How Immunotherapy is Used to Treat Cancer
Immunotherapy uses the body’s own immune system to kill the cancer cells, sometimes resulting in a cure. The immune system is already good at finding and eliminating invaders like viruses and bacteria that can harm the body. Immunotherapy trains the immune cells to recognize and destroy cancer cells that are hiding in plain sight.
While it’s difficult to receive a cancer diagnosis, the good news is that treatment options are growing. Immunotherapy is one of the latest cancer therapy innovations.
There Are Several Types of Immunotherapies
What is Immunotherapy and How Does It Work?
Immunotherapy transformed cancer treatment. While immunotherapy isn’t the right treatment for all cancer types or all people, it has helped some with incurable cancers live long lives.
Cancer cells have flags, which immunotherapy can sometimes detect, so the soldier cells can find and destroy them.
Cancer cells sometimes trick the immune system into thinking they’re normal cells. If the immune system doesn’t recognize they’re harmful, they will be left alone to replicate.
Researchers continually develop and test new treatments and combinations to find the best ones for each person, which means future cancer treatment will be different than today’s cancer treatment. As genetic tumor profiling improves and knowledge of the immune system’s response to cancer grows, the oncology treatment will become more personalized.
There are hundreds of compounds in the research pipeline. Many are being tested in clinical trials. Providence medical centers run hundreds of clinical trials that patients can participate in, potentially getting tomorrow’s treatments today. Providence is one of 30 centers nationally participating in the Cancer Immunotherapy Trials Network and has been at the forefront of discovery and drug development for decades.
Some Providence patients, even those without cancer, will be invited to participate in the Geno4ME healthy populations study that Providence has recently launched. These patients will get their genome sequenced to better understand the role of genomics in disease prevention and treatment.
The Future is Now
No two cancers are alike. Treatment should be personalized based on the molecular changes driving the person’s tumor growth, or based on the immune response targets. Providence uses next-generation sequencing tests, also called comprehensive genomic profiling (CGP) to look for genetic changes to identify appropriate therapies.
This is called Precision Immuno-Oncology. Patients treated at Providence for advanced stage cancer may have their tumor tested with next-generation sequencing, which looks for least 523 commonly mutated genes, and this can help direct treatment.
A Brief History of Cancer Treatment
Cancer treatment has come a long way with some procedures dating back to ancient times. Treatment options include:
This treatment option uses the body’s immune system to recognize and kill cancer cells.
is Used to Treat Cancer
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Adoptive cell therapy
Adoptive cell therapy is also called cellular immunotherapy. It uses cells from your immune system to kill cancer cells. The process can take a few weeks and the patient needs molecular profiling first. It doesn’t work for everyone, but it can provide a long response or even a cure.
Here are three types of adoptive cell therapy advancing the next generation of Personalized Immuno-Oncology:
High-dose interleukin 2 (IL-2)
This therapy gives patients high doses of the protein IL-2. The protein helps the T-cells kill cancer cells. Providence Cancer Institute in Oregon is one of the top programs nationally for high-dose IL-2 immunotherapy.
The best-known immunomodulators are checkpoint inhibitor drugs. Dr. Walter J. Urba at Providence Cancer Institute’s Earle A. Chiles Research Institute in Portland, Oregon, was the lead investigator for the first checkpoint inhibitor trial that resulted in Food and Drug Administration approval.
That treatment, ipilimumab (Yervoy), blocks CTLA-4 signaling, which can lead to tumor eradication. Ipilumumab was approved in 2011 to treat patients with melanoma. The researcher who discovered this approach (Dr. James Allison) won the Nobel Prize for the discovery in 2018. There are now 8 FDA-approved checkpoint inhibitors to treat different cancer types.
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2010s and present
Some people benefit from combinations of these treatments, but not always in the same order. Researchers are trying to determine the best combinations and the best treatment order for different cancer types and stages.
These drugs target specific genetic mutations or DNA rearrangements that are driving a person’s cancer growth.
Treatments help the body’s immune system recognize and attack cancer cells.
Toxic agents in pill or intravenous form kill cancer cells, but some normal cells too.
This localized treatment focuses radiation beams on the treatment area to kill cancer cells.
Cutting the cancer out was the first treatment type and is still used to treat a majority of cancers today.
TIL therapy uses T-cells obtained from a surgically-removed tumor. The tumor contains cells that can recognize and kill cancer cells, but that function is suppressed in the tumor environment. Clinicians isolate and grow these T-cells in the lab, and infuse them back into the patient to kill cancer cells.
T-cells are removed from the body, and a T-cell receptor is modified so that the T-cell recognizes a specific genetic mutation or neoantigen within the cancer cell. These cells are then infused back into the patient’s body to fight cancer cells. Only a handful of medical centers offer this treatment, and Providence is one of them.
CAR T-cell therapy:
With chimeric antigen receptor cell therapies, T-cells (the immune system’s workhorses) are removed from the patient, and genetically modified in a lab to recognize proteins found on the surface of cancer cells, but not normal cells. They are grown to large numbers in the lab and finally infused back into the patient’s body to fight cancer cells.