IMMUNOTHERAPY is a revolutionary cancer treatment with profound potential for the treatment of cancer. The cancer cells thrive in our body because they are able to hide from our immune system. Certain drugs such as immunotherapies can either mark cancer cells so that it is easier for the immune system to find and destroy them or boost our immune system to work better against cancer. Various types of immunotherapeutic options available are:
(a) Immune checkpoint inhibitors: These drugs basically take the ‘brakes’ off the immune system, thus making our immune cells capable enough to recognize and attack cancer cells. Ex. Nivolumumab and Pembrolizumab. They have been recently launched in India and are approved for use in case of lung cancer, hodgkins lymphoma, kidney cancer, head neck cancer, malignant melanoma (type of skin cancer) and urinary bladder cancers.
(b) Cancer vaccines: A vaccine exposes the immune system to an antigen. This triggers the immune system to recognize and destroy that antigen or related materials thus helping us to prevent or treat cancer. Ex. HPV vaccine which can be used to prevent cervical, vaginal, vulvar or anal cancer in males and females.
(c) CAR T Cell Therapy:This therapy removes some of a person’s T cells ( type of immune cells) and alters them to make them more able to fight cancer. The altered T cells are then returned to the patient’s body to go to work effectively. Some researchers have called these re-engineered cells “a living drug. CAR T cell therapy though yet unavailable in India will soon get USA drug authority approval for use in pediatric and adult leukemia.
(d) Non-specific immunotherapies: These treatments boost the immune system in a general way, and help the immune system to attack cancer cells. Ex Interleukins and Interferon’s to be used for kidney cancer or chronic myeloid leukemia.
Immunotherapy side effects can be different than those seen with chemotherapy or radiation. They are usually related to stimulation of the immune system and can range from minor “flu like” symptoms like rash, itching, and fever, to major illness such as severe diarrhea, thyroid dysfunction, liver dysfunction and breathing difficulty. Immunotherapy can “train” the immune system to remember cancer cells and this “immune-memory” may result in long-lasting disease remissions which are maintained even after the treatment is completed.
IMMUNOTHERAPY in the coming years will be the backbone of treatment in various types of cancers.
Dr. Randeep Singh
Sr. Consultant & Unit Head - Medical Oncology
MBBS, MD (Paediatrics), DM (Medical Oncology)