Immunotherapy for Cancer
Our immune system can usually detect and destroy abnormal pre-cancer or cancer cells in the body thereby stopping cancer from growing. However, a cancer might develop when;
- our immune system is not strong enough to kill the cancer cells
- the cancer cells produce signals which trick or stop the immune system from attacking it
- the cancer cells are able to hide or escape from the immune system
Types of Immunotherapy
Immunotherapy helps our immune system to fight cancer by helping the immune cells recognise and attack cancer cells. There are several types of immunotherapy which have different mode of actions. You might need to have some tests to look for specific changes in proteins or genes in your cancer cells or blood sample to find out which (if any) type of treatment is likely to work. The decision and choice of immunotherapy as well how it is given (whether in combination with other treatment modalities) depends of the type and stage of cancer you have. This needs to be discussed with your surgeon and/or cancer doctor.
1. Checkpoint inhibitors. The normal body has checkpoint proteins known as Programme Cell Death Protein 1 (PD-1), Programme Cell Death Ligand 1 (PD-L1) and Cytotoxic T-Lymphocyte Associated protein 4 (CTLA-4) which prevent the immune system from being too active. CTLA-4 and PD-1 are found on T cells while PD-L1 are found on cancer cells and some types of immune cells. Cancer cells can make these proteins which are able to trick and prevent your immune cells from killing the cancer. Medications which block these checkpoint proteins are called checkpoint inhibitors and they stop the proteins on the cancer cells from pushing the ‘stop button’ on your immune cells. These include;
- Pembrolizumab (Keytruda)
- Nivolumab (Opdivo)
- Ipilimumab (Yervoy)
- Atezolizumab (Tecentriq)
- Avelumab (Bavencio)
- Durvalumab (Infimzi)
2. Monoclonal antibodies. These antibodies are manufactured in the lab and are designed to bind to specific target proteins on cancer cells (such as CD20, CD19 or CD3) so that the immune cells can identify these cells to kill them. Some antibodies block specific target proteins (such as HER-2) and prevents these cancer cells from surviving or growing. These include;
- Rituximab (Rituxan)
- Blinatumomab (Blincyto)
- Trastuzumab (Herceptin)
- Brentuximab vedotin (Adcetris)
- Alemtuzumab (Campath)
- Ado-trastuzumab emtansine (Kadcyla)
- Bevacizumab (Avastin)
3. Immune System Modulators. These medications enhance the immune response against cancers and they include Interferon (INF) and Interleukin (IL). This group also includes Immunomodulatory drugs (also known as biological response modifiers) such as;
- Thalidomide
- Lenalidomide
- Pomalidomide
- Imiquimod
Side Effects of Immunotherapy
All cancer treatment including immunotherapy have cause side effects. These depend on how healthy you are before your start you treatment, your type and stage of your cancer as well as the type and dose of immunotherapy you are getting.
Common side effects include fever, chills, fatigue, muscle aches, feeling weak, nausea or vomiting, headache and difficulty breathing. Others include skin rash or itchiness, weight gain, swelling, diarrhoea, palpitations. In addition, there are treatment specific side effects such as;
Checkpoint inhibitors may cause inflammation in any organ in your body causing these specific side-effects;
- Lungs (shortness of breath, cough or chest pain)
- Heart (myocarditis or palpitations)
- Nerves (muscle weakness or numb sensation)
- Colon (diarrhoea, stomach or abdominal pain)
- Skin (change in skin colour, rashes or itchiness)
- Pancreas (raised blood sugar)
- Kidney (nephritis)
Monoclonal antibodies may cause cytokine release or capillary leak syndrome causing these specific side-effects;
- Low blood pressure
- Rapid heartbeat
- Difficulty breathing
- Mouth sores or ulcers
- Heart issues
- Skin rashes
Immune system modulators may cause these side-effects;
- Lower blood counts (prone to infection or bleeding)
- Allergic reactions
- Mood changes
- Birth defects (must NEVER be taken during pregnancy)
Discuss with your doctor or oncologist about your personal cancer treatment plan
Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such.
If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.