What is Immunotherapy? 

              

Immunotherapy, as a cancer treatment plan, enables the human immune system to fight and get over cancer in as effectively a way as it can. It works in dual ways, one by suppressing the workings of the immune system and other, by enhancing it.

Normally, our immune system keeps up with the fight with diseases, and tumorous cells, but cancer cells can sometimes escape the powerful working of our immune system. This is primarily due to three reasons, the most common of them being a genetic predisposition to cancer, which fools the immune system into believing that there is nothing dangerous, when, in fact, there actually is a lot going on.

Immunotherapy gives extra abilities to our immune system and makes it a better fighter against these cells, helping it identify the cells and destroying them from their very core. Lately, different types of immunotherapy have been introduced in the medical arena, that not only helps your body prevent the acquisition of cancer, but also in removing it from your body.

Some of these immunotherapy variations include the immune checkpoint inhibitors, t-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators.

  • We have found solutions to resist the progression of cancer, predicting immunotherapy responses, and reducing side effects while working with our patients, and we hope to work with the consistent zeal throughout.

Is Immunotherapy for cancer treatment a new therapy and does it work?

Immunotherapy has been there for so many years but now research has started and what we have seen it does not work for everybody and every cancer. There are few predictive biomarkers which guide us and tell us whether immunotherapy will work or not. One has to be very rationale in deciding whom to give it or not. We have seen dramatic improvement in some patients. Patient selection is the key.

Figure showing response of immunotherapy in patient with stage 4 malignant melanoma.

What is difference between chemotherapy and Immunotherapy?

Chemotherapy continues to be an important part of cancer treatment and has limited efficacy and when chemotherapy fails very less options remain. Side effects remain an issue with chemotherapy. Immunotherapy has very less side effects, easy tolerable, one hour infusion. Can be done on OPD basis. Immunotherapy also can give rise to serious side effects and one has to be careful and monitor such effects to diagnose them on time and treat.

 

Can Immunotherapy be used in early stage cancers ?

Yes in some cancers immunotherapy can be given so cancer does not come back and patients are cured of disease. Research is going on and in future we might omit chemotherapy and give only immunotherapy in adjuvant settings. In early stage cancers role of immunotherapy is established in kidney cancer/RCC, lung cancer, breast cancer, liver cancer, esophagus cancer, urinary bladder cancer, head and neck cancer, melanoma (skin cancer), and some blood cancers

In prostate cancer, stomach cancer, colon and rectal (intestinal) cancer, sarcomas and bone cancers immunotherapy can be given after progression to stage 4 and after failure of chemotherapy or other established treatment

Can Immunotherapy cure stage 4 cancers?

Word cure is not the appropriate words to use .We see long term disease control with immunotherapy and few of our patient survived beyond 5 years which was not possible earlier .Some patients have very good disease control and continue to be on immunotherapy. e,g Immunotherapy in malignant melanoma, immunotherapy in lung cancer.

Immunotherapy showing dramatic responses in lung cancer

How can one tell whether Immunotherapy is working?

You see your physician and he can guide you on this. Responses of immunotherapy can be checked both by clinical examination and scans done periodically.

How is Immunotherapy given?

Immunotherapy is given by intravenous injection .It usually is one hour infusion.

What tests are needed to check whether Immunotherapy will work or not?

There are different predictive biomarkers available that will tell us the amount of benefit with immunotherapy .Although we can use Immunotherapy sometimes without looking at these biomarkers. Different tumors have different biomarkers

  • PD-L1
  • TILs (Tumor-infiltrating lymphocytes)
  • TMB (Tumor Mutation Burden)
  • MSI (Microsattelite Instability)

What are the side effects of Immunotherapy?

Side effects are less but immunotherapy activates immune system of body that can attack any organ and cause side effects. e.g. Thyroiditis,colitis,hepatitis,cystitis.

What are alternatives to Immunotherapy?

Different therapies do exist. Some common alternatives are chemotherapy, targeted therapy and hormone therapy

If the Immune system protects us from Bacteria, Fungi, Viruses, and different infections but why it does not protect us from cancer.

