Immunotherapy uses the body's immune system to target and kill cancerous cells. It is a blanket term covering several treatments. Some boost the body's disease-fighting abilities, while others train the body to attack only certain kinds of cells found in tumors.
One of the many treatments is checkpoint inhibitors. They treat cancers such as lung cancer and melanoma skin cancer by blocking proteins that prevent the immune system from attacking cancerous cells in the body.
Alternate Name of Immune Checkpoint Inhibitors
Monoclonal antibodies
Body Location of Immune Checkpoint Inhibitors
Immune system
How Immune Checkpoint Inhibitors is Performed?
The human body's immune system fights diseases and keeps it healthy by protecting it from viruses and bacteria. T cells contain checkpoint proteins on the surface which turn on for an immune response and proteins to turn it off.
For example, in the case of an infection, checkpoint proteins will instruct the T cell to become active and destroy the foreign body. However, if T cells remain active for too long, they can also end up destroying healthy cells. Hence, other checkpoint proteins instruct T cells to switch off.
Some cancer cells produce high protein levels that can cause the T cells to switch off instead of attacking them. Here, the T cells fail to recognize cancerous cells or kill them.
Checkpoint inhibitors are drugs that block the checkpoint proteins. They stop the protein on the cancerous cells and activate the immune system. T cells can now locate and attack cancer cells easily.
Immune checkpoint inhibitors are usually administered intravenously (through veins in the arm). This procedure typically lasts for thirty to ninety minutes every two to four weeks. The number of treatment sessions will vary based on the type of cancer and the drugs given.
Preparation of Immune Checkpoint Inhibitors
The patient needs to keep certain points in mind before treatment begins:
- Any unusual or allergic reactions to the prescribed drug must be brought to the physician's attention.
- Blood tests are required before each treatment.
- Other drugs interact with immune checkpoint inhibitors. Patients need to consult their doctors and pharmacists before taking any sort of medication during this time.
- Specific immune checkpoint inhibitors may damage sperm or harm babies during pregnancy. It is best to use birth control during treatment till at least five months after the last dose.
- Patients should not breastfeed during treatment.
- Doctors, dentists, and other professionals need to be informed of the patient's treatment before getting another treatment from them.
Procedure Type of Immune Checkpoint Inhibitors
Intravenous procedure
Follow Up
The procedure can take anywhere between thirty and ninety minutes, depending on the drug used and the treatment plan decided by the physician.
Once the procedure is completed, the patient can be asked to wait for observation, depending on how they feel.
If they feel fine, they can leave almost immediately after, with permission from the physician in charge. This is an ambulatory/outpatient procedure, which means the patient can leave the same day without requiring an overnight hospital stay unless they show severe symptoms.
It always helps to have someone with the patient who can drive them home in case of any fatigue or tiredness from the treatment.
Risks of Immune Checkpoint Inhibitors
The side effects of immune checkpoint inhibitors include
- Rash
- Diarrhea
- Fatigue/tiredness
- Dry cough and breathlessness
- Nausea
- Skin rash, itchy skin
- Poor appetite
- Constipation
- Muscle and joint pain, numbness
Some rare, serious side effects of immune checkpoint inhibitors include
Infusion reactions: Some patients may have allergic reactions such as fever, chills, itchy skin, dizziness, and wheezing while getting the drugs for treatment. They need to be brought to the doctor's attention immediately.
Autoimmune reactions: Since the treatment drugs target checkpoint proteins, they essentially stop the "brakes" of the immune system. This, in turn, can cause the immune system to attack other parts of the body, causing life-threatening problems to the lungs, intestines, liver, and other organs. Corticosteroids are then administered to counter it.
Recovery of Immune Checkpoint Inhibitors
Tumors see a significant reduction in size over 18-24 months depending on the drug, the treatment, and the type of tumor being targeted.
Patients need to make follow-up appointments with their oncologists or concerned physician regularly. Blood work, as well as CT scans, need to be taken periodically as well.
Patients with caregivers or family members looking after them need to ensure that these helpers will be handling body fluids and constantly need to keep their hands clean.
As nutrition may be affected, food rich in fiber may help patients respond better to certain treatments and drugs.
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