What Is Immunotherapy And Its Roles In Cancer Treatment?
Cancer continues to be one of the leading causes of illness worldwide, affecting millions each year. Despite significant progress in surgery, chemotherapy, and radiation, effectively eradicating cancer remains a major challenge. Recently, cancer immunotherapy has emerged as a groundbreaking treatment option.
By utilising the body's immune system to identify and destroy cancer cells, immunotherapy offers a promising alternative to traditional therapies, bringing new hopes to patients once considered untreatable.
The objective of this blog is to explore how Immunotherapy for cancer treatment is revolutionising and its potential to change the future of cancer treatment.
What are the types of immunotherapy for cancer treatment?
There are various types of immunotherapy used in cancer treatment. Each type targets different aspects of the immune response or interacts with the immune system in unique ways.
These therapies have been developed over many years and have proven to be particularly effective for certain types of cancer, including melanoma, lung cancer, and certain blood cancers.
Type of Immunotherapy | Description | Examples (Immunotherapy drugs) | Effectiveness & Challenges |
| Checkpoint Inhibitor Therapy | Targets immune checkpoints, molecules on immune cells that regulate immune responses. Cancer cells use these checkpoints to avoid immune attacks. | Pembrolizumab and Nivolumab | Effective for melanoma, lung cancer, and head & neck cancer. Side effects include autoimmune responses. |
| CAR T-cell Therapy | Involves modifying a patient’s T-cells to enhance their ability to recognise and kill cancer cells by adding chimeric antigen receptors (CARs). | Customised treatment can be given | Effective for blood cancers like ALL and non-Hodgkin lymphoma. Side effects include cytokine release syndrome (CRS). |
| Monoclonal Antibodies | Lab-made antibodies that mimic immune system proteins to target cancer-specific antigens on tumour cells, either killing cancer cells directly or recruiting immune help. | Rituximab and Trastuzumab | Effective for lymphoma and breast cancer. It can be used in conjunction with other treatments. |
| Targeted Therapy for Cancer | Targets cancer cells based on their genetic makeup or molecular characteristics, often working with immunotherapy. | Erlotinib and Imatinib | Targets specific proteins or mutations in cancers like non-small cell lung cancer and chronic myelogenous leukaemia (CML). |
What are the major side effects of immunotherapy?
Cancer immunotherapy can offer significant benefits, but it may cause side effects, which vary by therapy type and individual response. Below are common cancer immunotherapy side effects:
- Fatigue: One of the most commonly reported side effects, fatigue can range from mild to severe, impacting daily activities.
- Skin reactions: Rash, itching, and redness are common, especially in treatments like checkpoint inhibitors.
- Gastrointestinal issues: Diarrhea, nausea, and abdominal pain may occur due to immune activation in the gut.
- Endocrine disorders: Immunotherapy can cause inflammation in the thyroid (hypothyroidism or hyperthyroidism), adrenal glands, or pituitary gland.
- Inflammation of organs: Autoimmune diseases can occur, leading to inflammation in organs such as the lungs (pneumonitis), liver (hepatitis), or colon (colitis).
- Fever: A mild to moderate fever can develop as the immune system is activated.
- Joint and muscle pain: Musculoskeletal symptoms, such as arthritis or muscle pain, are also reported by some patients.
- Lung issues: Pneumonitis, or inflammation of the lungs, can lead to coughing, shortness of breath, and chest pain.
- Appetite loss: Decreased appetite and unintended weight loss may occur during treatment.
- Infusion reactions: Some patients may experience fever, chills, or difficulty breathing during or shortly after receiving an infusion of immunotherapy.
Which cancers does immunotherapy treat?
Immunotherapy is a groundbreaking treatment approach that harnesses the body's immune system to fight various types of cancer. It has shown effectiveness across a range of cancers, offering new hope for patients.
Below are the types of cancer treated with immunotherapy:
- Melanoma: One of the most responsive cancers to immunotherapy, especially with checkpoint inhibitors like pembrolizumab and nivolumab.
- Non-Small Cell Lung Cancer (NSCLC): Immunotherapy can significantly improve survival rates, especially when combined with chemotherapy.
- Bladder Cancer: Checkpoint inhibitors such as atezolizumab and nivolumab have been FDA-approved for advanced bladder cancer.
- Kidney Cancer: Immune checkpoint inhibitors can be used to treat renal cell carcinoma, often in combination with other therapies.
- Hodgkin Lymphoma: Immunotherapy has been effective in treating relapsed or refractory Hodgkin lymphoma.
- Head and Neck Cancer: Checkpoint inhibitors have shown promise in treating squamous cell carcinoma of the head and neck.
- Cervical Cancer: Pembrolizumab has been approved for advanced or recurrent cervical cancer.
- Colorectal Cancer: Microsatellite instability-high (MSI-H) or mismatch repair-deficient cancers respond well to immunotherapy.
