What is immunotherapy?
Immunotherapy means using the body's own natural defenses to identify, attack, and kill cancer cells. While there are many approaches to immunotherapy, they all involve harnessing the body's own immune system to fight cancer.
This sounds simple, but the relationship between cancers and the immune system is very complex. Many cancers develop ways of hiding from the immune system or turning it off. To be successful, immunotherapy requires an understanding of how cancers evade the immune response and how that response can be activated or enhanced.
We're national leaders in immunotherapy.
In the last ten years, immunotherapy has emerged as an important and exciting treatment for many types of cancer. Our researchers and physicians are leading the way to develop these innovative therapies that bring new hope to cancer patients. Our research partner, Georgetown Lombardi Comprehensive Cancer Center, the only comprehensive cancer center designated by the National Cancer Institute in Washington, D.C., is a national leader conducting clinical trials to answer the many questions about how best to use these treatments and improve outcomes for patients.
A multidisciplinary team approach
Cancer is a complicated group of diseases, and the best cancer treatment requires a team of experienced experts who specialize in specific cancer types. For patients receiving immunotherapy, that team needs to work closely together to make optimal treatment decisions, evaluate the therapy results, and manage any side effects that occur.
MedStar Health brings a full team of experts to every patient receiving immunotherapy. The multidisciplinary team of specialists combines their skills and experience to develop individual treatment plans and provide a full spectrum of physical and emotional support to patients and families.
If you or someone you love has been diagnosed with cancer, this information will help you understand how immunotherapy works and determine if this approach might be a potential treatment option for you.
How immunotherapy works
There are two basic ways in which the immune system can attack cancers.
- Agents that boost the overall immune response
- Agents that enable the immune system to recognize and fight the tumor (called monoclonal antibodies)
The most common immunotherapy drugs today are those that help the immune system recognize and fight the cancer. Cancers work by deactivating the normal immune response. One important group of immunotherapy agents is “checkpoint inhibitors.” These drugs block the cancer’s ability to “put the brakes on the immune system.” This allows the T-cells and other components of the immune system to attack cancers and destroy tumors.
There are many other types of immunotherapy, and clinical trials are ongoing. These include:
- Cancer vaccines engineered to attack cancers
- Radioimmunotherapy combines specially designed antibodies with a radioactive substance targeted to the cancer cells
- Adoptive T-cell therapies in which cells are removed from a person's tumor, reengineered and then reinjected back into the patient
Promising results for many cancers
There are an increasing number of cancers in which immunotherapy is being studied. Early successes were with people who have advanced melanoma. Patients with this type of skin cancer have responded well to immunotherapy and have often seen a complete disappearance of their tumors and responses that last for years. Non-small cell lung cancer and cancers of the prostate, thymus, breast, kidney (renal cell), bladder, brain, blood, ovaries, leukemia, and lymphomas have all demonstrated promise but are still under investigation. Clinical studies are also underway to determine if immunotherapy is effective for many other types of cancer.
While some people have responded well to immunotherapy, the overall response rate remains in the 20-30 percent range. One very important goal of research is to find ways to predict who will respond and to develop new approaches that increase the response rate so that every patient has the opportunity to benefit from these therapies.
What to expect
To determine if immunotherapy will work for you, there are a variety of tests, or biopsies, that we use to collect information about the cancer cells, including their genetic makeup and the proteins on their surface. Through biopsies and bloodwork, we can identify particular cancer cell vulnerabilities that help us predict whether or not your particular cancer will respond to immunotherapy or other cancer treatments.
Currently, immunotherapy treatment is delivered intravenously through an I.V. placed in the arm. If you are a good candidate for immunotherapy, your care team will identify the type of immunotherapy that will be most effective. The type of immunotherapy you receive will determine how many treatment sessions you will need and for how long. Some patients undergo immunotherapy every two weeks, while others may receive immunotherapy once every six weeks.
Patients seem to tolerate immunotherapy better than chemotherapy with fewer side effects. Your team will monitor you closely throughout and after treatment to see how your body responds to treatment.
