Types of Immunotherapy

October 24, 2024

This page was reviewed under our medical and editorial policy by Alexis Boling, MSN-RN, CNML, director, nursing, Immune Effector Cell & Gene Therapy Program, City of Hope^® Cancer Center Duarte

Immunotherapy plays a significant role in treating some cancers. It works either by boosting the patient’s natural immune system defenses against cancer or by using laboratory-created components to restore, modify or enhance the ability to recognize cancer cells. Depending on the type and stage of a patient’s cancer and specific biomarkers, immunotherapy may be used alone or in combination with other cancer treatments.

Bispecific Antibodies

Bispecific antibodies target two different antigens or two epitopes (part of an antigen) at the same time. Because many factors and signaling pathways help cancer grow, bispecific antibodies have a broader application than monoclonal antibodies, which target only one antigen. These newer treatments may act like a cocktail of monoclonal antibodies, allowing them to spawn several anti-tumor responses at the same time, potentially in a single treatment. More than 100 bispecific antibodies are in clinical trials, and more than 10 have been approved by the U.S. Food and Drug Administration (FDA).

Learn more about bispecific antibodies

CAR T Cell Therapy

Chimeric antigen receptor (CAR) T cell therapy takes white blood cells (which includes T cells) from the patient, enhances the T cells in a laboratory and then returns them to the patient intravenously through an IV (a small catheter in the vein). The modified cells make a protein called chimeric antigen receptor (CAR), which enables them to identify, attach to and destroy cancer cells quickly. Growing a large batch in the laboratory usually takes two to eight weeks. CAR T cell therapy is a type of adoptive cell therapy, and it may also be called adoptive immunotherapy or immune cell therapy.

Learn more about CAR T cell therapy

Checkpoint Inhibitors

The immune system has a safeguard feature that keeps it from mistakenly attacking healthy cells. Each cell has a checkpoint protein that tells the immune system to hold back and keeps it from becoming so strong that healthy cells are destroyed. Cancer cells might use these proteins to avoid the immune response. During cancer treatment, checkpoint inhibitors may block these checkpoint proteins, producing a stronger response to cancer cells. These types of medications are given intravenously every three to six weeks through a needle inserted into a vein.

Learn more about checkpoint inhibitors

Cytokines

Cytokines are proteins that play an important role in the body’s response to germs and inflammation. They signal the immune system to go to work, but they also impact how cancer cells interact with one another and other immune and non-immune cells. In addition, cytokines regulate aspects of cell growth, cell survival, inflammation and metastasis, among other processes. The FDA has approved several cytokine-based therapies that are given intravenously that help to direct the immune system and reduce the survival of cancer cells. Other cytokines help to manage inflammation and chemotherapy side effects and may also be given intravenously, in a muscle or under the skin.

Learn more about cytokines

Monoclonal Antibodies

Monoclonal antibodies are laboratory-created immune system proteins that mimic those made in the human body. They help the immune system recognize germs that cause disease and mark them as targets. This mechanism allows the immune system to zero in on the foreign cells while sparing the healthy ones. Many monoclonal antibodies have been studied and approved to treat a wide array of cancers. Some mark cancer cells as foreign, while others bring immune cells directly to cancer. They are administered intravenously.

Learn more about monoclonal antibodies

Oncolytic Virus Therapy

Oncolytic virus therapy is an emerging treatment area. The therapy breaks apart cancer cells to be destroyed by the immune system while leaving healthy cells untouched. It does this by infecting the cancer cells with a genetically modified virus. The FDA has approved one of these therapies so far, called T-VEC, to treat metastatic melanoma, and many others are being tested in clinical trials.

Learn more about oncolytic virus therapy

Cancer Vaccines

Cancer vaccines strengthen the immune system and help it quickly recognize and destroy cancer antigens. Unlike other vaccines, which aim to prevent disease, cancer vaccines are given after the patient receives a cancer diagnosis. These vaccines, which contain antigens that are common in cancerous cells but scarce or absent in healthy ones, teach the immune system to recognize and destroy the cancer cells. Cancer vaccines may be tailored to the individual using the patient’s own tumor cells for maximum success.

Learn more about cancer vaccines

Tumor-Infiltrating Lymphocyte

Tumor-infiltrating lymphocytes (TIL) use T cells from the patient’s tumor. These immune cells are tested in a laboratory, and those that quickly recognize the tumor are multiplied in large quantities. Later, these cells are returned to the patient through an IV to attack and overpower the tumor. With strength in numbers, the massive increase in T cells helps stop the immune-suppression signals released from the tumor and destroys the cancer cells.

Learn more about tumor-infiltrating lymphocytes

Natural Killer Cell Therapy

Natural killer (NK) cells are produced in the bone marrow and spread throughout the body. Their two major functions are to search for and destroy infected or cancerous cells and to regulate immune function. In cancer tissue, the number of naturally occurring killer cells is significantly reduced. In NK therapy, the patient’s NK cells are removed, enhanced or multiplied in a laboratory and then returned through an IV in a vein. This treatment may be combined with cytokine treatment as well.

Learn more about natural killer cell therapy

Gene Therapy

Gene therapy is a method of altering a patient’s genes to treat disease. It may involve replacing or inactivating disease-causing genes or introducing new or modified genes to fight cancer. The FDA recognizes several types of gene therapy products:

• Plasmid DNA
• Viral vectors
• Bacterial vectors
• Human gene editing technology
• Patient-derived cellular gene therapy products

Other Immunotherapies

Some other immunotherapy treatments include the following.

Engineered T cell receptor (CR) therapy: This treatment uses receptors (proteins) on a type of immune cell called T cells. These are modified in a laboratory to recognize and attack targets (antigens) on abnormal cells, including cancer cells, which has been shown to impede tumor development.

Agonists: These treatments use molecules that bind to and activate receptors on cancer cells to boost the anti-tumor response. Agonists are often used with other immunotherapies, including gene therapy and CAR T cells.

Antibody-drug conjugates (ADCs): These are targeted therapeutic agents that zero in on cancer cells with fewer toxic side effects than some other treatments. They include a targeted drug that zeroes in on cancer cells and then delivers chemotherapy to destroy them. These are highly successful in distinguishing between healthy cells and cancerous ones.