Oct 1, 2018 – James Allison, of the US, and Tasuku Honjo, of Japan, won the noble price in physiology and immune-oncology for the work they did on molecules that act as breaks to our immune system and do not allow the immune system to recognize and kill cancer cells. This laid the foundation for immunotherapy for the treatment of cancer. Why is immunotherapy so innovative, because it does not directly kill cancer cells but improves and boosts the body’s own immune system to fight cancer.

James Allison and Dr. Padmanee Sharma-Scientists in immune-oncology

How do you find clinical trials that are testing immunotherapy?

To find clinical research studies that involve immunotherapy visit Find NCI-Supported Clinical Trials or call the Cancer Information Service, NCI’s contact center, at 1-800-4-CANCER (1-800-422-6237).

NCI’s list of cancer clinical trials includes all NCI-supported clinical trials that are taking place across the United States and Canada, including the NIH Clinical Center in Bethesda, MD.

Related Resources

I wish to learn more about cancer immunotherapy and its treatment options for different cancers.

Immunotherapy for lung cancer treatment in Delhi/India

 Immunotherapy for blood cancer lymphoma, and hematological malignancies
 Immunotherapy treatment for melanoma/skin cancer in Delhi/India
 Immunotherapy for kidney cancer in Delhi/India

 Immunotherapy treatment for head and neck cancer
 Immunotherapy treatment for stomach, colon and esophageal cancer in Delhi/India
 Immunotherapy for urinary bladder cancer in Delhi

Research

https://www.cureus.com/articles/17222-harnessing-the-immunomodulatory-effects-of-radiation-in-urinary-bladder-cancer#:~:text=Extensive%20preclinical%20data%20supports%20the,the%20systemic%20anti%2Dtumor%20effect.

https://www.ojionline.org/article.asp?issn=2589-1871;year=2020;volume=4;issue=3;spage=110;epage=114;aulast=Patil

https://ijmio.com/cardiotoxicity-in-patients-on-trastuzumab-in-her2-positive-breast-cancer-a-retrospective-analysis-from-a-center-in-north-india/

https://www.crstonline.com/article.asp?issn=2590-3233;year=2020;volume=3;issue=1;spage=146;epage=147;aulast=Abbas

https://www.researchgate.net/publication/343512692_Predictors_of_Occult_Neck_Metastasis_and_Extra_Capsular_Spread_in_Early_Oral_Cancers

https://pubmed.ncbi.nlm.nih.gov/30050778/

https://pubmed.ncbi.nlm.nih.gov/31607695/

https://pubmed.ncbi.nlm.nih.gov/31807489/

https://www.proquest.com/openview/d26bb79fb4948a5db6724295f88156a5/1.pdf?pq-origsite=gscholar&cbl=226512

https://pubmed.ncbi.nlm.nih.gov/31489291/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6498714/

https://www.journalofcurrentoncology.org/article.asp?issn=2589-8892;year=2018;volume=1;issue=2;spage=97;epage=100;aulast=Patil

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348784/

https://www.researchgate.net/publication/334632035_Cancer_Awareness_amongst_Nurses_in_a_Tertiary_Care_Hospital_in_North_Delhi_India

https://www.crstonline.com/article.asp?issn=2590-3233;year=2021;volume=4;issue=1;spage=55;epage=60;aulast=Abbas

https://www.crstonline.com/article.asp?issn=2590-3233;year=2020;volume=3;issue=1;spage=146;epage=147;aulast=Abbas

 

Dr. Waseem Abbas

Director research @MAX institute of cancer care.

Senior consultant medical and Hemato-oncology @MAX cance centre shalimarbagh.

Clinical lead in Medical oncology from MAX cancer centre shalimarbagh.

This has encouraged dr Abbas to dedicate himself to research in the field of immunotherapy. He has treated so far 500 patients with immunotherapy and has published research in International and National journals. Apart from that dr Abbas has done some breakthrough research in this field. Dr abbas have dedicated his life to immunotherapy research and are the pioneer of immunotherapy in India.