What is immunotherapy? ‘Smart drug’ era in cancer treatment: The fourth method after surgery, radiotherapy and chemotherapy… Here are the 10 most frequently asked questions and their answers…
New treatment methods are constantly being developed against cancer, the disease of our age. While undoubtedly how the treatment will be applied is determined by the type of cancer, its stage and the general health status of the patient, “immunotherapy”, which we hear more and more frequently, is among the methods that have come to the fore in recent years with some of its features.
Medical Oncology Specialists believe that immunotherapy, developed to treat diseases such as cancer by using the immune system; He says that it is accepted as the fourth main treatment method in cancer treatment after surgery, radiotherapy and chemotherapy.
Experts answered 10 questions about this effective treatment method and made important warnings and recommendations.
1- What is the immunotherapy method?
Immunotherapy experts stated that there are a number of treatment methods developed to treat diseases such as cancer by using the immune system and shared the following information:
When immunotherapy is mentioned among the public, the treatment group called “immune checkpoint inhibitors” is understood. The most common immunotherapy treatment methods are monoclonal antibodies, immune checkpoint inhibitors, cancer vaccines, adaptive cell transfer (for example, CAR T-cell therapy) and cytokine therapy. Each type of treatment targets cancer cells by activating the immune system in different ways.The application and effectiveness of these methods depend on the type and stage of the cancer and the general health of the patient.
2- How does immunotherapy benefit?
Normally, cancer cells can evade the immune system and grow uncontrollably. In particular, drugs called “checkpoint inhibitors” activate the immune system by eliminating the obstacles that prevent T cells from attacking cancer cells. Some immunotherapies work by producing antibodies against molecules specific to cancer cells.
3- Is immunotherapy a smart drug therapy?
Immunotherapy falls into the category of so-called “smart drug” treatments. This treatment aims to target cancer cells while causing minimal damage to normal cells. Immunotherapy is considered an important part of “smart drug” strategies in cancer treatment, as these drugs focus on specific molecules that help the immune system recognize and destroy cancer cells.
4- Is it superior to chemotherapy?
Immunotherapy and chemotherapy are two different groups of drugs used in cancer treatment. Each has advantages and disadvantages. Immunotherapy targets and attempts to destroy cancer cells by strengthening the immune system; It generally has fewer side effects. On the other hand, chemotherapy aims to kill cancer cells directly and can be used to treat all types of cancer. However, its side effects are often more severe and can also damage healthy cells. Determining which treatment method is “superior” depends on the type of cancer, its stage, the patient’s overall health, and many other factors.
5- In which cancers is it used?
Immunotherapy is considered an effective treatment option for many types of cancer. It is especially common in cancer types such as malignant melanoma, lung cancer[1, 2], head and neck cancers, kidney cancer, bladder cancer and colon cancer, and in all types of tumors with suitable pathological features; It can be used both in the early stages and in the last stages. These drugs, which were first used in cancer treatment in the world in 2011, have been procured from abroad and administered to cancer patients in our country since 2012. In recent years, “ipilimumab” and “nivolumab” treatment expenses within the scope of immunotherapy can be covered by health insurance according to the policy and treatment details.[3]
6- Is it suitable for every cancer patient?
Immunotherapy may not be suitable for every cancer patient. The effectiveness of the method; It varies depending on the type of cancer, its stage, the patient’s general health condition and previous treatments.
Some types of cancer respond well to treatment, some may not. For example; While malignant melanoma and some lung cancers respond fairly well, other types, such as brain tumors or pancreatic cancer, are less sensitive to treatment.
7- What are the side effects of immunotherapy?
Side effects may occur due to overactivation of the immune system and generally depend on the type of cancer and the drug used. Common side effects include; fatigue, skin rashes, loss of appetite and nausea. More serious side effects; It may include organ inflammations such as arthritis (joint), hepatitis (liver), colitis (intestine), hypophysitis (pituitary gland) and thyroiditis (thyroid gland).
These side effects can often be treated with immunosuppressive drugs such as corticosteroids.[4] Additionally, treatments for specific side effects (for example, hormone replacement therapy for thyroid dysfunction) can also be applied.[5]
8- Is it administered independently of other treatments?
Immunotherapy can be used both alone and with chemotherapy, depending on the type of cancer, its stage, and the patient’s general health condition. In some cases, it is considered an effective option alone for cancer types that do not respond to chemotherapy. Especially in advanced stage cancers or cancers with certain molecular markers (PD-L1, MSI), immunotherapy can be preferred as an independent treatment.
9- Does immunotherapy cure cancer completely?
Although immunotherapy may be effective in some types of cancer, it does not guarantee complete cure; Additionally, a positive response may not be obtained in every patient. For example; It can provide long-term disease control in some types of cancer, such as advanced-stage melanoma or lung cancer. However, the complete recovery of cancer, that is, the destruction of all cancer cells and the failure of the disease to return, depends on factors such as the type of cancer, its stage, the general health condition of the patient and the genetic characteristics of the cancer.
10- How long does the treatment take?
Treatment duration; It may vary depending on the type of cancer, its stage, the patient’s response to treatment and side effects. Immunotherapy treatment is usually administered for periods ranging from a few weeks to several months, and in some cases may continue until the cancer is under control or maximum benefit is achieved. In some patients, treatment may be stopped early due to side effects.
References:
- Zhang S and Cheng Y (2023) Immunotherapy for extensive-stage small-cell lung cancer: current landscape and future perspectives. Front. Oncol. 13:1142081. doi: 10.3389/fonc.2023.1142081
- American Cancer Society. Immunotherapy for Small Cell Lung Cancer: Immune checkpoint inhibitors.
- El Sayed R, Blais N. Immunotherapy in Extensive-Stage Small Cell Lung Cancer. Curr Oncol. 2021 Oct 12;28(5):4093-4108. doi: 10.3390/curroncol28050347. PMID: 34677265; PMCID: PMC8534845.
- Hussain Y, Khan H. Immunosuppressive Drugs. Encyclopedia of Infection and Immunity. 2022:726–40. doi: 10.1016/B978-0-12-818731-9.00068-9. Epub 2022 Apr 8. PMCID: PMC8987166.
- NIH National Cancer Institute. Immunotherapy Side Effects