Immunotherapy: Here’s What You Need to Know

Our immune system is made up of our white blood cells, our lymph nodes and even our bone marrow. The main job of this amazing collection of body tissues is to help our bodies fight off disease and stay healthy. Researchers are now finding ways to harness that disease-fighting prowess in the war on cancer. Immunotherapy drugs harness our immune system to find and get rid of cancer cells.

Several immunotherapy drugs have been approved to fight cancer, and hundreds more are being tested in clinical trials. Your doctor may recommend immunotherapy to fight your cancer. There are pros and cons to this approach.

Benefits

  1. Immunotherapy works differently from radiation and chemotherapy, so it may work when those treatments don’t.
  2. Because it targets just your immune system and not your body in general, it causes different side effects than traditional chemotherapy.
  3. Some immunotherapy is used in conjunction with other standard treatments, like chemotherapy, to help them work better.
  4. By tuning your immune cells to be on the lookout for cancer, when you have immunotherapy, those cells keep going after cancer cells if they come back, keeping you cancer-free for longer.
  5. It is an option for some people who had no other recourse. In 2016, immunotherapy drugs accounted for 4 of the 13 new anticancer treatments approved by the FDA, and the American Society of Clinical Oncology named cancer immunotherapy the 2016 Advance of the Year.

“We are fortunate here (at Sylvester Comprehensive Cancer Center) to partner with leading drug development companies to develop new immunotherapies, and provide our patients with access to cutting-edge treatments,” says Dr. Breelyn Wilky, a medical oncologist with Sylvester. “In particular, our Phase I clinical trial group has multiple studies of new immunotherapy drugs not available elsewhere in South Florida.”

Successes

Targeted immunotherapies help the immune system recognize and target cancer cells. Cancer vaccines and so-called checkpoint inhibitors are forms of targeted immunotherapy. The FDA has approved immunotherapy drugs to treat melanoma, lymphoma, non-small cell lung cancer, renal cell carcinoma, bladder cancer, cervical cancer, and certain head and neck cancers.

One example of successful immunotherapy has been in people with lung cancer who take nivolumab or pembrolizumab. In some people who had been given a few months to live, these therapies have enabled them to live for years. But others with essentially the same cancer had no response.

Most of the recently approved immunotherapy drugs are checkpoint inhibitors, drugs that target a specific chemical checkpoint, such as PD-L1.  These are molecules on tumor and immune cells that, when activated, release the brakes on the immune system and encourage it to fight the cancer.

The cautions of immunotherapy

  1. It is not side-effect free. They are just different. Because immunotherapy stimulates your immune system, it may feel like you have an infection: fever, chills, fatigue. You could get swelling, weight gain, fluid retention, even diarrhea. However, most of the time, these calm down after the first treatment. But some may be severe.
  2. You could have a local reaction to the injection: itching, swelling or redness.
  3. They can take off the normal safeguards that keep your immune system from attacking normal tissue, sometimes mistaking other organs for cancers and attacking them.
  4. Immunotherapy may take longer than traditional therapies to have an impact on your cancer.
  5. Not everyone responds to immunotherapy. In some cases, only a certain subset of people with a cancer will respond: patients with the PD-L1 checkpoint signal on lung cancer cells respond better, for instance. In other cases, doctors don’t know why it works for less than half the people who try it. However, you could get a partial response: your tumor stops growing but doesn’t go away. In those cases, you may live longer with your cancer but not be cured.
  6. Some people get used to the therapy and it stops working on their cancers.
  7. Immunotherapy is expensive. Some drugs may cost $150,000 or more a year. When insurance covers part of it, your co-pays may still be considerable.

All in all, immunotherapy shows great promise for helping your immune system help you if you have cancer. However, only you and your doctor can determine if the risks and benefits of a particular immunotherapy are right for you.