- Esophageal Cancer: Some patients with advanced esophageal cancer have benefited from immune checkpoint inhibitors.
- Triple-Negative Breast Cancer (TNBC): Immunotherapy, especially when combined with chemotherapy, is becoming a standard of care for advanced TNBC.
Immunotherapy continues to expand in its scope, providing patients with treatment options that were previously unavailable or less effective.
What is the success rate of immunotherapy for different cancer treatments?
The success rate of immunotherapy can vary depending on the type of cancer, the specific immunotherapy used, and the individual patient's response.
Some general success rates for immunotherapy across different cancer types are:
- Melanoma: 40-60% response with checkpoint inhibitors (e.g., pembrolizumab, nivolumab), some achieving long-term remission.
- Non-small cell lung cancer (NSCLC): 20-30% response, higher in patients with high PD-L1 expression; improved with chemotherapy.
- Bladder cancer: 20-30% response with checkpoint inhibitors (e.g., atezolizumab, nivolumab).
- Kidney cancer: 20-40% response with immune checkpoint inhibitors; higher with combination therapies.
- Hodgkin lymphoma: 60-70% response with PD-1 inhibitors for relapsed or refractory cases.
- Head and neck cancer: 15-20% response, higher in certain subgroups.
- Cervical cancer: 10-15% response with pembrolizumab.
- Colorectal cancer: 40-50% response for MSI-H cancers, higher for mismatch repair-deficient cancers.
- Triple-negative breast Cancer: 20-30% response, with some long-term remission.
- Esophageal cancer: 10-20% response in advanced or metastatic cases.
Expert’s take on choosing immunotherapy over standard cancer treatment:
Dr Sudhir Singh, Professor at King George's Medical University, said, "Chemotherapy and targeted therapy have significant side effects, while radiotherapy can also cause discomfort. Immunotherapy has minimal side effects. These drugs enhance the immune response against cancer by identifying and destroying cancer cells. Out of 100 patients, 10 are recovering rapidly, while in 20 patients who showed no response to chemotherapy, cancer progression halted."
Frequently Asked Questions
Q1. How does immunotherapy work for cancer?
Immunotherapy works for cancer by boosting or restoring the immune system's ability to recognise and attack cancer cells. It either enhances immune responses or helps the immune system overcome cancer's ability to evade detection.
Q2. What are some of the best immunotherapy drugs for cancer treatment?
Some of the best immunotherapy drugs for cancer treatment include Pembrolizumab, Nivolumab, and Atezolizumab. These checkpoint inhibitors help the immune system recognise and attack cancer cells effectively.
Q3. What are the common side effects of immunotherapy in cancer patients?
Common side effects of immunotherapy in cancer patients include fatigue, skin rashes, and gastrointestinal issues like diarrhoea. In some cases, it can cause autoimmune reactions, leading to inflammation in organs such as the lungs, liver, or intestines. These side effects are usually manageable with proper monitoring and treatment adjustments.
Q4. Immunotherapy vs chemotherapy: which is better?
Immunotherapy boosts the body's immune system to target and destroy cancer cells, offering longer-lasting effects and fewer side effects than chemotherapy. Chemotherapy uses drugs to kill rapidly dividing cancer cells but can damage healthy cells, leading to more severe side effects. The choice depends on cancer type, stage, and individual patient factors.
Q5. How costly is immunotherapy in India?
The cost of immunotherapy in India is typically high, ranging from ₹50,000 to ₹3,00,000 per session, depending on the type of therapy and cancer being treated. For advanced treatments like CAR T-cell therapy, the cost can exceed ₹20 lakhs. However, the price may vary based on the hospital, location, and specific drug used.
Wrapping up
Immunotherapy has revolutionised cancer treatment, offering hope for cancers once deemed untreatable. Despite its promise, challenges like side effects, treatment resistance, and accessibility remain. Ongoing research and advancements will continue to improve cancer immunotherapy, making it more effective with fewer side effects.
In the future, the combination of immunotherapy, targeted therapy, and personalised medicine may bring us closer to eradicating cancer.
Also, read our other blogs on immunotherapy:
1. Immunotherapy Awareness: What You Need To Know!
2. Immunotherapy For Liver Cancer
References
1. Justiz Vaillant AA, Nessel TA, Patel P, et al. Immunotherapy. [Updated 2024 Apr 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519046/
2. Zhang C, Durer S, Thandra KC, et al. Chimeric Antigen Receptor T-Cell Therapy. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537294/
3. Emens LA, Middleton G. The interplay of immunotherapy and chemotherapy: harnessing potential synergies. https://pmc.ncbi.nlm.nih.gov/articles/PMC5012642/
4. Kichloo A, Albosta M, Dahiya D, Guidi JC, Aljadah M, Singh J, Shaka H, Wani F, Kumar A, Lekkala M. Systemic adverse effects and toxicities associated with immunotherapy: A review. https://pmc.ncbi.nlm.nih.gov/articles/PMC7968107/
