Revolutionizing Cancer Treatment with Immunotherapy

Authored By: Emma Robinson

Art By: Amy Em

Immunotherapy is one of the most anticipated recent developments in cancer treatment, providing hope for those who are resistant to traditional chemotherapy and radiation. The first instance of immunotherapy in cancer treatment was during the second half of the 19th century. Two German physicians Fehleisen and Busch noted that tumor size shrunk in their patients during concurrent infection. They tried to recreate these results but were unsuccessful [1]. Another physician, William Coley aimed to perform a similar experimental treatment for bone cancer in 1891 [2]. However, it was not until further developments in the field of immunology in the 1960s that significant advancements were made in utilizing the immune system to target cancer cells. 

As immunotherapy activates the various cells of the immune system, it has become more successful as we have developed a better understanding of those cells and their functions. The immune system normally produces cells that recognize and combat abnormal cell growth [3]. However, cancer cells develop characteristics  that prevent the immune system from recognizing  and destroying them. Immunotherapy aims to redirect existing immune cells or trigger developing cells to specifically target these camouflaged cancer cells. In the 1990s, the first immunotherapies to treat cancer were approved by the FDA [4]. Since then, the availability of  immunotherapies have expanded, along with the variety of cancers they can effectively treat [5]. 

There are now multiple types of immunotherapies that target the different components  of the immune system. One of the more successful is the immune checkpoint inhibitor which essentially triggers the body to react with an immune response that is stronger than normal [6]. Immune checkpoints usually keep the immune system from attacking the body’s own cells, but during cancer treatment, such a response is desired. This treatment has been successful for treating melanoma, prostate cancer, kidney cancer, head and neck cancer, and more [7]. 

Another exciting immunotherapy treatment option is T-cell transfer therapy. This option aims to optimize the immune response with targeted immune cells by taking T-cells that are already attacking the tumor, identifying the most effective cells, growing them artificially, and then injecting them back into the patient [8]. This individualized approach to cancer treatment has been used to successfully fight leukemia, lymphoma, multiple myeloma, and even some childhood cancers [9]. 

There are also monoclonal antibody therapies which create unique antibodies in a laboratory that can be injected into a patient that specifically tag their cancer cells for destruction by their body’s immune system [10]. This is one of the more common immunotherapy types as antibodies are relatively easy to produce and are not as technically challenging as T-cell transfers. These antibody therapies are commonly used to treat cancers including colorectal cancer, leukemia, and lung cancer [11]. 

A final type of immunotherapy that has recently been developed is anti-cancer vaccines. While this may sound analogous to the vaccines that some individuals receive to prevent cancers, these particular vaccines aim to help those who already have cancer. Similar to the commonly used vaccines that help the body recognize viruses, cancer vaccines also aid in the body’s recognition and destruction of abnormal or foreign material, in this case, atypical cancer cells [12]. Cancer vaccines are being used to treat leukemia, breast cancer, and kidney cancer [13].

While immunotherapy has led to more cancer patients surviving and remaining cancer free, that does not mean it is not without complications. Since this treatment increases the immune system's response, many patients experience symptoms such as a high fever and fatigue similar to when their body is fighting a virus. In some patients this reaction can become severe and lead to organ failure and neurologic dysfunction [14]. There are also reported cases of long-term sequelae on non-cancer cells including damaging immune cells that are incorrectly targeted by the hyperactive immune system. One possible solution to alleviate these concerns is to determine which biomarkers identify patients who are more at risk for developing complications and recommend alternative treatments for this subset of patients [15]. 

Despite these issues, immunotherapy remains a highly promising development in the world of cancer treatment. As of July 2023, there were over 23 immunotherapy treatments approved by the FDA to treat a vast array of cancer types [16]. However, more research needs to be done to make this a more widespread treatment option, including crafting treatments that target more cancer types as well as making these therapies more affordable. At the moment, cancer immunotherapy treatment costs an average of $100,000 per treatment with the cost of newer options rising even  higher  [17]. While cancer treatment of any kind is expensive, this is a barrier that needs to be addressed in order to provide more patients with an effective and lasting remission. As this field continues to be explored, it offers an amazing potential for a world in which cancer remission is a possibility for everyone. 

1. Dobosz, P., & Dzieciątkowski, T. (2019). The Intriguing History of Cancer Immunotherapy. Frontiers in Immunology, 10, 2965. https://doi.org/10.3389/fimmu.2019.02965

2. Zhang, Y., & Zhang, Z. (2020). The history and advances in cancer immunotherapy: Understanding the characteristics of tumor-infiltrating immune cells and their therapeutic implications. Cellular & Molecular Immunology, 17(8), 807–821. https://doi.org/10.1038/s41423-020-0488-6

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15. CPR23 - Spotlight on Immunotherapy: Pushing the Frontier of Cancer Medicine. (n.d.). Cancer Progress Report. Retrieved September 27, 2024, from https://cancerprogressreport.aacr.org/progress/cpr23-contents/cpr23-spotlight-on-immunotherapy-pushing-the-frontier-of-cancer-medicine/

16. CPR23 - Spotlight on Immunotherapy: Pushing the Frontier of Cancer Medicine. (n.d.). Cancer Progress Report. Retrieved September 27, 2024, from https://cancerprogressreport.aacr.org/progress/cpr23-contents/cpr23-spotlight-on-immunotherapy-pushing-the-frontier-of-cancer-medicine/

17. Schaft, N., Dörrie, J., Schuler, G., Schuler-Thurner, B., Sallam, H., Klein, S., Eisenberg, G., Frankenburg, S., Lotem, M., & Khatib, A. (2023). The future of affordable cancer immunotherapy. Frontiers in Immunology, 14, 1248867. https://doi.org/10.3389/fimmu.2023.1248867