Immunotherapy, a game changer in cancer treatment

Immunotherapy stimulates the body’s immune system to recognise and combat cancer cells while not directly affecting the tumour cell. Also, due to the fact that it is effective against a variety of cancers, acceptance is rising, writes Dr C N Patil

A tremendous amount of progress has been made in medical science and cancer research as a result of the ongoing technological revolution in cancer treatment. Modern cancer treatment approaches like immunotherapy, which have demonstrated encouraging outcomes in treating patients with advanced disease, are being hailed as “game-changers” and “miracles in the making”. This technique activates the immune system of our body to particularly fight and target conditions like cancer. This treatment employs the body’s own immune system to eradicate cancer cells. Immunotherapy, sometimes referred to as immuno-oncology, is a targeted therapy that can be given to patients in a variety of ways, including pills, shots, antibody treatments, cellular therapies, intravenously, orally, topically, or by a catheter. In addition to being explored in clinical trials for immune-based treatments for many different cancer types, this therapy has been approved for the treatment of malignancies like melanoma, lymphoma, and lung cancer. Immunotherapy is a relatively new technique compared to conventional cancer treatment modalities like surgery, radiation, and chemotherapy. Depending on the type of cancer you have, your oncologist may combine immunotherapy with other treatments such as surgery, radiation therapy, and chemotherapy, or they may use it alone if all other options have failed. Doctors occasionally adopt this cutting-edge technology as a first line of treatment.

How does immunotherapy work?

Our immune system is crucial in protecting our body from both external and interior infections and illnesses, yet it is unable to identify internal problems like cancer cells. This typically occurs as a result of the cancer cells’ lack of the exterior signals that our immune system uses to recognise foreign invaders that are essentially “hiding” from it. Moreover, cancer cells tell our immune system not to kill them. In some circumstances, our immune system is too frail to recognise and eliminate these cells, and we may need outside assistance. Immunotherapy is crucial in this situation since it strengthens our immune system’s capacity to eliminate tumour cells, slows the growth of cancer cells, and inhibits them from spreading to other parts of the body.

What are the various immunotherapeutic alternatives that are available?

Currently, there are many different immunotherapeutic strategies that can be employed to treat cancer.

Immune checkpoint inhibitors: These medications support the immune system’s ability to identify and eliminate cancer cells.

Cancer vaccines: They present an antigen to our immune system, causing it to recognise and eliminate it or its linked components and stop the spread of cancer cells. For instance, both males and females can have the HPV vaccine to prevent cervical, vaginal, vulvar, or anal cancer.

CAR T-Cell therapy: Our T-cells are altered and removed throughout this therapy to increase their capacity to fight cancer cells.

Non-specific immunotherapies: These therapies aim to strengthen our immune system and combat cancer cells.

What are the side effects of
immunotherapy?

Since immunotherapy stimulates the immune system, its side effects are significantly different from those of chemotherapy and radiation treatments. These include rashes, itching, fever, severe diarrhoea, thyroid dysfunction, liver dysfunction, and difficulty in breathing.

What are the advantages of
immunotherapy?

Immunotherapy has the significant benefit of teaching human immune systems to recognise cancer cells and establishing an “immune memory” that leads to long-lasting disease remissions that are sustained even after treatment is finished. Other benefits include:

Prevents the destruction of normal cells during the treatment.

Avoids conditions like Osteoradionecrosis (bone death) and prevents loss of taste.

Although the average cost of therapy is between Rs 1 to 4 lakh every cycle, it is both affordable and cost-effective.

When should you undergo
immunotherapy?

Because not all cancers respond to immunotherapy, you might not need it if your cancer has already been treated with surgery, radiation, or chemotherapy. The best course of action is to first discuss it with your oncologist before starting any trials.

How can you tell if immunotherapy is effective or not? How many cycles will a patient need?

Our bodies typically take 3–4 months to respond to immunotherapy. CT/PET-CT scans are used to evaluate this reaction. Immunotherapy usually requires three to four cycles before a patient responds. If the treatment yields a positive result, it is continued until both the patient and the tumour are affected by the medication.

(The author is HOD and lead consultant in medical oncology & haemato-oncology at a Bengaluru-based hospital.)