal antibodies
Monoclonal antibodies are drugs that are designed to bind to specific targets in the body. The goal is that they produce an immune response that kills the cancer cells. Some types of monoclonal antibodies “mark” the cancer cells so that it is easier for the immune system to identify them and kill them. These specific type of antibodies are called “targeted therapy.”2
Adoptive cell transfer
Adoptive cell transfer is a type of treatment that boosts the natural ability of your body’s T-cells to fight the cancer. T-cells are a white blood cell and an integral part of the immune system. This process begins by taking T-cells from the cancer tumor and then isolating the cells that are most active against your specific type of cancer or modifying the genes in them in order to make them more able to find and destroy your cancer cells. Large amounts of these T-cells are grown in a laboratory. While they are being grown, the patient may have procedures done to reduce their immune cells. After these treatments, the T-cells that were grown are given back to the patient through a needle. Then they can go on to attack the cancer in the body.2
Cytokines
Cytokines are proteins produced by your body’s cells. They have an important role in your body’s immune system. They are vital to the immune response and the body’s ability to respond to cancer. Interferons and interleukins are the two main types of cytokines used to treat cancer.2
Treatment Vaccines
Treatment vaccines help to boost your body’s immune system response to cancer cells. These vaccines are not the same as the ones that prevent you from getting diseases, such as tetantus or whooping cough.2
BCG (Bacillus Calmette-Guerin)
BCG is a type of immunotherapy that is used to treat bladder cancer. It is a weakened form of the bacteria that causes tuberculosis. When inserted into the bladder through a catheter, it causes an immune response to kill the cancer cells.2
History:
In 1890, scientists Emil von Behring and Shibasaburo Kitasato, found that by injecting diphtheria toxin into animals it subsequently produced a serum containing an anti-toxin that provided passive anti-diphtheria immunity to people. This should that serum could be used as a therapy and that immunity did not need to be produced internally, but that it could be transferred as well.3 Also in 1890, William Coley, a surgeon, began to notice a different phenomenon. He had a patient who had complete remission of their cancer following two attacks of an infection with Streptococcus pyogenes. He tested this by injecting streptococcal cultures into other patients after this particular case and found that there was tumor regression in these cancer patients. He published his results in 1893 and was the first individual who seriously attempted cancer immunotherapy.4
Today’s Situation/Diseases Treated by Immunotherapy
Immunotherapy is not used as widely as other cancer treatments such as surgery, chemotherapy or radiation. Immunotherapy is currently used to treat melanoma, lung cancer, lymphoma, leukemia and prostate cancer.5 There is a great deal of research being completed on the different types of immunotherapies and the different types of cancer that can be treated by it. Some of the new research that is being conducted is a focus on newer monoclonal antibodies, treatments that target immune system checkpoints, newer cancer vaccines, oncolytic viruses and other ways to boost the immune system.6
Immunotherapy, also called biologic therapy, is a type of cancer treatment that uses your own body fight off cancer. Immunotherapy specifically targets your immune system. The immune system is what helps your body fight off infection and other diseases.1 The immune system is composed of white blood cells as well as organs and tissues of the lymph system. Substances that are normally found in the body are kept track by the immune system. Anything that the immune system does not recognize, it attacks. However, cancer cells are difficult for the immune system to detect. The reason for this is because cancer begins when cells become altered and grow uncontrollably. The immune system does not always recognize cancer cells as foreign and therefore does not attack them.2
Immunotherapy can be done by either stimulating your immune system to work harder or smarter and attack the cancer cells or by giving the individual immune system components, such as man-made immune system proteins. Immunotherapy can work by boosting the body’s immune system in a general way or by training the immune system to attack the cancer cells specifically. Some cancers respond better to immunotherapy than others. Immunotherapy can be used by itself for some cancers or combined with other treatments.2
