Immunotherapy

What is immunotherapy?

The immune system’s job is to recognise and attack what does not belong. Immunotherapy strengthens this system so it can act better against cancer.

Types

• Immune checkpoint inhibitors: remove the brakes that hold back the immune response
• Monoclonal antibodies: lab-made proteins that attach to a specific target on cancer cells
• T-cell transfer: immune cells are taken from the body, strengthened and multiplied in the lab, and returned
• Treatment vaccines and immune system modulators

How is it given?

Mostly into a vein and, depending on the treatment, as a pill, skin cream or directly into the bladder. The schedule may be daily, weekly, monthly or in cycles, and treatment is usually as an outpatient.

Its side effects differ from chemotherapy

Many side effects happen because the activated immune system also attacks healthy tissue. Your doctor cannot say in advance whether a side effect will appear, when it will start or how severe it will be.

Common side effects:

• Injection-site reactions: pain, swelling, redness and itching
• Flu-like symptoms: fever, chills, weakness, nausea, muscle and joint aches, tiredness and headache
• Diarrhoea, and swelling and weight gain from fluid retention

Organ inflammation: the skin, bowel, lungs, liver or hormone glands such as the thyroid may be affected, and less often the heart, pancreas and kidneys. Severe reactions are rare but can be dangerous.

Before you start, ask your care team what signs to watch for and what to do if they appear. Report diarrhoea, a new cough or breathlessness, and do not treat them yourself.

How is the effect measured?

With examinations, questions about how you feel, blood tests and scans.