Immunotherapy to Treat Cancer

Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. The immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues of the lymph system.

Immunotherapy is a type of biological therapy. Biological therapy is a type of treatment that uses substances made from living organisms to treat cancer.

As part of its normal function, the immune system detects and destroys abnormal cells and most likely prevents or curbs the growth of many cancers. For instance, immune cells are sometimes found in and around tumors. These cells, called tumor-infiltrating lymphocytes or TILs, are a sign that the immune system is responding to the tumor. People whose tumors contain TILs often do better than people whose tumors don’t contain them.

Even though the immune system can prevent or slow cancer growth, cancer cells have ways to avoid destruction by the immune system. For example, cancer cells may:

  • Have genetic changes that make them less visible to the immune system.
  • Have proteins on their surface that turn off immune cells.
  • Change the normal cells around the tumor so they interfere with how the immune system responds to the cancer cells.

Immunotherapy helps the immune system to better act against cancer.

What are the types of immunotherapy?

Several types of immunotherapy are used to treat cancer. These include:

  • Immune checkpoint inhibitors, which are drugs that block immune checkpoints. These checkpoints are a normal part of the immune system and keep immune responses from being too strong. By blocking them, these drugs allow immune cells to respond more strongly to cancer.Learn more about immune checkpoint inhibitors.
  • T-cell transfer therapy, which is a treatment that boosts the natural ability of your T cells to fight cancer. In this treatment, immune cells are taken from your tumor. Those that are most active against your cancer are selected or changed in the lab to better attack your cancer cells, grown in large batches, and put back into your body through a needle in a vein.T-cell transfer therapy may also be called adoptive cell therapy, adoptive immunotherapy, or immune cell therapy.Learn more about T-cell transfer therapy.
  • Monoclonal antibodies, which are immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be better seen and destroyed by the immune system. Such monoclonal antibodies are a type of immunotherapy.Monoclonal antibodies may also be called therapeutic antibodies.Learn more about monoclonal antibodies.
  • Treatment vaccines, which work against cancer by boosting your immune system’s response to cancer cells. Treatment vaccines are different from the ones that help prevent disease.Learn more about cancer treatment vaccines.
  • Immune system modulators, which enhance the body’s immune response against cancer. Some of these agents affect specific parts of the immune system, whereas others affect the immune system in a more general way.Learn more about immune system modulators.

Which cancers are treated with immunotherapy?

Immunotherapy drugs have been approved to treat many types of cancer. However, immunotherapy is not yet as widely used as surgerychemotherapy, or radiation therapy. To learn about whether immunotherapy may be used to treat your cancer, see the PDQ® adult cancer treatment summaries and childhood cancer treatment summaries.

What are the side effects of immunotherapy?

Immunotherapy can cause side effects, many of which happen when the immune system that has been revved-up to act against the cancer also acts against healthy cells and tissues in your body.

Learn more about immunotherapy side effects.

How is immunotherapy given?

Different forms of immunotherapy may be given in different ways. These include:

  • Intravenous (IV)
    The immunotherapy goes directly into a vein.
  • Oral
    The immunotherapy comes in pills or capsules that you swallow.
  • Topical
    The immunotherapy comes in a cream that you rub onto your skin. This type of immunotherapy can be used for very early skin cancer.
  • Intravesical
    The immunotherapy goes directly into the bladder.

Where do you go for immunotherapy?

You may receive immunotherapy in a doctor’s office, clinic, or outpatient unit in a hospital. Outpatient means you do not spend the night in the hospital.

How often do you receive immunotherapy?

How often and how long you receive immunotherapy depends on:

  • Your type of cancer and how advanced it is
  • The type of immunotherapy you get
  • How your body reacts to treatment

You may have treatment every day, week, or month. Some types of immunotherapy given in cycles. A cycle is a period of treatment followed by a period of rest. The rest period gives your body a chance to recover, respond to the immunotherapy, and build new healthy cells.

How can you tell if immunotherapy is working?

You will see your doctor often. He or she will give you physical exams and ask you how you feel. You will have medical tests, such as blood tests and different types of scans. These tests will measure the size of your tumor and look for changes in your blood work.

What is the current research in immunotherapy?