Side effects of immunotherapy
All cancer treatments have side effects, but the side effects of immunotherapy are different from those experienced by people using traditional therapies. Immunotherapy side effects result from the immune system attacking healthy cells and cancer cells. For many people, these side effects are relatively minor or temporary. These include:
- Fever or flu-like symptoms
- Thyroid problems
- Problems with other endocrine glands
- Colitis — an inflammation of the digestive system that can cause pain or diarrhea
In some instances, these problems can be severe—but they can almost all be treated effectively. If a patient experiences side effects, they do not have to stop taking immunotherapy.
Because immunotherapy is still a new approach, we're still learning about the long-term side effects of taking these agents. But, research is underway to help doctors and patients decide when to stop treatment and what problems might result from taking immunotherapy for long periods of time.
Is immunotherapy for me?
Right now, immunotherapy is most often used to treat cancers that are diagnosed at an advanced stage or have spread to other places in the body after primary treatment. There is no simple formula for knowing whether immunotherapy is right for you. It depends on the kind of cancer you have, its stage, previous treatments you have had, and other factors such as your overall health. Not everyone responds to immunotherapy. One of the most important areas of research is finding ways to understand why some patients respond well and others do not—and bring the benefits of immunotherapy to every patient.
Is immunotherapy a cure?
For patients who respond to immunotherapy, the benefits are real and, in many cases, remarkable. People with different kinds of advanced cancers are experiencing remissions that last for months or years, and in some instances, appear to be cured. Some people's cancers disappear entirely. Others have long periods of time in which their tumors do not grow or progress. These durable responses are one of the things that make doctors and researchers excited about immunotherapy.
As researchers learn more about the immune system, doctors will have additional therapies to offer patients and will be able to better identify cancer patients who will benefit from immunotherapy.
Looking for expert cancer care?
With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.
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Rebecca Yolowitz, CRNP,DNP
Kayla Marie Sesto, PA-C
Miki Kajiwara Alexander, FNP, MSN,RN
Sosipatros Alexander Boikos, MD
Kidist Worku, CRNP
Maya M. Beplat, NP-C
Samir N. Khleif, MD
Jacqueline Lucy Galdos, FNP,BC
Erin C. Ruane, CRNP,ANP,BC
Alaa Ali, MD,MSC
Hematology & Medical Oncology
Pedro E Alcedo Andrade, MD
Caileigh Lauren Pudela, MD
Pediatric Hematology Oncology
Kamyar Nader, MD
Myeloma, Leukemia, Hematology & Hematologic Malignancy
Brandon Raab, ACNP-BC
Hima Bindu Lingam, MD
Colleen Ralph, CRNP
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7501 Surratts Rd. Ste. 101 Clinton, MD 20735
25500 Point Lookout Rd. First Fl. Leonardtown, MD 20650
18109 Prince Philip Dr. Ste. B100 Olney, MD 20832
3800 Reservoir Rd. NW Washington, DC 20007
5601 Loch Raven Blvd. Russell Morgan Building First Floor Baltimore, MD 21239
12 MedStar Blvd. Ste. 180 Bel Air, MD 21015
110 Irving Street, NW Washington, D.C., 20010
9103 Franklin Square Dr. Suite 1800 Baltimore, MD 21237
Clinical trials and research
There are hundreds of clinical trials underway studying immunotherapy in many different kinds of cancer. If you are a good candidate and meet eligibility requirements, your care team will recommend clinical trials that may benefit you.
Through our partnership with the Georgetown Lombardi Comprehensive Cancer Center, we continue to find new ways to improve cancer treatment and outcomes using immunotherapy.
An expert’s perspective
Deputy Director of the Georgetown Lombardi Comprehensive Cancer Center, is one of the nation’s top experts on immunotherapy for the treatment of melanoma and kidney cancer.
“We have so many new options for our melanoma and kidney cancer patients. We are seeing some remarkable results, even cures for people with very advanced disease, but there is still a lot we need to investigate through clinical trials. These therapies are really changing how we think about cancer, and how we as cancer specialists work together.
It is very satisfying to see these treatments working so well in some of our patients. With combination therapies, we’re getting over half of our advanced melanoma patients, for example, back to their lives, which wasn’t possible even a few years ago — but we have to do the studies that will make the benefits of immunotherapy available to more patients.”