Immunotherapy is a biological therapy that uses the body’s natural defences to fight cancer. Substances made by the body or made in a laboratory are used to enhance or restore the immune system that works by destroying cancer cells and thereby stopping cancer from growing.
What types of cancer can be treated with immunotherapy
Theoretically, any cancer can be treated with immunotherapy. However, the first attempts at immunological manipulation began 100 years ago. Still, there have been clinical studies, especially in the last five years, where an impact on the survival of cancer patients has been demonstrated with new therapies that are transforming the lives of these patients while opening paths for future research.
Since 2016, when the therapeutic advance of the year in cancer was considered, two products have been marketed with a specific indication for melanoma and metastatic lung cancer with a survival benefit where there are few therapeutic options.
Since then, clinical benefit has been demonstrated in various tumours such as head and neck cancer, lung cancer, bladder cancer, kidney cancer, breast cancer, melanoma and other skin cancers, liver cancer, lymphomas, leukaemias, and there are currently trials in clinical for other tumours. This benefit has been observed in the metastatic phase of these tumours, which has generated high expectations that it can be incorporated in earlier stages of the disease to increase the possibility of cure.
Different types of immunotherapy
The monoclonal antibodies known for decades are used in many tumours such as brain, breast, lung, colon, ovarian, prostate, stomach, and lymphomas. They are one of the natural substances produced by lymphocytes against tumour-specific proteins.
-Specific vaccines against viruses that induce certain types of cancer such as the papillomavirus (which causes cancer of the genitals, year and throat), hepatitis B (inducer of hepatocarcinoma) or certain prostate cancers. They act like any other vaccine by injecting viral substances that induce the specific immune response to that type of cancer.
Immune control inhibitors are responsible for the expectations achieved in recent years, thanks to the knowledge of tumours’ molecular mechanisms to inhibit the immune response.
Cellular therapy. They use the patient’s immune cells, which are prepared in the laboratory and activated by the tumour. A few years ago, cytotoxic T lymphocytes were used. Better-activated lymphocytes have been designed with more specific receptors and significant activity in all tumours.
In the Oncology platform of the Quirón Salud Hospital in Torrevieja, we have equipped ourselves with a room known as the “White Room” necessary to develop these cell therapies.
Immunotherapy Side Effects
Although immunotherapy is relatively specific because it tends to recognise abnormal tumour cells and not heal them, this treatment is not harmless. Sometimes there is a local reaction in the injection area, a febrile illness similar to a flu-like process, but on other occasions (infrequent), due to the massive release of immune substances. This clinical picture resembles shock that can occur. Septic with circulatory collapse and organ failure, mainly lung and kidney, ends up being of all organs and potentially fatal. This happens very frequently with Interleukin2 and with CAR-T cells. Sometimes the immune cells react against the patient’s healthy tissues, generating what are known as autoimmune diseases that affect the skin, the digestive tract, the lungs,
The cure of cancer will come from hand immunotherapy.
It is too early to say that immunotherapy will generically cure cancer. From a conceptual point of view, we believe that it will play at least a crucial role. Since the first immunological therapies, we know that patients with metastatic melanoma and metastatic kidney cancer, incurable with other types of treatment, were cured, although in less than 10% of cases. So preliminary evidence we have. New immunological therapies will improve this ratio, mainly when applied to earlier stages of the disease. They are already managing to displace less effective and more toxic chemotherapy, which is already an advance because it improves the tolerance profile and the patient’s well-being in addition to her survival.
Immunotherapy is currently the most active field of cancer research in the world. If you actively investigate the search for predictive molecular factors of benefit with this type of treatment. Several molecular markers have focused the attention of researchers, such as PDL1, currently widely used, and genes related to the production of interferon-gamma.
At the Oncology Platform of the Quirón Salud Hospital in Torrevieja, where we have been studying tumour genes for ten years to predict response to chemotherapy by analysing all the tumour genes, we are developing a predictive signature of clinical benefit with immunological treatment based on the expression of the number of genes influence their effectiveness.