Immunotherapy

An advanced form of precision medicine, immunotherapy harnesses the power of the body's own immune system, enhancing its natural ability to fight and destroy harmful invaders such as cancer. Because this innovative treatment can turn the immune system--which is more powerful than any known cancer drug-- against tumor cells, it holds great promise for many cancer patients.

At Tampa General Hospital's Cancer Institute, we believe precision oncology represents the future of cancer care. Our multidisciplinary team works closely with each patient to develop a personalized treatment plan that will potentially lead to the best possible outcome and quality of life. In recognition of our patient-centered approach, U.S. News & World Report has awarded TGH the "High Performing in Cancer" designation for 2023-24, which is their highest accolade for cancer care.

How Does Immunotherapy Work?

Several years ago, researchers discovered that many types of cancer can evade detection by the body's immune system by "putting the brakes on" the immune cells that would normally attack and destroy the tumor. Based on that knowledge, scientists developed the first class of immunotherapy medications. Known as immune checkpoint inhibitors, these drugs can effectively "take the brakes off"; the immune cells and thus help the immune system fight the cancer.

Of course, no two patients and no two cancers are exactly alike. Scientists continue to investigate certain biomarkers, such as genes and proteins, that can provide insights about each patient's cancer, including its genetic makeup, behavior and interactions with the immune system. Armed with that information, the patient’s treatment team can better determine the optimal immunotherapy approach.

What to Expect With Immunotherapy

In addition to immune checkpoint inhibitors, cancer immunotherapy may involve:

Different forms of immunotherapy are administered in different ways, such as intravenously, orally, topically or intravesically. For enhanced effectiveness, many cancer immunotherapy treatments are used in combination with surgery, chemotherapy, radiation therapy or targeted therapy.

What Conditions Can Be Treated With Immunotherapy?

Immunotherapy works by helping the immune system recognize and home in on tumor cells. As such, this groundbreaking option can be used to treat virtually every type of cancer, including those that are highly resistant to chemotherapy and radiation therapy.

Immunotherapy for Bladder Cancer

Early-stage bladder cancer may be treated with intravesical immunotherapy. A physician inserts a thin, flexible tube (catheter) in the urethra and guides it into the bladder, then uses the catheter to deliver medication directly to the bladder. This type of immunotherapy can be effective for small tumors that are confined to the bladder lining and have not spread into the deeper layers of the bladder wall. Another treatment option for advanced bladder cancer is systemic immunotherapy, which is delivered intravenously and travels throughout the body via the bloodstream.

Immunotherapy for Breast Cancer

An immune checkpoint inhibitor known as pembrolizumab is currently approved by the U.S. Food & Drug Administration (FDA) for treating certain patients with early-stage or metastatic triple-negative breast cancer. Patients with high-risk, early-stage triple-negative breast cancer may receive a combination of immunotherapy and chemotherapy before surgery, while patients with metastatic triple-negative breast cancer may receive a combination of immunotherapy and chemotherapy as their primary treatment.

Immunotherapy for Colon Cancer

Thus far, two immune checkpoint inhibitors--pembrolizumab and nivolumab have shown promise for treating Colorectal Cancer. The FDA has approved this type of immunotherapy for patients with a subtype of metastatic colorectal cancer known as microsatellite instability-high disease.

Immunotherapy for Liver Cancer

The liver filters blood received directly from the digestive system and other parts of the body. When performing this vital function, the liver plays a unique role in determining which proteins are harmful invaders and which can be safely ignored, then relays that information to the immune system so it can respond accordingly. Some types of liver cancer have unique immune-suppressive capabilities that capitalize on the power of the liver to influence the body's immune response and effectively "convince" it to ignore the tumor. As such, liver cancer may be less responsive to immunotherapy than other types of cancer. However, research is ongoing, and scientists are continuing to learn more and expand the immunotherapy options for liver cancer patients.

Immunotherapy for Lung Cancer

In recent years, immune checkpoint inhibitors have become an important tool for treating advanced lung cancer. The FDA first approved nivolumab for treating squamous cell lung cancer (after the initial treatment stopped working), and later approved it for treating all types of non-small cell lung cancer (also after the initial treatment stopped working).

The FDA has also approved the use of pembrolizumab after chemotherapy for treating lung tumors that express a specific protein (PD-L1), and later approved it as a first-line treatment for some patients. Finally, the FDA has approved the use of atezolizumab after chemotherapy for treating all types of non-small cell lung cancer.

Immunotherapy for Melanoma

Immunotherapy has transformed the treatment of melanoma. Specifically, several FDA-approved immune checkpoint inhibitors have increased the overall survival rate for patients with metastatic melanoma.

Immunotherapy for Prostate Cancer

The FDA has approved a groundbreaking treatment vaccine for prostate cancer. Known as sipuleucel-T, the vaccine is tailored to match each patient’s unique immune system.

Immunotherapy Side Effects

Although immunotherapy is designed to strengthen the body's immune system so that it can better attack cancerous cells, the "supercharged"; immune system may mistakenly attack healthy tissues as well. As a result, immunotherapy can cause inflammation in healthy tissues throughout the body, which in turn can cause side effects such as:

  • Fatigue
  • Itchy skin rashes
  • Diarrhea
  • Nausea and vomiting
  • Decreased thyroid hormone levels

Any side effects of immunotherapy are usually mild and short-lived. However, it is still important to discuss them with a physician who can suggest ways to manage the associated discomfort or, if necessary, pause the immunotherapy until the side effects improve.

How Effective Is Immunotherapy?

Cancer immunotherapy is highly effective for certain patients, helping them to live longer and improving their quality of life. However, it is not equally effective for everyone. As scientists investigate the reasons why immunotherapy works well for some patients but not others, they continue to find ways to refine and personalize this promising cancer treatment.

Immunotherapy vs. Chemotherapy

Both chemotherapy and immunotherapy can be effective for treating cancer. However, they treat cancer in different ways. Chemotherapy works by directly targeting and damaging rapidly dividing cancer cells, and its effects last only as long as the chemo drugs remain in the body.

Unlike chemotherapy, immunotherapy works by boosting the body's immune system, which in turn fights the cancer. Because immunotherapy can "teach"; the immune system how to identify and destroy cancerous cells, its beneficial effects can extend long after the treatment is completed.

Benefit From World-Class Care at TGH

The outstanding research team at TGH is continually working to gain a deeper understanding of how different patients and cancers respond to immune-based therapies so more patients can benefit from these innovative cancer treatments. If you would like to learn more about immunotherapy, contact us at (800) 844-4151 to request an appointment.