Immunotherapy

What is it ?

Immunotherapy is a cancer treatment that stimulates our immune system to target and destroy cancer cells.

In cancer development, cells evade the immune system. The principle of immunotherapies is to help the immune system recognize these cells so that it can eliminate them.

How it works ?

There are several forms of immunotherapy available in oncology/hematology to strengthen the immune system.

Immune checkpoint inhibitors

The immune system can either accelerate or slow down in response to the presence of microbes in the body through "checkpoints."

During an infection, the immune system speeds up to eliminate microbes (bacteria, viruses). Once the microbes or virus-infected cells are cleared, the immune system needs to slow down.

Cancer cells have the ability to inhibit the immune system themselves to avoid being destroyed.

Immune checkpoint inhibitors work by blocking the action of cancer cells and reactivating the immune system to destroy these cancer cells.

Currently, immune checkpoint inhibitors target and block the action of the CTLA-4 protein, the PD-1 receptor, or the PDL-1 ligand.

CAR T cells

CAR T cells are T lymphocytes modified to express a receptor on their surface called a chimeric antigen receptor (CAR).

The principle of this treatment involves extracting T lymphocytes from a patient, then genetically modifying them to express this receptor, which allows them to more specifically recognize cancer cells.

Once genetically modified, the qualified medical staff reinfuses these lymphocytes back into the same patient.

Amélie, 48, shares her experience with her battle against breast cancer and her treatment with immunotherapy.

Side effects

The adverse effects of immunotherapy can affect various organs and may appear at different times during treatment.

Identifying these effects is crucial for effective management.

The most common adverse effects are :

• Infusion reactions
• Fatigue
• Skin effects : redness and itching
• Gastrointestinal effects : diarrhea, nausea, vomiting
• Endocrine effects
• Respiratory effects : cough and shortness of breath

Indications

The medical staff uses these immunotherapies for several conditions: skin cancer, lung cancer, kidney cancer, head and neck cancer, bladder cancer, triple-negative breast cancer, Merkel cell carcinoma, lymphomas, and more.

Most often, it is nurses who administer immunotherapies intravenously.

However, immunotherapy is not used systematically.

Not all patients are eligible for immunotherapy, and not all cancers are responsive to immunotherapy.