Researchers are focusing on several major areas to improve immunotherapy, including:

  • Finding solutions for resistance.
    Researchers are testing combinations of immune checkpoint inhibitors and other types of immunotherapy, targeted therapy, and radiation therapy to overcome resistance to immunotherapy.
  • Finding ways to predict responses to immunotherapy.
    Only a small portion of people who receive immunotherapy will respond to the treatment. Finding ways to predict which people will respond to treatment is a major area of research.
  • Learning more about how cancer cells evade or suppress immune responses against them.
    A better understanding of how cancer cells get around the immune system could lead to the development of new drugs that block those processes.
  • How to reduce the side effects of treatment with immunotherapy.
Find more information about immunotherapy clinical trials near you HERE.

Immunotherapy to Treat Cancer was originally published by the National Cancer Institute.

Accelerating Progress with the Power of Data

Collecting and securely sharing cancer research data is saving lives. It allows researchers to identify trends, patterns, and other insights that could be used to inform screening and treatment approaches, all while protecting patient privacy. And as we work to deliver on the promise of precision medicine, it’s exciting to witness the power of these data in improving outcomes for patients and families.

Engaging Patients as Partners in Making Data More Inclusive

As associate director of Count Me In, Dr. Corrie Painter is working to make research data inclusive of many patient experiences. Credit: National Cancer Institute

“It was a vulnerable, dark moment in my life. How is this anyone’s reality?” That’s how Dr. Corrie Painter felt when diagnosed with angiosarcoma, a rare cancer that forms tumors in the lining of blood vessels. She was 36 with two young children, and as a scientist working on her Ph.D. in biochemistry, she immediately looked into existing research but found little available.

“I was diagnosed in 2010 by someone who had no idea what to do with me, and my data wasn’t being collected to help anyone else,” she said, adding that making data inclusive of as many patients as possible helps show patterns to improve knowledge and treatments. Wanting to harness data this way led her to work at Count Me In (CMI), a nonprofit partnering with patients who choose to share their tumor samples, medical history, and experiences. CMI makes this data available to scientists through repositories like the Genomic Data Commons, part of NCI’s Cancer Research Data Commons.

As CMI’s associate director, Corrie fosters open data and collaboration for a number of understudied cancers. She also stresses the need to include communities traditionally left behind by medical research. “We have a lot of work to do, and it’s incumbent on us inside research to figure out how to build trust in [underrepresented] communities,” she said, adding that some groups haven’t even been asked to participate.

“The goal is to leverage these data to make good on the promise of precision medicine for everyone,” Corrie said. For its Angiosarcoma Project alone (launched in 2017), CMI data uncovered genes associated with the cancer and opened the door to possible new therapies. Corrie, now 11 years postdiagnosis, is cautiously excited. “The work isn’t done, but I’m hopeful that we reach a day when someone who is told they have cancer will have less anxiety because they know it can be dealt with.”

Using the Power of Data against Colorectal Cancer

Rebecca Siegel used what she found in her analysis of Surveillance, Epidemiology, and End Results (SEER) Program data to change colorectal screening guidelines.  Credit: National Cancer Institute

Rebecca Siegel believes in the power of data to save lives. The signing of the National Cancer Act 50 years ago came with a commitment to collecting, analyzing, and disseminating cancer data, including surveillance data, which tracks different cancer statistics and patient demographics. Without these data, said Rebecca, “we wouldn’t know where we’re doing well and where improvement is lacking.”

Case in point: until recently, colorectal cancer (CRC) guidelines advised that screenings begin at 50, to catch cases early and save lives. But Rebecca, a scientific director at the American Cancer Society, looked at data from 1995–2016 in NCI’s Surveillance, Epidemiology, and End Results Program and other similar registries and saw an increase in the number of people under 50 being diagnosed with CRC. The median age at diagnosis had also dropped, from 72 in 2002 to 66 in 2016. Based on the trends, Rebecca anticipated the median age to be even lower for 2020. She estimated that 18,000 people—12% of all CRC patients—would be diagnosed under 50, with half between ages 45 and 49.

“The consensus [in the research community] now is to begin screening at 45 instead of 50,” said Rebecca, whose analysis changed national screening guidelines. But we shouldn’t stop there. While more research is needed to determine why cases are going up in younger groups, she stressed that there are opportunities “for prevention and early detection, primarily through screening but also behavior changes.” Encouraging healthier lifestyles in younger people and increasing risk awareness in patients and providers to help prevent delayed diagnoses are some tactics to implement now.

