>Dr. Amit Agarwal

Dr. Amit Agarwal
Director & HOD
Medical Oncology
BLK Cancer Centre
BLK Super Speciality
Hospital, New Delhi

A New Ray of Hope

Immunotherapy - Making New Strides in
Cancer Treatment

Immunotherapy in India is a new class of cancer treatment that has delivered astonishing results till date. Also known as Biologic Therapy or Biotherapy, it is a new type of Cancer treatment that enhances the body’s immune system to fight against Cancer. Immunotherapy for Cancer can be done either by training the immune system to recognise the Cancer cells and destroy it or by stimulating the immune system to destroy the tumour cells by using antibodies.

There are several types of Immunotherapies - passive Immunotherapies (monoclonal antibodies), non- specific Immunotherapies and active specific Immunotherapies (Cancer vaccines). Immunotherapy Cancer treatment brings in a new ray of hope for the Cancer population. With this method, the immune system can be boosted, directed or restored by the different kinds of Cancer Immunotherapy.

Focusing on the IS of the host rather than the Tumour has proven to be an effective strategy in a number of Tumour cases. However, this approach is not new. In the seventies, instillation of intracavitary Bacillus Calmette-Guerin (BCG) for the treatment of superficial Bladder Tumours was found to be an effective treatment. A few years later, the first positive studies with cytokines further supported the strategy of boosting the IS of the host to attack Cancer. Thus, interleukin 2 (IL2) or interferon alfa (IFNα) have been used for decades for the treatment of Kidney Cancer or Melanoma in some specific indications.

But it was the development of antibodies that enabled inhibition of key immune checkpoints that meant a breakthrough in Cancer therapy. The anti-PD-1 antibody nivolumab received the FDA-approval in March 2015 for squamous Lung Cancer treatment. In addition, antibodies targeting PD-1 or PD-L1 have demonstrated their efficacy and safety in additional Tumours, including Non-Small Cell Lung Carcinoma (NSCLC), Renal Cell Carcinoma (RCC), Bladder Cancer, and Hodgkin’s Lymphoma. Almost at the same time, the field of adoptive cell transfer has exploded. The Chimeric Antigen Receptor (CAR) T technology has provided strong evidence of efficacy in the treatment of B cell malignancies, and different T cell based treatments are currently under investigation for different types of Tumours.

Immunotherapy is not totally safe and has side effects which can vary from person to person. The side effects can vary depending on the type of Immunotherapy you receive and how your body responds. Since your immune system takes care of your whole body, Immunotherapy can cause inflammation in any of the organs in the body. This can mean that some people with an autoimmune disease such as Lupus or Rheumatoid Arthritis may find it difficult to have Immunotherapy safely. Common side effects include fatigue, skin rash and diarrhoea – which can vary in severity and duration.