What Is Immunotherapy And Its Roles In Cancer?

Did You Know? 

Cancer can attenuate the functions of your immune system. Most blood cancers such as leukemia affect the bone marrow by replacing the healthy immune cells cells with cancerous cells. The working of the immune system declines due to a lack of immune cells and fails to strike the cancer cells. Thus, cancer spreads to distant parts of the body. Also, you must have heard that cancer treatment, especially chemotherapy can weaken the immune system and as a result, there is a dip in levels of white blood cells.

Let’s read more to know “what is immunotherapy in cancer”, “the role of immunotherapy in cancer, and its benefits”. 

What Is Immunotherapy In Cancer? Understand The Role And Goals

Immunotherapy has become a revolutionary treatment that works by influencing the immune system. Immunotherapy is a treatment that attacks cancer cells by using our immune system. Immunotherapy drugs boost the immune system to detect and destroy cancer cells. Immunotherapy can be started off only if your diagnosis is confirmed with the gene testing.

This therapy has been proved as a promising treatment for almost 20 types of cancer. It is used in treating cancers of advanced stage and also it helps in preventing the recurrence of early stage cancers. Clinical trials have proved strong evidence of improvement in survival rates of cancer patients who have had their immunotherapy as it aims to kill only the cancer cells without damaging the normal cells.

Not all cancer patients are suitable for getting immunotherapy. However there are factors such as stages of cancer and the gene makeup of the tumor that determines the usage of immunotherapy in treating cancer. The other reason is also that immunotherapy is still being studied for every type of cancer to explore its effectiveness. The goal of immunotherapy in cancer treatment is to produce precise and systemic effects by not damaging the healthy cells.

Types Of Cancer That Immunotherapy Can Treat:

• Bladder cancer
• Breast cancer
• Blood cancers
• Colorectal cancer
• Esophageal cancer
• Cervical cancer
• Head and neck cancer
• kidney cancer
• Lung cancer
• Liver cancer
• Prostate cancer
• Skin cancer

Factors That Affect The Immune System:

Our immune system involves a vast network of cells, lymph glands, and tissues. The responsibility of our immune system is to protect our bodies against microorganisms. White blood cells play a huge part in protecting us from dreadful infections. White blood cells and their classification are majorly involved in fighting against infections and cancer. 

Cancer: In Certain types of cancers that include leukemia, myeloma, or lymphoma the cancer occurs directly in the cells of bone marrow leads to reduction in immune cell counts. People with blood cancers are always vulnerable to infections because of this depletion of immune cells. Thereby, immunotherapy helps in enhancing the blood cell count to fight the malignant cells. 

Chemotherapy: Chemo medications produce systemic action while destroying the cancer cells as a result of this, the white blood cells also get destroyed and affect the bone marrow. Patients receiving chemotherapy are at risk of infection because they lack enough immune cells to fight the microorganisms.

The purpose of immunotherapy came into existence for the above stated reasons with the goal of treating cancers and managing the side-effects of chemotherapy.

Did You Know? 

Immunotherapy is not a replacement to chemotherapy. Chemotherapy and immunotherapy are two distinct treatment strategies to combat cancer. Here’s what you need about the difference between chemotherapy and immunotherapy-

Chemotherapy works by inhibiting the growth of cells, it can produce a systemic effect by inhibiting both the cancerous cells and healthy cells.

In contrast to chemotherapy, immunotherapy works by enhancing the immune system to attack the cancerous cells, thereby retards the tumor growth and declines the disease progression.

How Is Immunotherapy Administered To Patients?

Immunotherapy is prescribed to cancer patients and can be given either by an intravenous route through injections or I.V infusions or in oral dosage forms.

Types Of Immunotherapy:

Here are the five types of immunotherapy used in cancer. Keep reading to understand the role of immunotherapy in cancer and learn what are the drugs involved in cancer immunotherapy in India.

