Cancer.Net®: Doctor-Approved Patient Information from ASCO®

Immunotherapy: An Introduction

What is Immunotherapy in Cancer Treatment?

Jyoti D. Patel, MD, Member, American Society of Clinical Oncology: Immunotherapy is using your body's own immune system to fight cancer.  There are a couple of different ways to do it.  One, we can stimulate your own immune system, or rev it up so it recognizes cancer and can fight it.  Or two, we can give a patient parts of the immune system, such as proteins or antibodies, that help the immune system fight a cancer.

Often we'll call immunotherapy biologic therapy, and we use these words interchangeably.  The underlying theme is that we use your body's own immune system to fight cancer.

Building on what we know about our own immune system and keeping foreign substances in check, we've learned that we can rev up our own immune system to fight cancer.  And this has really come into fruition in just the past few years.

Cancer Treatment Advances with Immunotherapy

Dr. Patel: Although we've had decades of research, not until 2010 was there a drug approved that predictably improved survival in melanoma, the drug ipilimumab.  The idea, again, is that if we can detect a substance as foreign and we can train our own immune system to go for those cells, we improve survival.

This has absolutely revolutionized how we approached some cancers.  Particularly some very difficult to treat ones, such as melanoma or lung cancer.

For other cancers and for other disease states, we're trying to understand how we can utilize the immune system and immune therapy in combination with other approaches.  So it may be in combination with chemotherapy or radiation.  It may be after surgery.

This is an area of a lot of scientific inquiry. We have over 900 trials in immunotherapy drugs ongoing in the United States.  We're just starting to understand how to put the pieces together.

Immunotherapy is one of the most important advancements we've made in the treatment of cancer in the past decades.  We now know that immunotherapy affects many more diseases than we ever thought.  We know that it may be beneficial in early stage disease.  We're learning how to combine it with other therapies to improve outcomes for all patients.

Types of Immunotherapy

Dr. Patel: Immunotherapy can work in several ways.  One is immunotherapy vaccines. 

Immunotherapy vaccines utilize certain proteins that are introduced to a body to rev the immune system against a cancer cell.  So for decades, that has been an area of active interest, but more recently we found that certain vaccines can develop proteins that are very specific for cancer cells and improve survival.

Another type of immunotherapy is by utilizing classes of drugs that are checkpoint blockade inhibitors.  So the idea is that cancer cells put up checkpoints or they put breaks on the immune system.  And these proteins are expressed on cancer cells, and sometimes even in the tissue stroma, such that your normal immune system can't get to the cancer cells and can't kill the cancer cells.

We're learning that there are multiple checkpoints and we're learning how to combine different checkpoint blockade inhibitors to improve survival.  The reason we have the checkpoints is so your own immune system doesn't go overboard and kill normal cells or cause problems.  

Another immunotherapy is adaptive cell transfer, and that's where white blood cells are taken from a patient's body and conditioned so they recognize cancer cells.  This has been particularly promising in some cancers, but it's still in its early phases and it's not widely available.

Another immunotherapy that is more general is giving antibody therapy that may be directed at particular white blood cells.

Questions to Ask Your Doctor

Dr. Patel: If you are meeting an oncologist, it's absolutely worthwhile to ask whether immunotherapy is appropriate for your kind of disease.  Not all cancers have proven benefit yet. 

Another question to ask is, what's the aim of the immunotherapy?  Is it to eradicate the disease?  Is it to make a patient live longer? 

Importantly, patients should ask whether the treatment will be tolerable.  Are there cumulative side effects?  Do the benefits outweigh the risks?  In the duration of therapy, is this a drug that you may be on for one or two years?

Most oncologists are very excited about immunotherapy.  It has really revolutionized our approach to patients with cancer, and we know there are consistent benefits in certain kinds of cancers.

Where to Get More Information

Dr. Patel: Cancer.Net is a great resource for patients and their families, particularly for immunotherapy.  It will explain clinical trials, it'll explain advancements in immunotherapy, and help you frame questions that may be important on your cancer journey.

[Closing and Credits]

Cancer.Net®: Doctor-Approved Patient Information from ASCO®

ASCO's patient education programs are supported by Conquer Cancer Foundation of the American Society of Clinical Oncology. ConquerCancerFoundation.org

Dr. Mary Wilkinson, Dr. Raymund Cuevo, and the staff at Medical Oncology & Hematology Associates of Northern Virginia

Carolyn B. Hendricks, MD, The Cancer for Breast Health

Hasbro Children’s Hospital

Helen F. Graham Cancer Center at Christiana Care Health System

The Adele R. Decof Comprehensive Cancer Center at The Miriam Hospital. The Miriam Hospital is a teaching hospital of The Warren Alpert Medical School of Brown University

Video Footage and photography courtesy of:

St. Jude Children’s Research Hospital Biomedical Communications

Moffitt Cancer Center

University Hospitals Case Medical Center Seidman Cancer Center

The opinions expressed in the video do not necessarily reflect the views of ASCO or the Conquer Cancer Foundation.

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