Immunotherapy has been the strongest success so far in the ongoing process of treatments for cancer treatment. While trying to hit some cells that can multiply rapidly, chemoradiation, immunotherapy may focus on intensifying the overall human immune system for a better conflict against the extant cancer present in the organism. An immune system is considered to be the most potent weapon that the human body has since it can recognize abnormal cells—which may possibly cause cancer and destroy those cells. However, these cancer cells find a way around this immune surveillance to enable growth and proliferation.
It surmounts the above-mentioned hurdles by making the immune system functional or modifying it, thus helping the former in identification and attack. This immunotherapy has proved marvelously effective for certain types of cancer and has presently emerged as a promising subject for further study which could turn the tables around for those struggling against the so-called difficult cancers and, to an extent, those thought unachievable at all.
Dr. Vikesh Shah is one of the top Immunotherapy Doctors in India who is actually treating patients with such advanced cancer care and is really helping many of his patients who are undergoing very transformative benefits in immunotherapy.
Immunotherapy is the treatment of the body’s own immune system fighting cancer. It consists of cells that include white blood cells, antibodies, lymph nodes, and the spleen that defend the body from infections, illnesses, and diseases. Moreover, it fights cancer by identifying and destroying abnormal or cancerous cells.
Ideally, the immune system is designed to recognize and delete even cancer cells before they develop into tumor-forming cells. Sometimes, however, cancerous cells escape this surveillance mechanism. For one, the cancerous cells can conceal their abnormal markers or put out immune-suppressing signals. For another, cancerous cells can even foster an immune cell-inhibiting microenvironment. Immunotherapy breaks this cycle, though, and enables the immune system to better recognize and destroy the cancerous cells.
How Does Immunotherapy Work?
Immunotherapy may either stimulate the immune system to provide a greater response or it can modify the immune cells in order to have them recognize the cancer cells to induce cell death. This includes some types of immunotherapy that make the immune system more potent for identifying and eliminating cancer cells. The other treatments are enhancing the number or the functionalities of T cells, natural killer cells, among other white blood cells.
Targeting of Cancer-Specific Antigens:
Cancerous cells generally harbor aberrant proteins that are referred to as antigens. These antigens carry the unusual expression on the cancerous cells in which it is possible for the immune system to identify which one targets those antigens in a way that it becomes targeted for immunocellular-mediated attacks. Immunotherapy allows the immune system to recognize the specific antigens that point towards such malignancy then takes the immune cells to target and kill the specific cancerous cells.
Immunochemotherapies Avoid Immune Suppression
Cancer cells induce immune suppression by giving signals that the immune system should avoid. Some treatments drown out those signals, thereby working on the basis of “unmasking” cancer cells. The reason is that there is a strong attack on part of the immune system.
All these treatments are targeted with several effects; it works based on the type of cancer and their distinctive way of dealing with the treatment.
Classification of Immunotherapy
There are several types of immunotherapy and these all work differently in further enhancing the immune system’s fight against the cancerous cells. Some are used alone, while others combine with other forms of treatment therapy for cancerous cells such as surgery, chemotherapy, and irradiation. Below are some of the common forms of applied immunotherapy,
1. MABs:
Monoclonal antibodies are also known as MABs. These are designed antibodies. These might resemble the natural immune system’s ability of waging war against infection and cancer. In a lab, MABs are prepared with an aim to strike proteins outside the cancer cell. Once attached, the monoclonal antibody can initiate the action of the immune response by combining with attacking action on cancerous cells. MABs fall under different categories of working differently.
Some of these drugs actually bind to antigens on the cancer cells targeting them for destruction by the immune system. Then there are the MABs that actually activate the immune cells like T cells that become capable of identifying and destroying cancer cells.
Inhibition of cell survival signals that cancer cells use as a strategy to mask from the immunity: Certain MABs prevent the survival signals used by the cancer cells from masking them.
Therefore, there is no mechanism by which such cancer cells would hide.
Case in point, Trastuzumab Herceptin in breast cancer; resultant due to excess expression of HER2 protein resulting in its overpopulation.
2. Checkpoint Inhibitors
A checkpoint inhibitor is one of the monoclonal antibodies that particularly blocks proteins acting as brakes on the immune system. Such proteins are present both on cancer cells and immune cells like T cells; hence, these immune cells are not attacking cancer. Once such checkpoint inhibitors block these proteins, they release the brakes of the T cells to identify and destroy the cancerous cells.
The most common checkpoint proteins are PD-1, or Programmed Cell Death-1; PD-L1, or Programmed Cell Death Ligand-1; and CTLA-4, or Cytotoxic T-Lymphocyte Antigen-4. These are involved in the regulation of immunity, so they prevent autoimmunity along the way. Some of the checkpoint proteins utilized by cancer for its resistance in being immunologically detected include the use of some CTLA-4.
For example, the PD-1 inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) proved remarkable in the fight against melanoma, non-small cell lung cancer, kidney cancer, and many more. Another checkpoint inhibitor, CTLA-4 ipilimumab (Yervoy), also proved very effective.
Checkpoint inhibitors have revolutionized the practice of cancer. It has brought about long-term remissions and become an alternative approach for conventional methods. They may also trigger some immune-related adverse effects because of the immune attack on healthy tissues.
3. Cancer Vaccines
These help the immune system to recognize the cells as abnormal and fight the cancerous cells. It is roughly comparable to the vaccines that could be administered in order to prevent infectious diseases by a particular virus or bacteria; so cancer vaccines would, therefore, aid in recognition of those proteins that are on cancerous cells and also to have an intention of destroying it.
