Immunotherapy shows success in treating cancer

Cancer cells are smart, so they put up a shield around themselves and work hard to survive. In order to kill them, cancer treatments have to be smarter. Research being done with immunotherapy drugs is extremely exciting because therapies are now able to work with the immune system to allow the body's natural systems to locate and kill cancer cells.

In 1990, researchers started to investigate immunotherapy drugs and found they had positive effects. It wasn't until 2011 to 2014 that cancer researchers started to realize that immunotherapy drugs worked well for cancer. Today, immunotherapy has been used successfully to treat several kinds of cancer, including certain types of lung cancer, prostate cancer, and melanoma. Lung cancer is diagnosed more than 220,000 times each year in the U.S. Immunotherapy treatment of lung cancer is very exciting for the medical community because it could help target lung cancer cells specifically and improve survival rates.

In general, immunotherapy uses various ways to harness the body's own strength through the immune system to fight specific diseases. For example, vaccines use the immune system to fight infections. Vaccines have been used for more than 100 years. Similarly, cancer immunotherapy is a treatment that stimulates the immune system to fight cancer cells.

Cancer cells are not our own cells, so they should be killed by our immune system. However, they develop a shield to protect themselves. This shield is called a checkpoint. Cancer cells hide behind this checkpoint shield to escape from the immune system. Recently approved checkpoint inhibitors remove that shield so our immune system can find the cancer cells and kill them.

Medications known as interferons or interleukins are among several types of immunotherapy that have been used since the 1990s to fight cancer, with varying success. In 2011, the U.S. Food & Drug Administration approved the use of Ipilimumab for advanced melanoma treatment. Then, in 2014, checkpoint inhibitor drugs called Pembrolizumab and Nivolumab were approved to treat certain types of lung cancer.

By the end of 2017, Nivolumab, Pembrolizumab, and three other checkpoint inhibitors (Atezolizumab, Avelumab, and Durvalumab) were approved for treatment of various cancers, including kidney cancer, bladder cancer, certain forms of skin cancers, Hodgkin's lymphoma, head and neck cancer, and liver cancer.

Checkpoint inhibitors are given similar to most chemotherapy drugs. Patients come into the infusion clinic, where venous access is established, and the infusion is given over a period of 30 to 90 minutes, while the patient is monitored. After the infusion is complete, the patient goes home and follows up with a medical oncologist.

As with all types of cancer treatment, immunotherapy can have side effects, too. As the name suggests, immunotherapy treatment activates the immune system. Too much of an active immune system can attack various organ systems and can cause some related side effects. However, this type of treatment has less frequent and less severe side effects when compared to traditional chemotherapy.

Recent studies in certain types of stage 4 lung cancer have shown that in patients treated with immunotherapy, the quality of life was better and the treatment was more effective compared to chemotherapy. For example, severe side effects occurred in about 50 percent of the patients receiving traditional chemotherapy, while severe side effects only occurred in 5 percent of the patients receiving immunotherapy.

There are also other types of immunotherapies. One type is called cellular immune therapy. During this type of treatment, cancer-fighting immune cells are taken from a patient, treated in various ways to make them stronger so they will target and fight specific types of cancer cells, and then the immune cells are infused back into the patient.

Cancer vaccines are another type of immunotherapy being used (and being researched) for certain types of cancers.

At Tunnell Cancer Center, our expert medical oncologists utilize immunotherapy treatments for certain types of cancer, and we hope research continues in this area. Surgery, chemotherapy, and radiation treatments are still the most successful treatment options for most cancers. If you are a cancer patient, talk to your medical oncologist or make an appointment for a consultation with a medical oncologist at Tunnell Cancer Center to determine if you are a candidate for immunotherapy and to discuss the benefits and side effects.

As Sussex County continues to expand, so does Tunnell Cancer Center, which plans to open a new cancer center in Millville in the next few years. Tunnell Cancer Center is supported by the community as part of Beebe Healthcare, a nonprofit community healthcare system.

For more information about supporting Tunnell Cancer Center and Beebe Healthcare, contact the Beebe Medical Foundation at 302-644-2900 or foundation@beebehealthcare.org.

Dr. Nisarg Desai is a medical oncologist and hematologist with Tunnell Cancer Center. To learn more about Tunnell Cancer Center, go to www.beebehealthcare.org/tunnell-cancer-center. To learn more about the proposed expansion or to sign up to receive updates, go to www.nextgenerationofcare.org.