Immunotherapy and Cancer
What is Cancer Immunotherapy?
Immunotherapy is a type of therapy that uses the patient's own immune system, or parts of it, to fight diseases like cancer.
In oncology, immunotherapy has been studied for decades alongside traditional treatments like chemotherapy and radiotherapy. Recent advancements, however, show very promising results.
To combat cancer cells, which proliferate rapidly at the expense of healthy cells, two main immunotherapy approaches are used to counter their multiplication.
- By enhancing the body's immune system's ability to detect and eliminate cancer cells, we can effectively boost its anti-cancer response.
- By administering molecules to the immune system to improve its defenses and make it more efficient at detecting and eliminating cancer cells.
Cancer immunotherapy is also known as biological therapy or biotherapy.
Not all techniques are equally effective against all cancers. Some are highly effective for certain cancer types and less so for others, partly due to differences in their mechanisms of action. About 50% of patients respond positively; the challenge lies in increasing this percentage.
Which Tumors Does Immunotherapy Work For?
Immunotherapy has proven effective in treating several advanced-stage cancers, including melanoma, lung cancer, renal cell carcinoma, head and neck cancer, Hodgkin's lymphoma, Merkel cell carcinoma (a rare and aggressive skin cancer), and certain esophageal and urothelial cancers (cancers of the bladder lining). Studies are ongoing for triple-negative breast cancer.
Let's explore the world of immunotherapy, this promising advancement in cancer treatment, to better understand its mechanisms and various forms. Understanding our immune system is crucial to grasping its full potential.
Types of Cancer Immunotherapy
Monoclonal Antibodies (mAb)
Using cutting-edge technology, these artificial proteins are identical to those found in our natural immune system. Produced in the laboratory, they can target specific parts of cancer cells. These proteins, called antibodies, can recognize and neutralize harmful proteins, called antigens. Various types of antibodies can be produced to protect our bodies from threats by moving through organs and tissues until they encounter and neutralize the target antigen.
Researchers aim to create laboratory-produced antibodies that attack cancer cell antigens. This is challenging but essential. Without a thorough understanding of these antigens, monoclonal antibody immunotherapy is ineffective. Currently, it's only effective against certain cancer types.
Immune Checkpoint Inhibitors
This treatment aims to release the immune system's checkpoints, allowing it to detect and attack cancer cells. A key function of our immune system is distinguishing abnormal from healthy cells and attacking only the former. It uses "checkpoints"—specific molecules or cells—that must be activated to initiate an attack. However, cancer cells often exploit these immune "brakes" to avoid being targeted. Deactivating the checkpoints removes this protection and allows cancer cells to be recognized.
CAR-T Therapy
CAR-T (Chimeric Antigen Receptor T-cells) are modified cells highly effective against certain blood cancers. Their use, however, remains limited for most solid tumors.
This innovative approach combines immunotherapy with gene therapy. Immune cells (T lymphocytes) are taken from the patient, modified to recognize and attack cancer cells, multiplied in the lab, and then re-infused.
Anti-cancer Vaccines
Vaccination is a preventive approach to cancer. It equips a healthy person's body with the tools to fight pathogens that can promote certain cancers.
These vaccines function similarly to others, but protect against infections linked to cancer rather than the flu, tetanus, or rashes. Examples include vaccines against hepatitis B (a risk factor for liver cancer) and HPV (which helps prevent various cancers, including cervical, uterine, and throat cancers).
Non-Specific Cancer Immunotherapies
Individual therapies can strengthen the immune system and optimize its anti-cancer response, or be combined with conventional treatments for enhanced results.
Immune or biological therapies can be administered intravenously, orally, topically, or intravesically.
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The Effects of Immunotherapy on the Body
Cancer immunotherapy offers great hope. This new approach could reduce the side effects and risks often associated with conventional treatments like chemotherapy.
However, because these therapies regulate the immune system rather than directly targeting the tumor, secondary reactions vary greatly and show considerable individual variability.
While immunotherapy strengthens the immune system, this can also have harmful consequences, including autoimmunity (immune cells attacking healthy cells), similar to diseases like rheumatoid arthritis, lupus, or psoriasis. In short, while aiming to strengthen the immune system, immunotherapy can sometimes trigger autoimmunity.
The most common side effects involve the gastrointestinal system, skin, liver, lungs, endocrine system, and kidneys.
Other frequently observed side effects include:
- Generalized pain;
- Bloating and weight gain;
- Nausea and vomiting;
- Pain;
- Flu-like symptoms (joint pain, fever, chills, headache, fatigue);
- Blood pressure changes (increase or decrease);
- Palpitations;
- Increased susceptibility to infections;
Most side effects are mild and manageable with symptomatic medication and preventive measures, which oncologists explain to patients.
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