What You Need To Know About Immunotherapy

Immunotherapy has completely restructured the treatment of various types of cancers. Tasuki Honjo and James P Allison did pioneering work of research in the 1990s. They established that there were ways to activate the immune system to attack cancer. At last, this discovery led to major breakthroughs in developing new cancer treatments.  

In the year 2018, they achieved the Nobel prize in medicine for this major accomplishment. Much appreciated worldwide by the scientific community for completely changing the outcomes for certain cancer patients.

Let us understand the basics of Immunotherapy.

How does Immunotherapy work?

It works by stimulating, or boosting, the natural defences of the immune system, so it works harder or smarter to find and attack cancer cells.

Cancer cells are very smart. Their goal is to avoid your body’s natural defence mechanism against anything that is foreign (e.g. viruses, bacteria, abnormal cells). Many cancers have a complex mechanism that makes them “inactivate” our body’s T-cells and be able to evade our immune system. 

This is the part of the story where Immunotherapy kicks in. It blocks this negative signal and leads our immune system to completely destroy cancer cells.

Does Immunotherapy work for all cancers?

The answer is NO, sadly. But, there are certain types of cancers for which Immunotherapy has shown great promise. For instance:

• Kidney cancers
• Melanoma (it’s one of the skin cancers)
• Lung cancers
• Certain types of blood cancers (For example- Hodgkin’s lymphoma)

Immunotherapy has given hope that it can also benefit some patients who have stomach cancers, advanced oral cancers, etc.

To see if immunotherapy can help in improving the outcomes, there is a lot of research ongoing on other types of cancers. But the standard treatment for now for most patients remains the same. These are the 3 basic pillars of oncology i.e. surgery, chemotherapy, and radiation therapy.

Does Immunotherapy have any side effects? 

• Conventional chemo can show side effects like nausea, vomiting, hair loss, low blood counts, diarrhea, etc. 
• But unlike them, immunotherapy drugs have a different side effect profile. Many patients often don’t experience any side effects at all.
• A few patients develop mild side effects and these are easily managed. It could be skin rashes, thyroid hormonal fluctuations, fatigue, etc.
• However, the immune system becomes overly active in a small minority of patients (3-5%). It can attack the normal organs like the lungs, liver, intestine, etc.
• Then, we give the patients steroid medications to suppress the immune system and prevent further damage. It’s done while temporarily holding the drug.

How costly is Immunotherapy?

Common drugs mostly used in India, Nivolumab, and Pembrolizumab for immunotherapy are very costly. Approximately INR 2  Lakh will be the cost of a single vial of pembrolizumab (Keytruda,100mg) costs. These medications every 3 weeks period have to be injected to achieve their therapeutic benefits. Like all drugs The cost of these drugs are expected to come down drastically. 

However, do not lose hope just yet. The financial toxicity of these medications can be reduced in certain ways. One such way in which these drugs are used at much lower doses than the US FDA-approved dosages is the use of ‘low-dose immunotherapy’. A study shows unlike traditional chemotherapy drugs, their drugs are effective even when given at these low doses. 

This will ensure to as many cancer patients as possible these life-saving medicines reach successfully. There is testing going on in India with clinical trials that are low-dose immunotherapy in cancer patients.

Who should I take this treatment under?

Chemotherapy and immunotherapy should always be taken under the guidance of a trained oncologist. It is vital for treatments like these. Experts will explain the side effects, benefits, and precautions in detail to the patient and their family members. They will also be available 24*7 in case during treatment any minor/major side effects emerge. The patients can this way expect the best chances of getting cured and prolonging their life!

Winding-up

To make informed decisions about your treatment, talking with your healthcare team is crucial. Many doctors specialize in advanced treatment therapies like other targeted and immunotherapy. Make sure you take a consultation before taking an important decision about immunotherapy.