Immunotherapy: A Modern Approach to Cancer Treatment
TABLE OF CONTENTS
Cancer treatment has evolved significantly in recent years, with immunotherapy emerging as one of the most modern and promising approaches. Dr. Kunjahari Medhi, Senior Director Medical Oncologist at Medanta Medicity Hospital Gurugram, provides valuable insights into this groundbreaking treatment method.
What is Immunotherapy?
Our immune system naturally protects us from foreign particles, including bacteria, viruses, and fungi. It also helps keep us free from different diseases, including cancer. However, cancer cells have a specific characteristic of evading the immune system - meaning that immune cells cannot recognise cancer cells as harmful substances.
Immunotherapy works by activating the immune system so that these immune cells can recognise cancer cells as harmful products or foreign particles. Once activated, these immune cells can effectively kill the cancer cells. This is the fundamental basis of cancer immunotherapy.
Types of Immunotherapy
According to Dr. Medhi, there are five main types of immunotherapy:
Immune Checkpoint Inhibitors: These are currently the most widely used type
Cancer Vaccines
Non-specific Immunotherapy
T Cell Therapy
Oncolytic Viruses
Among these, immune checkpoint inhibitors are most commonly used in practice. The Drug Controller General of India (DCGI) has approved five immunotherapeutic drugs, monoclonal antibodies, to be used in various cancers in India. These five drugs are:
Pembrolizumab
Nivolumab
Atezolizumab
Ipilimumab
Durvalumab
These five drugs are routinely being used for various cancers in India.
Cancers Where Immunotherapy is Used
Immunotherapy, especially immune checkpoint inhibitor immunotherapy, is primarily used in advanced stages of cancer and, in some cases - of stage 3 cancer as well. The cancers where immunotherapy can be used include:
Malignant melanoma
Colorectal cancer
Liver cancer
Head and neck cancer
Stomach cancer
Can Cancer be Cured with Immunotherapy?
Dr. Medhi explains that immunotherapy has different kinds of responses depending on the case. Immunotherapy can give excellent results in some instances, particularly when there are positive biomarkers like PDL1, MSI-high, or deficient MMR.
While there are rare chances of a complete cure, in most cases, immunotherapy can effectively control the disease, prolong life, and improve patients' quality of life.
Side Effects of Immunotherapy
Unlike chemotherapy, immunotherapy has fewer side effects but is not completely without them. Traditional chemotherapy and targeted therapy often cause side effects like:
Hair loss
Oral ulceration
Low blood counts
Decreased appetite
Weight loss
Weakness
These side effects are generally not seen with immunotherapy. However, since immunotherapy works by activating the immune system, over-stimulation and overactivity of the immune system can lead to different side effects, including:
Joint pain
Diarrhea
Hormonal imbalances (like alteration of thyroid hormone levels)
Pneumonitis (lung problems)
How is Immunotherapy Administered?
The five immunotherapy drugs mentioned earlier are monoclonal antibodies administered by injection. These treatments are given at two to three-week intervals as a daycare procedure. Patients only need a two to three-hour hospital admission; they come to the hospital, receive their injection, and go home the same day.
There are very few infusion-related complications, making immunotherapy very easy to administer. Dr. Medhi mentions that these immunotherapeutic drugs are routinely used in their practice at Medanta Hospital.
Frequently Asked Questions
What is immunotherapy?
Immunotherapy is a cancer treatment approach that activates the body’s immune system to identify & kill cancer cells that would otherwise evade detection.
What types of immunotherapy are available?
There are five main types: Immune Checkpoint Inhibitors, Cancer Vaccines, Non-specific Immunotherapy, T Cell Therapy, and Oncolytic Viruses. Of these, Immune Checkpoint Inhibitors are most commonly used in India.
For which cancers is immunotherapy used?
Immunotherapy is used primarily for advanced stages of cancer and some stage 3 cases. It’s effective for lung cancer, kidney cancer, malignant melanoma, breast cancer, colorectal cancer, liver cancer, head and neck cancer, and stomach cancer.
Can immunotherapy cure cancer?
While complete cures are rare, immunotherapy can effectively control the disease in many cases, extending life and improving quality of life, particularly in patients with positive biomarkers like PDL1, MSI-high, or deficient MMR.
What are the side effects of immunotherapy?
Immunotherapy has fewer adverse effects than chemotherapy but can cause issues related to overstimulation of the immune system, including joint pain, diarrhoea, hormonal imbalances, and pneumonitis (lung inflammation).
How is immunotherapy administered?
The approved immunotherapy drugs are given as injections at 2-3 week intervals in a daycare setting. Patients typically spend only 2-3 hours at the hospital per treatment session.
This blog has been converted from the Youtube video- Immunotherapy: Types, Side Effects I Dr. Kunjahari Medhi I Medanta Gurugram
