Immunotherapy

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The most advance cancer treatment

In recent cancer research, one of the most advanced treatments is immunotherapy.  Opdivo that is a immunotherapy drug is very famous because its development was led by Dr. Tasuku Honjo, who was a professor of Kyoto University, Japan, and because the drug will cost more than 0.35 million dollars per year.   

 

 

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credit:  Opdivo  Bristol-Myers Squibb

 

Difference between Immunotherapy and Chemotherapy

While chemotherapy uses drugs that kill cancer cells, immunotherapy activates immune cells to kill cancer cells. 

 

Types of Immunotherapy

Immune Checkpoint Inhibitors

Immune checkpoint inhibitors are drugs that inhibit cancer cells from inactivating the immune system.

 

These drugs activate T cells, which are immune cells, to kill cancer cells.

Immune Cell Therapy

Immune cell therapy is a treatment consisting of steps of removing immune cells from the patient, altering their genes to help fight cancer, growing them, and transfusing them back into the patient. This type of treatment should be treated for each patient and is still experimental.

 

Bispecific Antibody Therapy

Bispecific antibody therapy is an alternative treatment to immune cell therapy.  Since bispecific antibodies attach to both cancer cells and T-cells, the T-cells can effectively kill the cancer cells.

 

Vaccine Therapy

Vaccine therapy is another form of immunotherapy.  Cancer vaccines are to treat the disease once the patient has it.  In this therapy, the immune system is presented with the cancer so as to attack the cancer.   

 

Although BCG was developed for tuberculosis, it has long been used for bladder cancer.  BCG is likely to trigger the immune system to attack the cancer.  Other vaccines are expected to treat cancer in combination with immune checkpoint inhibitors.

 

Types of Cancer Treatable with Immunotherapy

Types of cancer that immune checkpoint inhibitors can treat include advanced melanoma, Hodgkin’s lymphoma, lung cancer, kidney cancer, and bladder cancer.  Drugs for other types of cancer are being studied and tested.

 

Immune cell therapy has been successfully used for blood cancers such as leukemia and lymphoma.

 

Approved and Available Checkpoint Inhibitors

As immune checkpoint inhibitors approved by Ministry of Health, Labour and Welfare, Japan and available on the market are Yervoy (ipilimumab) and Opdivo (nivolumab), made by Bristol-Myers Squibb.  Keytruda (pembrolizumab) made by Merck is currently on clinical trial. 

Effectiveness of Immunotherapy

In immunotherapy, immune checkpoint inhibitors are effective in 20 percent to 40 percent of patients with melanoma.  Patients with advanced disease may have remissions that last for years.  Combining two immune checkpoint inhibitors may increase the effectiveness.  But the drugs may not work for patients at all. 

 

In immunity cell therapy, 25 percent to 90 percent of patients with lymphoma or leukemia patients may have complete remissions.  While the remissions of diseases may last for years, relapses of diseases may occur within a year.

 

Complications of Immunotherapy

Immune checkpoint inhibitors can cause severe complications that are mainly autoimmune diseases, in which the immune system attacks not only healthy tissue, but also cancer.  The autoimmune diseases cause inflammation in various tissues and organs such as dyspnea in the lungs, diarrhea in the intestine, and pain and rheumatoid arthritis in the joints and muscles.  In addition, the immune system may also attack vital glands like the thyroid gland and pituitary gland.  These immune reactions may be treated with steroid drugs such as prednisone.

 

Immune cell therapy may have severe and potentially fatal complications resulting from the overstimulation of the immune system.  Although the complications can be alleviated, patients may need to have treatment in an intensive care unit.