Types:
There are several different types of immunotherapy that are used in the treatment of cancer. The different types are: monoclonal antibodies, adoptive cell transfer, cytokines, treatment vaccines and BCG.2
Monoclonal antibodies
Monoclonal antibodies are drugs that are designed to bind to specific targets in the body. The goal is that they produce an immune response that kills the cancer cells. Some types of monoclonal antibodies “mark” the cancer cells so that it is easier for the immune system to identify them and kill them. These specific type of antibodies are called “targeted therapy.”2
Adoptive cell transfer
Adoptive cell transfer is a type of treatment that boosts the natural ability of your body’s T-cells to fight the cancer. T-cells are a white blood cell and an integral part of the immune system. This process begins by taking T-cells from the cancer tumor and then isolating the cells that are most active against your specific type of cancer or modifying the genes in them in order to make them more able to find and destroy your cancer cells. Large amounts of these T-cells are grown in a laboratory. While they are being grown, the patient may have procedures done to reduce their immune cells. After these treatments, the T-cells that were grown are given back to the patient through a needle. Then they can go on to attack the cancer in the body.2
Cytokines
Cytokines are proteins produced by your body’s cells. They have an important role in your body’s immune system. They are vital to the immune response and the body’s ability to respond to cancer. Interferons and interleukins are the two main types of cytokines used to treat cancer.2
Treatment Vaccines
Treatment vaccines help to boost your body’s immune system response to cancer cells. These vaccines are not the same as the ones that prevent you from getting diseases, such as tetantus or whooping cough.2
BCG (Bacillus Calmette-Guerin)
BCG is a type of immunotherapy that is used to treat bladder cancer. It is a weakened form of the bacteria that causes tuberculosis. When inserted into the bladder through a catheter, it causes an immune response to kill the cancer cells.2
History:
In 1890, scientists Emil von Behring and Shibasaburo Kitasato, found that by injecting diphtheria toxin into animals it subsequently produced a serum containing an anti-toxin that provided passive anti-diphtheria immunity to people. This should that serum could be used as a therapy and that immunity did not need to be produced internally, but that it could be transferred as well.3 Also in 1890, William Coley, a surgeon, began to notice a different phenomenon. He had a patient who had complete remission of their cancer following two attacks of an infection with Streptococcus pyogenes. He tested this by injecting streptococcal cultures into other patients after this particular case and found that there was tumor regression in these cancer patients. He published his results in 1893 and was the first individual who seriously attempted cancer immunotherapy.4
Today’s Situation/Diseases Treated by Immunotherapy
Immunotherapy is not used as widely as other cancer treatments such as surgery, chemotherapy or radiation. Immunotherapy is currently used to treat melanoma, lung cancer, lymphoma, leukemia and prostate cancer.5 There is a great deal of research being completed on the different types of immunotherapies and the different types of cancer that can be treated by it. Some of the new research that is being conducted is a focus on newer monoclonal antibodies, treatments that target immune system checkpoints, newer cancer vaccines, oncolytic viruses and other ways to boost the immune system.6
- National Cancer Institute. Immunotherapy. Accessed on July 12, 2016 http://www.cancer.gov/about-cancer/treatment/types/immunotherapy
- American Cancer Society. What is cancer immunotherapy? Accessed on July 12, 2016 http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-what-is-immunotherapy
- Cancer Research Institute. Timeline of Progress. Accessed on July 12, 2016 http://www.cancerresearch.org/our-strategy-impact/timeline-of-progress/timeline-detail
- Parish, C.R. (2003). Cancer immunotherapy: The past, the present and the future. Immunology and Cell Biology, 81, 106-113.
- National Cancer Institute. Immunotherapy: Using the immune system to treat cancer. Accessed on July 12, 2016 http://www.cancer.gov/research/areas/treatment/immunotherapy-using-immune-system
- American Cancer Society. What’s new in cancer immunotherapy research? Accessed on July 12, 2016 http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-whats-new-immuno-res