1. Immune checkpoint inhibitors: Checkpoints are nothing but the proteins present in the cells that prevent the immune system from attacking the healthy cells. The checkpoints act as a switch that reacts to immune responses. In cancer, these checkpoints are often switched off by the malignant cells to protect them from being destroyed by the immune cells.

The immune checkpoint inhibitors act by boosting the immune function to recognize the cancer cells and destroy them. The drugs involved here are pembrolizumab, nivolumab, atezolizumab, durvalumab, avelumab, and ipilimumab which are commonly prescribed in the treatment of breast cancer, cervical cancer, stomach cancer, colorectal cancer. 

These drugs do not attack the cancer cells directly; instead, they produce their action by blocking the checkpoints or proteins, thereby helping the immune cells to react firmly against the cancer cells.

2. Monoclonal antibodies are the antibodies that are synthesized in laboratories. In general, antibodies are proteins that occur naturally in our bodies in response to foreign particles or microbes. Similarly, these man-made antibodies work by targeting the cancer cells. The monoclonal antibodies bind to the specifically targeted cancer cells and leave a mark. Thus, making it tangible to the immune cells to destroy them. 

However, many monoclonal antibodies are approved for their usage in cancer treatment. Among them is bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor in the tumor blood vessels. Bevacizumab binds to the protein, inhibits the tumor blood vessel growth, and retards the growth of cancerous cells. This drug is used extensively in colorectal cancer, lung cancer, and advanced breast cancer. 

3. Immunomodulators boost the body’s immune system to fight against malignant cells. Immune modulating drugs include thalidomide, lenalidomide, and pomalidomide which produce their action by helping the bone marrow to secrete normal healthy blood cells. The immunomodulatory drugs function by increasing T cell growth factor levels that play a significant role in attacking the cancer cells and destroying them. Immunomodulatory drugs are used widely to treat multiple myeloma, leukemias, and sarcoma. 

4. Cytokines are used in the treatment of cancer. Cytokines are proteins made naturally by the immune system, and they play a significant part in the growth and functioning of immune cells. The cytokines act by signalling the immune system to attack and destroy the cancer cells. Interferons, growth factors, and interleukins are referred to as cytokines. There are synthetic cytokines that help in triggering the immune response, If the immune function is impaired in cancer. 

• Interferon and interleukins act by increasing the activity of white blood cells which inhibit the cancer cells and their growth. Interferon-alpha, a cytokine has been extensively used to manage leukemia, melanoma, and lymphoma.
• Interleukins, especially the Interleukin-2 medication, inhibit tumor growth by cutting off the formation of blood vessels also known as angiogenesis. Interleukins-2 are widely used in the treatment of kidney and skin cancer.
• Specific growth factors like granulocyte colony-stimulating factors(G-CSF) and granulocyte-macrophage colony-stimulating factors (GM-CSF) act as immune boosters. These factors are administered to uplift the immune system’s reaction against the cancer cells and enhance the levels of white blood cells to prevent the risk of infections.

Did You Know? 

Most patients are prone to infections as a result of cancer therapy. Chemotherapy drugs can affect the growth of blood cells and cause a reduction in levels of white blood cells, which makes the patients vulnerable to infections. In these cases, immunotherapy acts as a savior. G-CSF and GM-CSF are called hematopoietic growth factors, and they are used to decline these adverse effects of chemotherapy by elevating the blood counts. 
 

“Cure Cancer With Immunotherapy” 

Immunotherapy also involves a few cancer vaccines made of dead or inactive proteins to prevent cancer. Such vaccines involve the HPV vaccine, which helps prevent HPV-related cervical or oral cancer, and there is hepatitis -B vaccine, which protects against liver cancer. These two vaccines are also involved in cancer immunotherapy in India.

Immunotherapy is a newer treatment strategy to combat cancer by stimulating our immune system to recognize and knockdown cancer cells. It is recommended that before you start with immunotherapy, do discuss with your oncologist regarding its risks and benefits.