Lowering the CRC screening age from 50 to 45 “will save countless lives over the long term,” and it’s thanks to the tracking and analysis of surveillance data that we have this chance to help improve prevention and diagnosis.

Harnessing Data to Drive Progress in Childhood Cancers

Dr. Brigitte Widemann, a branch chief in NCI’s Center for Cancer Research, wants to meaningfully share data to improve outcomes for patients with childhood cancer.  Credit: National Cancer Institute

“Just think if I had a patient with a rare tumor and could access data from the other 30 or so patients out there with the same tumor,” said Dr. Brigitte Widemann, “I could learn more about the course of the disease and make better treatment recommendations.” This is true for all cancers, but Brigitte believes that it could be especially helpful in childhood cancers.

However, childhood cancer data is often only stored at the institution where a child is treated. “We don’t yet have a meaningful mechanism to share the wealth of data, which can include tumor and blood samples as well as genomic sequencing,” said Brigitte.

To develop ways to connect and share these data with the research community, NCI started the Childhood Cancer Data Initiative (CCDI). “Building on the success of projects like The Cancer Genome Atlas (“TCGA”—a landmark program that cataloged genetic mutations responsible for cancer), and the Therapeutically Applicable Research to Generate Effective Treatments program (“TARGET”—an NCI initiative to understand childhood cancer at the molecular level), NCI launched CCDI in 2020 to learn from every child with cancer in the United States,” said Dr. Louis Staudt, director of NCI’s Center for Cancer Genomics. “Capturing and sharing this data will be instrumental in deepening our understanding of these unfortunate diseases.”

Brigitte, who is chief of NCI’s Pediatric Oncology Branch, points out that patients and families often want to contribute data to help research progress. “I’d say most patients are eager to share,” she said. One patient recently asked her when his next tumor biopsy would be, so that he could contribute his samples. “When I told him that he didn’t need more biopsies, he said, ‘Well, if you ever want to learn more, just tell me.’”

The idea of learning from every child and having every child benefit really resonates with Brigitte. At the end of the day, she said, it’s not just about “taking data and advancing research, but also making sure it all goes back to improvements for patients.”

Accelerating Progress with the Power of Data was originally published by the National Cancer Institute.

FirstHealth Breaks Ground at New Cancer Center

By Laura Douglass,
May 27, 2021

FirstHealth of the Carolinas broke ground Thursday morning on its new $68 million comprehensive cancer center. The all-encompassing facility represents a major step forward for cancer treatment and patient care, from diagnosis to treatment, and most importantly, survivorship.

Construction of the four-story building is expected to continue through late 2022. The new structure and its adjoining parking deck on Page Road are located directly across the street from Moore Regional’s main hospital campus in Pinehurst.

FH Cancer Center rendering
FirstHealth Cancer Center, rendering courtesy of CPL Architecture

Art Medeiros, chairman of Foundation of FirstHealth Board, said building the multidisciplinary cancer center was both a practical and pragmatic decision. FirstHealth has a long-standing history of providing exceptional cancer services, but has grown and expanded beyond the capacity of its current facilities.

“What we’ve got here today is a groundbreaking not just of a building. It is our community’s commitment to a line in the sand that we will fight cancer,” Medeiros said, in an inspiring message to the large crowd that included FirstHealth officials, local elected representatives, oncology staff and medical providers. “I believe we are building a haven of hope. We are building a haven of healing. We are building a haven of help.”

FirstHealth CEO Mickey Foster noted it was a “very special day,” and thanked his predecessor, former CEO Dave Kilarski, for his initial vision of the cancer center. Foster also expressed thanks to the Foundation for FirstHealth Board for their philanthropic efforts, and the FirstHealth staff for their dedication, especially throughout the challenges of 2020 and the COVID-19 pandemic.

“This will be a healthcare destination for decades to come,” Foster said.

Natalie Hawkins, executive director of Partners in Progress agreed. “I think this new cancer center that FirstHealth is building is just an incredible investment in our community. I think Mickey Foster and his leadership team have done a phenomenal job bringing first-class quality care for cancer patients here to Moore County that will benefit the entire region.”