Preventive vaccines, also referred to as protective vaccines, are intended to prevent. They aim to protect a person from getting a problem. They attempt to stop people from contracting infections that cause these cancers. An example of this includes the use of the human papillomavirus vaccine, hepatitis B vaccine, amongst many others.
Therapeutic vaccines: These are drugs that will be used to treat already occurring cancers. The vaccines trigger immunities in the body to have it identify which cells are carcinogenic. Examples of such drugs include talimogene laherparepvec known to combat melanoma. Talimogene laherparepvec (T-VEC) contains an engineered herpes simplex virus; the virus induces infections of cancer cells, which would be killed eventually while causing immunity.
There is ongoing research on other types of cancer vaccines and, so far, has proven to be very promising for many types of cancers, including prostate and brain tumors.
4. Cytokines
These are the body proteins; they regulate how the immunity reacts. They work to make sure that, if possible communication is to be made, this takes place between immune cells. Such cells are engaged with one another; they act as a means by which coordination occurs. Specific types of cytokines may augment an immunity used in cancer fighting.
Interferons: These are cytokines that fall into a class due to the antiviral and immuno-enhancing properties. Interferon-alpha is a drug used for the treatment of melanoma, CML, and renal cell carcinoma.
Interleukins: These are cytokines that stimulate T cell activation and natural killer cells. IL-2 is a drug used in the treatment of renal cell carcinoma and melanoma.
Although it has been proven to boost immune responses, cytokine therapy has also been associated with some major side effects such as flu-like symptoms, fever, and chills. It is hence given selectively and closely monitored.
5. CAR T-cell Therapy
CAR T-cell therapy is a completely new form of immunotherapy that introduces the man’s T cells to techniques of gene engineering, which enables it to identify and destroy the cancer cells. T cells are one of the most important white blood cells that contribute much to human immunity as well as to its action against removing infections and cancers.
CAR T-cell therapy. It takes a patient’s blood T cells, cultures them in a lab, and fits them with a receptor that can latch onto an antigen that may exist on the surface of the malignancy. They multiply and go after those cancers once infused back into their body.
CAR T-cell therapy was extremely effective in curing blood cancers like acute lymphoblastic leukemia and many different types of lymphomas. It was pretty dramatic in a pulled-together group including some kids with leukemia that had nothing left.
This could lead to dangerous conditions, for instance, the release of cytokine syndrome that could lead to fever, weakness, and further, organ destruction. Other hazards are central nervous system effects: confusion and seizure. However, CAR T-cell therapy brought renewed hope in dealing with cancers which had been unresponsive to the traditional treatments as earlier considered non-curative.
Who is Qualified for Immunotherapy?
It all depends on different aspects such as type of cancer, the stages of cancer, and the patient’s condition in general. Immunotherapy is not beneficial for everyone. It depends on patients how effective it proves to be, which is entirely subjective. In conclusion, immunotherapy is aptly applied as a treatment or drug if following criteria are present:
There are different types of cancers. The treatment works extremely well on specific types of cancer, such as melanoma, lung cancer, and lymphoma, while for other forms of cancers like pancreatic cancers, the treatment is not that effective.
This form of therapy would more than likely find most applicability when the disease has already become advanced or spread to metastasize within a body part and is too late when malignancy has exceeded the original organ in which the process started. This type of study that is ongoing discusses various kinds of previous phases of this disease.
Previous treatments—Patients exposed to any kind of chemotherapy, radiations, and surgery which must have probably weakened the immune system can undergo immunotherapy with all these above-said treatments at a time and thus raise the treatment effectiveness together.
At other times, the physician will need to test whether a particular immunotherapy will work or not. These tests check on any genetic and protein changes in the cancer cells or blood, which indicate good immunity to the treatment.
Side Effects of Immunotherapy
Although promising, immunotherapy is not without risks. Because it either increases or modifies the immune system, the immune system at times reacts with healthy tissues; thus, side effects of this nature are autoimmune in nature. They depend on the type of immunotherapy and how the patient responds to the therapy. Among some of the most common side effects of immunotherapy include the following:
Fatigue: Most patients feel tired or weak when under immunotherapy treatment.
Skin rashes: Redness or rash is the most common cutaneous reaction, especially with some monoclonal antibodies.
Gastrointestinal disorders: Immunotherapy may cause diarrhea, nausea, or colitis, which is the inflammation of the colon.
Endocrine disorders: Some immunotherapies can lead to thyroid, adrenal gland, or pituitary gland problems, leading to hormonal imbalances.
There is a risk of CRS, especially with CAR T-cell therapy, where one may present with fever, fatigue, and organ damage, especially in extreme conditions.
Conclusion: The Future of Immunotherapy
Immunotherapy has changed the face of cancer treatment. It offers hope to patients whose cancer previously had no cure. Since it harnesses the body’s natural immune system, immunotherapy represents the future of more targeted and personalized treatments that cause fewer side effects than their predecessors.
Although it remains much more to be learned about the technique of how it should function in order to have an effect upon many cancers, success has already been realized in some forms of cancers, which dramatically changed the treatment. New ways of immunotherapy may come in the form of new methods of delivering these treatments or possibly a way of combining the existing ones and promise a new horizon in the war on cancer. It remains one of the most promising approaches in the war against cancer, offering better hopes for outcomes and eventually a cure.
Dr. Vikesh Shah is an immunotherapy doctor in India and administers the newest immunotherapy treatment to the patients. It also caters to every individual’s requirements. Contact today and know how this can be incorporated into your treatment protocol for cancer. Take the first step toward cancer treatment with your immune system.