So, what exactly is immunotherapy?

 

Immunotherapy is the idea of harnessing the body's immune system to fight cancer. Our immune systems are built to fight off foreign entities that enter our body and research has shown that the same course of action our immune cells take against a virus such as the flu, they can take against cancer cells- they just need extra help and machinery to do so. Immunotherapy has the vast potential to change disease course and kill cancer offering a more personalized treatment approach and in many cases laving healthy cells untouched.

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Here is an outline of the different areas within immunotherapy: 

 

• Cancer Vaccines: 

      Vaccines towards diseases like small pox and polio have been nearly completely successful so, researchers have used the same approach for cancer. Introduce ‘cancer signaling’ in an unharmful methodology in order to begin an immune cascade against cancer cells. There are currently few FDA approved therapeutic cancer vaccines such as, Bacillus Calmette-Guerin (BCG) for early stage bladder cancer and Sipuleucel-T (Provenge) for prostate cancer and with more than 20 more under evaluation in clinical trials.

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Read more here.

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• Adoptive cell transfer or ACT:

Immune cells are be taken from a patient (or a donor) and are synthetically enhanced in a laboratory. They are then reintroduced into the body with improved immune capabilities, either through expanding immune cells in-vitro (outside the body) so that they may be returned in larger amounts, or by CAR T cell therapy, by synthetically engineering those cells in order to re-introduce a ‘better’ immune cell. These immune cells are engineered to be specific for neoantigens and can directly kill tumor cells when infused into patients. In 2017, two CAR T-cell therapies were approved by the FDA, one for the treatment of children with acute lymphoblastic leukemia (ALL) and the other for adults with advanced lymphomas. Nevertheless, this field of immunotherapy has a long way to go and researchers are cautious about its future against all types of cancers.

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Read more here.

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• Oncolytic Viruses

Oncolytic viruses are viruses that tend to infect and kill tumor cells more without harming healthy cells. There is only one FDA approved oncolytic virus to date but there are man more being evaluated in clinical trials. Talimogene laherparepvec (T-VEC, or Imlygic®) VEC for the treatment of some patients with metastatic melanoma when surgery is not an option.

 

Read more about oncolytic viruses here.

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• Cytokine Therapy 

Immune cells secrete a series of different cytokines. that promote inflammation and immune response. In cancer, cytokine therapy assists the immune system to kill cancer cells or to keep them from growing. Currently, just two cytokines (IFNα and IL-2) are used to treat cancer; other cytokines, are under evaluation in various phases of pre-clinical and clinical trials. (Nektar® has several under evaluation).

 

Interferon alfa-2b (Intron® A), Interferon alfa-2a (Roferon® A)

These two drugs are synthetic versions of IFNα, a cytokine that increases the resistance of healthy cells to an immune attack and makes cancerous cells more vulnerable.  This drug is used in the treatment against several cancer types (bladder cancer, melanoma, chronic myelogenous leukemia, multiple myeloma, hairy cell leukemia, Kaposi’s sarcoma, follicular non-Hodgkin’s lymphoma, condyloma acuminata, chronic myelogenous leukemia, kidney cancer, carcinoid syndrome, islet cell tumor, multiple myeloma, non-follicular non-Hodgkin’s lymphoma, cutaneous T-cell lymphoma, and desmoid tumor)

 

Aldesleukin (Proleukin®, IL-2)

This is a medicinal form of IL-2, a cytokine that inhibits growth and proliferation of cancer cells by making them more visible to the immune system. It is recommended for treatment for kidney cancer and melanoma. 

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Read more about cytokine therapy here. 

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• Immune checkpoint inhibitor drugs

These are a type of antibody treatment but instead of targeting a specific neoantigen to alarm the immune system they bind to proteins that have the ability to stop an immune system attack. When a cancer cell comes into contact with an immune surveillance cell, they can express a certain protein or ligand at the time of contact to stop a pending attack. Immune checkpoint inhibitors bind themselves to those ligands so they cannot bind to immune cells to shut them off therefore allowing an immune response to attack.