Immunotherapy

Checkpoint inhibitors

Your immune system has proteins called “checkpoints” that prevent it from overreacting. These immune checkpoints tell a type of white blood cell called T cells when to turn on and off, preventing them from destroying healthy cells.

Usually, T cells attack cancer cells. However, cancer cells also have immune checkpoints, which can turn off T cells. Immune checkpoint inhibitors stop this from happening, enabling T cells to recognize and destroy cancer cells.

Your care team may recommend checkpoint inhibitors for certain cancers that haven’t responded well to other treatments or have spread in the body. Some cancers treated with this type of immunotherapy include:

• Bladder cancer
• Cervical cancer
• Colorectal cancer
• GI cancers
• Head and neck cancer
• Kidney cancer
• Lymphoma
• Liver cancer
• Lung cancer
• Melanoma
• Triple-negative breast cancer

Adoptive cellular therapy

Adoptive cellular therapy is an immunotherapy that isolates and uses specific immune cells to fight cancer. It is also known as T-cell transfer therapy, adoptive immunotherapy or immune cell therapy. During these therapies, your care team multiplies or modifies immune cells in the lab and infuses them into your body to help your immune system work more effectively.

Different adoptive cellular therapies work in various cancer types. For example, CAR T-cell therapy is approved to treat blood cancer, while TIL therapy treats advanced melanoma.  

Tumor-infiltrating lymphocyte (TIL) therapy

Tumor-infiltrating lymphocyte (TIL) therapy improves the ability of your own TIL cells to fight cancer. These immune cells constantly move through your body and look for abnormal cells. When activated, they go from your blood into a tumor to kill cancer cells. But sometimes, they don’t work as they should, or your body doesn’t have enough TIL cells to fight off cancer effectively.

To boost the ability of TIL cells in your body, these cells can be taken from your body and activated and multiplied in the lab. Then, millions of cancer-fighting TIL cells are infused back into your blood to boost your immune system’s ability to destroy cancer.

Currently, TIL therapy is only approved by the Food and Drug Administration for people with advanced melanoma.

Chimeric antigen receptor T-cell therapy (CAR-T)

Chimeric antigen receptor T-cell therapy (CAR-T) is a form of immunotherapy that uses T cells to fight cancer.

T cells naturally work in your body to find and attack cancer cells. To do this, they have proteins called receptors. These receptors bind to proteins called antigens on the surface of cancer cells to help your body destroy them. But sometimes, T cells can’t recognize the antigens on cancer cells.

To give your T cells the receptors they need, doctors take T cells from your blood, add a synthetic receptor called a chimeric antigen receptor (CAR) in the lab, and multiply these modified T cells. The new CAR-T cells are then infused back into your body to target specific antigens on the surface of cancer cells.

CAR T-cell therapy is currently approved by the FDA to treat some types of blood cancer, including leukemia, lymphoma and multiple myeloma.

T cell receptor (TCR) therapy

Sometimes, T cells cannot recognize the cancer cells in your body. Like CAR-T therapy, T cell receptor (TCR) therapy modifies your own T cells to help them better identify and target cancer cells. But TCR therapy targets different antigens on cancer cells.

During TCR therapy, your T cells are modified and multiplied in the lab. Doctors can choose the specific target and type of T cell to change, allowing your team to make this therapy work for your cancer. TCR therapy is being studied in a range of cancer types, including blood cancers and solid tumors.

Chimeric antigen receptor (CAR) natural killer (NK) cell therapy

Most immunotherapies use the power of your T cells to fight cancer. But some therapies are being developed using other types of immune cells, including natural killer (NK) cells. NK cells look for and attack many types of abnormal cells in the body.

During chimeric antigen receptor (CAR) NK natural killer (NK) cell therapy, NK cells are multiplied or modified in the lab. Then, they are infused into your body, where they can better attack cancer cells. Unlike T cell therapies, NK cell therapy doesn’t require using your own cells.

Monoclonal antibodies

Monoclonal antibodies are lab-made antibodies that help your body recognize cancerous or foreign cells. Your immune system naturally makes proteins called antibodies that stick to specific antigens in foreign cells and tell your body to attack them. Monoclonal antibodies are created to act like natural antibodies.

Different types of monoclonal antibodies work in different ways. They may help find a specific target in cancer cells, help the immune system respond in a certain way, restrict the blood supply to a tumor, or deliver chemicals or radiation directly to cancer cells.

There are dozens of types of monoclonal antibodies approved to treat many conditions, including cancers such as:

• Bladder cancer
• Breast cancer
• Colorectal cancer
• Leukemia, including acute lymphocytic leukemia, acute myeloid leukemia and chronic lymphocytic leukemia
• Lymphoma, including non-Hodgkin’s lymphoma, B-cell lymphoma and T-cell lymphoma
• Multiple myeloma
• Non-small cell lung cancer
• Ovarian cancer

Cancer vaccines

Cancer vaccines work in a few different ways to either prevent or treat cancer.

• Preventive cancer vaccines: Preventive cancer vaccines work before you have cancer. They target viruses that are linked to certain types of cancer. The human papillomavirus (HPV) vaccine may help reduce your risk of HPV-related cancers, such as cervical cancer, anal cancer, penile cancer or head and neck cancer. The hepatitis B vaccine can prevent hepatitis, which is linked to liver cancer.
• Therapeutic cancer vaccines: Therapeutic cancer vaccines may be used as treatment when you already have cancer, including bladder cancer or prostate cancer. They use targets found on specific cancer cells to help your immune system differentiate between healthy and cancer cells.

Cytokines

Cytokines are proteins that influence your immune system’s response when it detects foreign cells or cancer cells. They manage immune cell growth and help communicate between your immune cells, signaling that they need to attack and coordinate a response.

• Interferons: While your body naturally makes interferons, this signaling protein can also be made in the lab as a cancer treatment. Interferons work by “interfering” with the growth of cancer cells and signaling your body to attack them. They’re most commonly used in cancers such as lymphoma, leukemia, melanoma and sarcoma.
• Interleukins: Interleukins help your immune cells communicate and trigger an immune response. For example, an interleukin called IL-2 increases the amount of white blood cells in your body to fight cancer. Currently, synthetic interleukins are made in the lab to treat kidney cancer and melanoma.